Updated: 10/9/2022

Selective Estrogen Receptor Modulators (SERMs)

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  • 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
      • estrogen 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.12.106) 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?

QID: 100407

Administration of raloxifene in the treatment of her previous breast cancer

8%

(24/309)

The patient is 46-years-old and has yet to enter menopause

5%

(14/309)

Combined oral contraceptive use from the age of 32 to 42

7%

(23/309)

The patient’s two previous pregnancies

4%

(13/309)

Tamoxifen regimen used to treat her previous breast cancer

73%

(225/309)

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