breast ca2 - cd45

[ArchivalUser]

A 52-year-old woman notices a mass in her left breast during a breast self-examination. Mammography shows a spiculated lesion corresponding to the palpable mass, and diagnostic core needle biopsy reveals infiltrating ductal carcinoma (IDC). Results of staging work-up, including bone scan, chest radiography, and computed tomography of the abdomen are negative for metastatic disease. She undergoes lumpectomy with axillary lymph node dissection. Pathology results show a 3.5-cm, poorly differentiated, estrogen- and progesterone-receptor“positive IDC. Resection margins are clear; all 12 lymph nodes are negative for metastatic cancer. Which of the following should be included in further treatment of this patient?

Close follow-up with mammography, chest radiography, complete blood count, and tumor marker analysis every 6 months
a Administration of tamoxifen alone
b Administration of tamoxifen and radiation therapy
c Administration of tamoxifen and anthracycline-based chemotherapy
d Administration of tamoxifen, anthracycline-based chemotherapy, and radiation therapy

[ArchivalUser]

b.................

[ArchivalUser]

tamoxifene only...i think radiation is not combined with axillary LND as it gives severe lymphedema

[ArchivalUser]

d...Administration of tamoxifen, anthracycline-based chemotherapy, and radiation therapy. Radiation therapy must be performed in conjunction with breast-conserving surgery (eg, lumpectomy) to reduce local and regional recurrences, unless there are contraindications for radiation therapy. The NSABP protocol B-06 study has shown that postoperative radiation therapy reduces the risk for locoregional recurrence from 35% to 10% in patients who undergo lumpectomy and axillary node dissection.2 Systemic adjuvant therapy also is indicated for most invasive breast cancers greater than 1 cm in size. Adjuvant hormonal therapy with 5 years of tamoxifen therapy reduces the odds of recurrence of breast cancer by as much as 50%,3 and chemotherapy reduces the risk by as much as 30%.4 The benefit from these 2 systemic treatment modalities is additive. The most optimal therapy for the case patient should include all 3 treatment modalities.