A 45-year-old woman has recently undergone lumpectomy and radiation therapy for a stage II breast cancer. She received chemotherapy for 6 months. Her periods ceased while she was receiving chemotherapy, and she remains amenorrheic. Her tumor was rich in estrogen receptor, and she is taking tamoxifen. Her hair is growing back, her energy is returning, and she has no specific complaints, but she is worried about recurrence. In addition to routine follow-up, what is the most appropriate management of this patient?

Routine tumor marker evaluation every 3 to 4 months (serum CAl 5-3, carcinoembryonic antigen)

Positron emission tomography now and annually

Bone scan and annual CT of the chest, abdomen, and pelvis

A 45-year-old woman has recently undergone lumpectomy and radiation th

1.	A 45-year-old woman has recently undergone lumpectomy and radiation therapy for a stage II breast cancer. She received chemotherapy for 6 months. Her periods ceased while she was receiving chemotherapy, and she remains amenorrheic. Her tumor was rich in estrogen receptor, and she is taking tamoxifen. Her hair is growing back, her energy is returning, and she has no specific complaints, but she is worried about recurrence. In addition to routine follow-up, what is the most appropriate management of this patient?
A.	Positron emission tomography now and annually
B.	No further management
C.	Routine tumor marker evaluation every 3 to 4 months (serum CAl 5-3, carcinoembryonic antigen)
D.	Bone scan and annual CT of the chest, abdomen, and pelvis
E.	Estrogen replacement therapy
Answer» C. Routine tumor marker evaluation every 3 to 4 months (serum CAl 5-3, carcinoembryonic antigen)

Discussion

No Comment Found

Related MCQs

A male patient presented with increasing weight loss and abdominal pain. He had a past history of Coeliac Disease, which up until now was asymptomatic on a gluten free diet. CT of the abdomen revealed a thickened loop of small bowel with a stricture and associated lymphadenopathy. A trucut of the nodes revealed a malignant neoplasm, Diagnosis is:
A 40 year old female presents with mediastinal hilar lymphadenopathy and she has recently noticed slight weight loss and a cough. Staging shows no other evidence of disease. A trucut biopsy reveals a lymphoma showing large cells with mirror image nuclei, lymphocytes, plasma cells and eosinophils. The following phenotype is seen; CD20 positive, CD3 negative, CLA positive, and CD15 positive
A 50 year old male presents with widespread lymphadenopathy. He has had recent fever and weight loss. A trucut biopsy reveals a malignant tumor with the following phenotype; Cytokeratin negative, CLA positive, CD3 positive, and CD30 positive
Which of the following equations is used to determine a positive predictive value?
A 55 year old male presents with a history of chronic dyspepsia and with recent weight loss. Investigation by gastroscopy reveals a reduction in specialised gastric glands and the presence of slender giemsa staining filaments on the mucosal surface. In addition a gastric mass is seen. This is composed of large B lymphocytes which are negative for cyclin D1 and BCL2. Monoclonality is identified.
A 28-year-old woman was found to have stage IV Burkitt s lymphoma. Her renal function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0 C with rigors and was treated with imipenem. Investigations (the following day):serum sodium 138 mmol/L (137 144)serum potassium 6.2 mmol/L (3.5 4.9)serum creatinine 215 mol/L (60 110)serum corrected calcium 1.60 mmol/L (2.20 2.60)serum phosphate 1.52 mmol/L (0.8 1.4)serum lactate dehydrogenase 1238 U/L (10 250)serum urate 0.69 mmol/L (0.19 0.36)What is the most likely cause of the renal impairment?
A 67-year-old man in previously good health is hospitalized because of a 2-day history of fever and diminished consciousness. The patient responds inconsistently to verbal commands. His temperature is 39.5 C (103.1 F); he has tachycardia, and his blood pressure is 80/58 mm Hg. There is no bleeding. His hemoglobin is 12.1 g/dL, leukocyte count is 29,000/ L with 80% neutrophils, and platelet count is 20,000/ L. Which of the following studies should be obtained in this patient?
A 37-year-old man is hospitalized because of fever and right-sided chest pain. He has been having fatigue and recently developed dyspnea on exertion and intermittent chills. At the age of 29 years he was diagnosed with stage III Hodgkin s disease and treated with multiagent chemotherapy and radiation therapy. A year ago, he developed mild anemia with no obvious cause. He takes thyroid hormone replacement when he remembers and has used fexofenadine as needed for allergic rhinitis for the past 5 years. On physical examination, his temperature is 38.7 C (101.7 F), pulse rate is 112/min, and blood pressure is 110/70 mmHg. There is dullness at the right lower lung and egophony. The hemoglobin is 8.5 g/dL, hematocrit is 26 %, leukocyte count is 2200/ L,and platelet count is 70,000/ L. What is the most likely diagnosis?
A 43-year-old man with severe acquired aplastic anemia has not responded to immunosuppressive agents. He remains neutropenic and transfusion-dependent for platelets and red cells. He has an HLA-identical brother who has been cleared as a donor for his planned allogeneic stem cell transplant.They are both cytomegalovirus-seronegative. Which of the following would be prevented by using irradiated cellular blood products for this patient?
A 34-year-old woman is evaluated because of progressive fatigue and recurrent attacks of abdominal pain. She weighs 61.2 kg (135 Ib). Her pulse rate is 110/min and her blood pressure is 110/70 mm Hg. She is pale, and her spleen is palpable 4 cm below the costal margin. Laboratory studies: Hemoglobin 6 g/dLHematocrit 20% Leukocyte count 2500/ L Platelet count 80,000/ L Reticulocyte count 10%Blood smear Anisocytosis and polychromatophilia Haptoglobin 0 mg/dLSerum lactate dehydrogenase 645 U/LThere is high level of hemosiderin in the urine.What is the most likely cause of this patients pancytopenia?

Discussion

No Comment Found

Related MCQs

Reply to Comment