08-30-2014, 01:37 PM
25.
An 81-year-old African American woman who has diabetes mellitus comes to the office for a routine appointment. The patient follows a prescribed diet and exercise regimen, and she takes metformin, enalapril, simvastatin, and aspirin. She says she feels well and has been active in her church and community. Vital signs are temperature 37.0°C (98.6°F), pulse 82/min, and blood pressure 145/78 mm Hg. Physical examination discloses a 2 × 2-cm, firm, mobile nodule in the upper outer quadrant of her left breast. The patient asks, "If I have cancer, what therapy is normally recommended for patients of my age?" Which of the following is the most appropriate recommendation?
A) Chemotherapy and radiation therapy
B) Lumpectomy and chemotherapy
C) Lumpectomy with radiation therapy
D) Radical mastectomy with radiation therapy
E) Observation only
Ans:
A) Chemotherapy and radiation therapy
I marked A in my exam and it was correct.
Breast irradiation should be recommended to older women with a life expectancy >5 years. Adjuvant hormone therapy remains a reasonable therapeutic option in elderly women with positive hormone receptor tumours. Aromatase inhibitors have demonstrated a better toxicity profile and effectiveness as adjuvant therapy than tamoxifen in young postmenopausal women but have not been specifically studied in the elderly population. The efficacy of adjuvant chemotherapy for breast cancer has been also established.
An 81-year-old African American woman who has diabetes mellitus comes to the office for a routine appointment. The patient follows a prescribed diet and exercise regimen, and she takes metformin, enalapril, simvastatin, and aspirin. She says she feels well and has been active in her church and community. Vital signs are temperature 37.0°C (98.6°F), pulse 82/min, and blood pressure 145/78 mm Hg. Physical examination discloses a 2 × 2-cm, firm, mobile nodule in the upper outer quadrant of her left breast. The patient asks, "If I have cancer, what therapy is normally recommended for patients of my age?" Which of the following is the most appropriate recommendation?
A) Chemotherapy and radiation therapy
B) Lumpectomy and chemotherapy
C) Lumpectomy with radiation therapy
D) Radical mastectomy with radiation therapy
E) Observation only
Ans:
A) Chemotherapy and radiation therapy
I marked A in my exam and it was correct.
Breast irradiation should be recommended to older women with a life expectancy >5 years. Adjuvant hormone therapy remains a reasonable therapeutic option in elderly women with positive hormone receptor tumours. Aromatase inhibitors have demonstrated a better toxicity profile and effectiveness as adjuvant therapy than tamoxifen in young postmenopausal women but have not been specifically studied in the elderly population. The efficacy of adjuvant chemotherapy for breast cancer has been also established.