Hormone responsive malignancy (breast cancer)

Question 1

Background

Answer 1

Most common form of malignancy in women
- Malignancy - presence of cancerous cells that can spread to other places

Risk factors
Age, early onset menstruation, Late menopause, Family Hx, Oral contraceptive & Post menopausal HRT

Management
Surgery, radiotherapy, drugs, or Combo

Question 2

Types of breast cancer

Answer 2

Early & locally advanced breast cancer
Surgery, Radiotherapy, or Drug
- Tamoxifen - given after surgery alone or with other meds
- Bisphosphonates can be used too
- Biologic trastuzamab can be used too

Women who decline chemo - can have goserelin
Anastrozole or letrozole also used

Advanced breast cancer
Endocrine therapy 1st line

• Aromatase inhibitors (anastrozole, letrozole, exemestane) to PTs with no Hx of endocrine therapy or previously used tamoxifen
• Tamoxifen + ovarian function suppression can be used if not already used once AND pre/peri menopausal women
• Ovarian function supressed offered to pre/peri women who disease is progressing too

MEN - Tamoxifen 1st line if Oestrogen receptor +ve B cancer

CHEMO is used 1st if life threatening/ Needed (organ involvement)

Biologics can be used too (trastuzumab)