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Selective Estrogen Receptor Modulators (SERMs)

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Topic updated on 11/05/16 5:37pm

Tamoxifen
  • Mechanism
    • estrogen antagonist in breast
    • estrogen agonist in endometrium, bone
  • Indications
    • estrogen-receptor positive breast cancer
  • Toxicity
    • ↑ risk of DVTs
    • ↑ risk of endometrial cancer
      • secondary to agonist activity
    • induces menopause
      • hot flashes
    • prevents osteoporosis
      • secondary to agonist action in bone
Raloxifene
  • Mechanism
    • estrogen antagonist in breast, endometrium
    • partial agonist in bone
  • Indications
    • osteoporosis in menopausal women
  • Toxicity
    • ↑ risk of DVTs
    • induces menopause
      • hot flashes
    • NO ↑ risk of endometrial cancer
      • secondary to antagonist activity in endometrium


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(M1.RP.106) A 46-year-old female presents with a primary complaint of irregular menstrual bleeding that has persisted for the last several months. Her medical history consists of 2 full-term pregnancies and invasive ductal carcinoma of the breast that was successfully treated one year ago. After an appropriate evaluation, she is given a diagnosis of type 1 endometrioid adenocarcinoma. Which of the following factors most likely increased this patient’s risk for developing this cancer? Topic Review Topic

1. Administration of raloxifene in the treatment of her previous breast cancer
2. The patient is 46-years-old and has yet to enter menopause
3. Combined oral contraceptive use from the age of 32 to 42
4. The patient’s two previous pregnancies
5. Tamoxifen regimen used to treat her previous breast cancer

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