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Breast Cancer — SCE Medical Oncology MCQ

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HardBreast CancerBreast CancerSCE Medical Oncology

A postmenopausal woman with pT2N1 ER-positive, HER2-negative breast cancer has completed 5 years of adjuvant tamoxifen and remains fit. Bone density is acceptable. What endocrine strategy follows NICE guidance?

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Correct answer: E — Offer extended aromatase-inhibitor therapy after discussing recurrence benefit, bone loss and musculoskeletal toxicity

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

C is correct. NICE recommends offering extended aromatase-inhibitor therapy to postmenopausal people at medium or high recurrence risk who have taken tamoxifen for two to five years; node-positive pT2 disease fits that risk context. The discussion must include modest recurrence benefit, bone-density loss, arthralgia and personal preference. A understates persistent late risk. B has no routine adjuvant role. D substitutes a CDK4/6 inhibitor without its specific treatment eligibility and timing. E combines two endocrine agents rather than using the evidence-based sequential strategy. Bone health and adherence require review during extension.

Reference: NICE NG101 early and locally advanced breast-cancer recommendations: https://www.nice.org.uk/guidance/ng101/chapter/Recommendations