Devita, Hellman, and Rosenberg's Cancer

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

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

Question 24.27. Which of the following is both a prognostic and predictive factor?

A. Axillary node involvement

B. ER

C. Patient age

D. Lymphovascular invasion

Question 24.28. The gains associated with adjuvant tamoxifen:

A. Are independent of patient age

B. Are less in patients who also receive adjuvant chemotherapy

C. Are dependent on patient menopausal status

D. Decline 10 years after diagnosis

Question 24.29. The use of AIs in the adjuvant treatment of postmenopausal women:

A. Improves OS when used as initial therapy, but not when used after

2 to 5 years of tamoxifen

B. Increases the risk of fracture for 10 years

C. Effectively lowers estrogen levels by 90%

D. Provides increased benefit when administered for 10 years

Question 24.30. You are seeing a 42-year-old premenopausal patient with newly diagnosed

stage I, ER+/HER2–breast cancer. Her surgeon had requested an Onco-

typeDX recurrence score assay, which returned with a score of 36. On

the basis of her recurrence score, the absolute improvement in her risk

of recurrence with the addition of adding cyclophosphamide (CMF) to

tamoxifen is predicted to be:

A. <5%

B. 14%

C. 22%

D. 30%

Question 24.31. You are seeing a 58-year-old woman with stage I breast cancer. She has

been taking tamoxifen for 30 months and you have advised switching her

hormonal therapy to exemestane on the basis of the IES trial results. In

discussing the potential benefits of this strategy compared with continuing

tamoxifen for the planned 5 years, you tell her that exemestane:

A. Improved disease-free survival (DFS) by∼25%

B. Improved OS in patients with ER+disease

C. Reduced contralateral breast cancers by∼40%

D. All of the above