Oncology Self-Study: Breast and Gynecologic Cancers

Mar 11, 2019

Test your knowledge of breast and gynecologic cancers with questions from self-evaluation activities on ASCO University.

The sixth edition of ASCO-SEP® is available for purchase in the ASCO University® bookstore, featuring 22 new and updated chapters and more than 190 new self-assessment questions in the book, as well as an online mock exam with 120 original self-assessment questions. Upon successful completion of both the ASCO-SEP book self-assessment questions and the mock exam, participants may request Continuing Education, American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC), Nursing, and Pharmacy credit through online modules. Visit university.asco.org for information about the latest edition of ASCO-SEP and other self-assessment resources.

Find complete answer rationales and suggested reading below.

  1. A 60-year-old post-menopausal woman in good health has completed adjuvant chemotherapy for a stage II breast cancer. The cancer was ER+, PR+, and her2/neu negative. She had a mastectomy as initial therapy. She asks you what she should do next to maximally reduce her risk of recurrence. Which of the following is the most appropriate next step?

  A. An aromatase inhibitor for 2 years followed by tamoxifen for 5 years

B. Tamoxifen for 5 years followed by an aromatase inhibitor for 5 years

C. Tamoxifen for 2 years followed by an aromatase inhibitor for 3 years

D. Tamoxifen for 5 to 10 years

E. An aromatase inhibitor for 5 to 10 years

  1. After having gastrointestinal symptoms for over a year and an unremarkable work-up, a 71-year-old woman undergoes a pelvic ultrasound, which is significant for a left ovarian mass. CT abdomen/pelvis is obtained and reveals left inguinal lymphadenopathy. She is referred to Gynecologic Oncology and undergoes full cytoreductive surgery with left inguinal lymphadenectomy. Pathology is significant for 2.5-cm left ovarian papillary serous carcinoma, implants on the left fallopian tube, one left pelvic lymph node and two left inguinal lymph nodes. What is the stage of the patient’s ovarian cancer?

A. II

B. I

C. IV

D. III

Rationale

1: E

Since the patient is post-menopausal she should start with an aromatase inhibitor. The recommended duration of 5 versus 10 years is currently controversial because the evidence is mixed with positive and negative trials. Tamoxifen is recommended as the first- line endocrine therapy for pre-menopausal breast cancer.

Suggested Readings

Burstein HJ, Temin S, Anderson H, et al. J Clin Oncol. 2014;32;2255-2269.

Goss PE, Ingle JN, Pritchard KI, et al. N Engl J Med. 2016;37;3.

2: C

Positive inguinal lymph node is considered stage IV.

Suggested Readings

Prat J, FIGO Committee on Gynecologic Oncology. J Gynaecol Obstet. 2014;124:1.

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