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AI Carpal Tunnel — SCE Medical Oncology MCQ

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HardBreast CancerAI Carpal TunnelSCE Medical Oncology

A premenopausal woman with HR-positive, HER2-negative metastatic breast cancer is taking tamoxifen and ovarian suppression. Ribociclib is proposed; baseline QTcF is 438 ms and electrolytes are normal. What is the most appropriate regimen-level action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Replace tamoxifen with a non-steroidal aromatase inhibitor before ribociclib

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

A is correct: ribociclib is not recommended with tamoxifen, even when baseline QTcF is acceptable. B mistakes an initiation ECG threshold for permission to use the combination; C cannot neutralise the interaction through monitoring; D also omits required ovarian suppression; E changes dose without removing the discouraged endocrine partner.

Reference: Kisqali UK summary of product characteristics (Current UK SmPC, accessed August 2026): https://www.medicines.org.uk/emc/product/8110/smpc