breast cancer

Question 1

sex hormone antagonists for breast cancer; name some

Answer 1

• tamoxifen
• letrozole
• anastrozole

Question 2

indications of sex hormone antagonists in breast ca

Answer 2

• early and locally advances ER+ve BC. = adjuvant rx to reduce risk of recurrence
• advanced ER +Ve BC to slow progression. if HER2 -ve - hormonal therapy first.
  in PMW - aromatase-i
  tamoxifen in pre and post MW who cannot take aromatase-i

Question 3

MOA sex hormone antagonists for breast cancer

Answer 3

most ca = er+ve. oestrogen binds to ca cells and helps proliferate. blocking = reduces.

tamoxifen = Selective ERM - x bind to receptor

aromatase-i - stop synthesis of oestrogen outisde ovary by blockign aromatase which converts androgens to oestrogens .

Question 4

SE sex hormone antagonists for BC

Answer 4

• Vaginal dryness
• hot flushes
• loss of bone density

tamoxifen specific

• increased risk of VTE and endometrial ca
• GI upset and headache

rare - tamoxi and aromatase -i = agranulocytosis and Liver failure

Question 5

CI to sex hormone antagonists

Answer 5

• tamoxifen; pregnancy and lactation

- aromatase-i; PREMW unless ovarian function supresssed or ablated e.g. oophorectomy

Question 6

interactions to tamoxifen

Answer 6

• Inhibits CYP450 - needed to metabolise warfarin = bleed

- SSRI fluoxetine and paroxetine ingibit hepatic activation of tamoxifen

Question 7

usual dose of tmaoxifen

Answer 7

20mg daily

Question 8

usual dose of anastrozole

Answer 8

1mg daily

Question 9

how long do most people take hormone antagonists for BC for

Answer 9

5 years