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  #1  
Old 10-06-2012
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Arrow Billy Step 1 Questions #9

A 54-year-old woman sees her physician after feeling a lump in her left breast. The physician palpates a firm, irregular
mass in the lower outer quadrant just beneath the lateral margin of the areola. A mammogram shows a 2-cm density with
focal microcalcifications. Excisional biopsy shows intraductal and invasive components of a breast carcinoma.
Immunohistochemical staining shows that the cells are positive for HER2/neu expression, but negative for estrogen
receptor and progesterone receptor expression. Flow cytometry shows a small aneuploid peak and a low S-phase. When
combined with doxorubicin, which of the following drugs is most likely to be useful in treating this patient?


□ (A) Hydroxyurea
□ (B) Celecoxib
□ (C) Raloxifene
□ (D) Tamoxifen
□ (E) Trastuzumab
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  #2  
Old 10-06-2012
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trastuzumab... mono clonal antiboday against her2 neu
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Old 10-06-2012
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I go with trastuzumab
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Old 10-06-2012
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Quote:
Originally Posted by billy View Post
A 54-year-old woman sees her physician after feeling a lump in her left breast. The physician palpates a firm, irregular
mass in the lower outer quadrant just beneath the lateral margin of the areola. A mammogram shows a 2-cm density with
focal microcalcifications. Excisional biopsy shows intraductal and invasive components of a breast carcinoma.
Immunohistochemical staining shows that the cells are positive for HER2/neu expression, but negative for estrogen
receptor and progesterone receptor expression. Flow cytometry shows a small aneuploid peak and a low S-phase. When
combined with doxorubicin, which of the following drugs is most likely to be useful in treating this patient?


□ (A) Hydroxyurea
□ (B) Celecoxib
□ (C) Raloxifene
□ (D) Tamoxifen
□ (E) Trastuzumab
My answer is E) Trastuzumab
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  #5  
Old 10-06-2012
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Correct Answer E is correct

The expression of HER2/neu suggests that biotherapy with trastuzumab may have some effectiveness. Drug
names with the suffix -mab are monoclonal antibodies that target a specific biochemical component of cells. This form of
biotherapy is useful because normal breast cells do not have HER2/neu expression. Doxorubicin is a standard
chemotherapeutic agent that is part of various multiagent protocols. Hydroxyurea is a cycle-acting agent that is not useful
in breast cancer. Celecoxib is an inhibitor of cyclooxygenase-2 in the arachidonic acid pathway that forms prostaglandins
as part of an inflammatory reaction. Tamoxifen is an antiestrogenic compound that has effectiveness in the treatment of
breast cancers positive for estrogen receptor.
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