NEET PG Medical – 2019 – Question – 95
True about treatment of early breast carcinoma?
a) Aromatase inhibitors are replacing tamoxifen in premenopausal women
b) Post mastectomy radiation therapy is given when 4 or more lymph nodes are positive
c) Tamoxifen is not useful in post-menopausal women
d) In premenopausal women, multidrug chemotherapy is given in selected patients
Show Answer
Correct Answer – B
Ans. B. Post mastectomy radiation therapy is given when 4 or more lymph nodes are positive
Tamoxifen:
- Effective in both pre & postmenopausal women (if hormone receptor positive)
- DOC in premenopausal women
Aromatase inhibitors:
- Proven more beneficial than tamoxifen in postmenopausal women.
MOA:
- By lowering estrogen in post-menopausal women with hormonereceptor- positive breast cancer.
- In post-menopausal women, most of body’s estrogen is from androgen.
- Aromatase inhibitors inhibits aromatase enzyme à blocking androgen into estrogenà lowering estrogen produced outside ovaries.
Uses:
- 1st line therapy in postmenopausal women, adjuvant setting or secondary agent after 1 to 2 years of adjuvant tamoxifen therapy.
Advantages:
- Reduced incidence of endometrial cancer.
Adverse effects: - Bone mineral density alteration-Ã osteoporosis & increased fractures in postmenopausal women.
Other options: - In premenopausal women with any form of adjuvant systemic therapy should receive multidrug chemotherapy.
