Master the board step 3

Oncology
Aromatase inhibitors are pure estrogen antagonists. They do not have the
selective estrogen receptor agonist (stimulatory) activity that tamoxifen does.
Aromatase inhibitors (anastrozole, letrozole, exemestane) do not lead to DVT,
but they can lead to osteoporosis, because they are antagonistic to estrogen
receptors in the bone.
Adjuvant Chemotherapy
Adjuvant chemotherapy is appropriate under the following circumstances:
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Cancer is in the axilla.
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Cancer is larger than 1 cm.
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It is more efficacious when the patient is still menstruating. Breast cancer in
menstruating women will not likely be controlled with estrogen antagonists,
such as tamoxifen or aromatase inhibitors.
Tamoxifen decreases risk
of breast cancer. BRCA
does not.
Trastuzumab
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A monoclonal antibody against the breast cancer antigen HER-2/NEU
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Useful in metastatic disease
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Modest efficacy with few adverse effects
Colon Cancer
The most important knowledge to have for Step 3 is the screening schedule and
indicators. Colon cancer is treated with surgical resection of the colon and
chemotherapy centered around a 5-fluorouracil regimen if high-risk stage 2
cancer or stage 3 or more.
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