Author Question: A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen ... (Read 9 times)

acc299 · **on:** Jul 23, 2018

A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen (Nolvadex). She asks the nurse if anastrozole (Arimedex) would work better for her. What will the nurse tell her?

a. Anastrozole is more likely to cause hot flushes than tamoxifen.
b. Anastrozole is more likely to promote endometrial carcinoma.
c. Cancer recurrence is higher with anastrozole.
d. Until she is postmenopausal, anastrozole will not be effective.

Question 2

A 45-year-old patient with a family history of breast cancer is considering using tamoxifen (Nolvadex) for cancer prevention.

The nurse performs a health history and learns that the woman had a child when she was 35 years old, that she has not had a hysterectomy, and that she experienced DVT when she was pregnant. What will the nurse tell the patient?
a. Because of her family risk and late childbearing, this drug is a good choice for her.
b. Her history of DVT outweighs any possible benefits she may have with this drug.
c. Since she has not had a hysterectomy, the risk of endometrial cancer is too great.
d. When she turns 50 years old, this drug will carry fewer risks for her.

amy.lauersdorf90 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: D
Anastrozole is used to treat ER-positive breast cancer in postmenopausal women. Because it does not block estrogen production in the ovaries, it is not effective in premenopausal women. It may cause hot flushes but is less likely to do so than tamoxifen. It is devoid of all estrogenic activity and does not promote endometrial cancer

Answer to Question 2

ANS: B
Tamoxifen is a good choice for women between the ages of 40 and 49 years as a cancer preventive, except for women at risk for DVT. Her family risk and late childbearing are indications for using tamoxifen, but only in women without increased risk of DVT. The risk of endometrial cancer increases with age and, without the risk of DVT, would not be a contraindication in a woman her age. Her risks of DVT do not change with age.