Cert Medical Oncology(SA) Phys Practice Questions - Sub-specialty Certificate In Medical Oncology Of The College Of Physicians Of South Africa Exam

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A 48-year-old premenopausal woman undergoes a left lumpectomy and sentinel lymph node biopsy for a 2.2 cm invasive ductal carcinoma. Pathology reveals Nottingham Grade 2 tumor, ER 95%, PR 80%, HER2 1+ (negative), and 0/2 lymph nodes involved (pT2N0M0). Genomic profiling with the 21-gene Recurrence Score (Oncotype DX) yields a score of 28. Which of the following is the most appropriate systemic adjuvant therapy recommendation based on TAILORx and RxPONDER trials?

Adjuvant chemotherapy (e.g., TC - docetaxel/cyclophosphamide) followed by tamoxifen combined with ovarian function suppression Adjuvant tamoxifen monotherapy for 5 years without chemotherapy or ovarian function suppression Adjuvant aromatase inhibitor (letrozole) monotherapy for 5 years without chemotherapy Adjuvant trastuzumab plus paclitaxel for 12 weeks followed by single-agent tamoxifen

Correct Answer:

Adjuvant chemotherapy (e.g., TC - docetaxel/cyclophosphamide) followed by tamoxifen combined with ovarian function suppression

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