A 44-year-old woman has a lumpectomy and radiation therapy for stage II breast cancer. She receives 6 months of chemotherapy. Her periods cease while she is receiving chemotherapy, and she remains amenorrheic. Her tumor was found to be rich in estrogen receptor, and she is taking tamoxifen. Her hair is growing back and her energy is returning, but she is having severe hot flushes that keep her awake at night. She is so tired during the day that she is unable to perform her job in a satisfactory manner. She also relates that she and her husband have been unable to have satisfying sexual relations because intercourse is painful for her. What would be the most appropriate treatment for this patient?

Question

Quizplus · Accepted Answer

This patient is experiencing common side effects of tamoxifen therapy, including hot flushes and vaginal dryness, which can lead to painful intercourse. A selective serotonin reuptake inhibitor (SSRI) can help alleviate the hot flushes, and nonhormonal vaginal lubricants can address the vaginal dryness without the risks associated with hormonal treatments in a patient with a history of estrogen receptor-positive breast cancer.

A 44-Year-Old Woman Has a Lumpectomy and Radiation Therapy for Stage