Devita, Hellman, and Rosenberg's Cancer

LWBK1006-24 LWW-Govindan-Review December 12, 2011 19:15

338 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 24.37. A 67-year-old woman has been taking anastrozole as adjuvant therapy

for stage I breast cancer for 4 years. She was recently found to have bone

metastases. After RT to a painful lesion at T8, she is asymptomatic. You

recommend:

A. Fulvestrant

B. Exemestane

C. Either will be equally effective

D. Neither will be effective

Question 24.38. In a recently reported phase III trial, the addition of ixabepilone to

capecitabine

A. Increased progression-free survival from 4.2 to 5.8 months

B. Increased objective response rate based on investigator, but not inde-

pendent review facility, assessment

C. Increased neutropenia, but not neutropenic fevers

D. All of the above

Question 24.39. A urologist tells you his mother has just been diagnosed with Paget’s

disease based on a punch biopsy of an area of crusting on her nipple. You

tell him:

A. It is associated with in situ or invasive breast cancer in only 50% of

cases.

B. Approximately half of Paget’s disease cases are hormone-receptor

positive.

C. It tends to be associated with underlying low-grade disease.

D. Underlying breast cancers are almost always located within 2 cm of

the nipple.

Question 24.40. Which of the following regarding treatment of breast cancer in the preg-

nant patient is FALSE?

A. Breast irradiation is contraindicated in the pregnant patient.

B. Mastectomy has no place in the treatment of pregnant patients who

have tumors amenable to breast conservation.

C. Adjuvant chemotherapy should be avoided in the first trimester,

because almost all chemotherapeutic agents cross the placenta and

are associated with a 15% to 20% risk of fetal malformation.

D. Chemotherapy can generally be administered safely during the second

and third trimesters of pregnancy; the risk of fetal malformation is

1% to 3% during this time, similar to the risk of fetal malformation

in healthy women.