Interactive Case Studies - Overview

View all Online CME

Continuing Education Information

Physicians' Education Resource is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physicians' Education Resource designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Impact of Bone-Sparing Therapies in a Premenopausal Patient With Stage II Breast Cancer Undergoing Adjuvant Ovarian Suppression

Release Date: October 31, 2008
Expiration Date: October 31, 2009

Interactive Case Study Overview

For premenopausal patients with hormone receptor–positive (HR+) early-stage breast cancer, multiple therapeutic options complicate treatment decision making. While both selective estrogen receptor (ER) modulators and ovarian ablation or suppression have demonstrated efficacy in this patient population, the optimal combinations of therapy and length of administration are unclear. Additionally, the roles of aromatase inhibitors (AIs) in premenopausal patients and of chemotherapy in patients with low-risk early-stage disease, particularly the benefit/risk ratios of these regimens, are under debate. Furthermore, bone complications present a frequent clinical challenge because many therapies for early-stage breast cancer can have a deleterious effect on bone density, leading to increased risk of fracture. This risk requires physicians to examine the therapeutic options for maintenance and restoration of bone health in patients with low bone mineral density who are receiving endocrine therapy. While several bone-targeted agents, including bisphosphonates, are under investigation in the adjuvant setting for prevention of bone loss, optimal timing and duration of therapy are still under investigation.

The purpose of this activity is to update physicians on the adjuvant therapeutic options for premenopausal patients with HR+ early-stage breast cancer, including prevention of treatment-related bone loss.

Target Audience

This educational activity is intended for medical oncologists involved in the care of patients with breast cancer. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

Upon completion of this educational activity, you should be able to:

  • Evaluate the efficacy and safety of endocrine therapy with or without chemotherapy for premenopausal patients with HR+ early-stage breast cancer
  • Assess the utility of additional endocrine therapy with a selective ER modulator or an AI in premenopausal patients with breast cancer who are receiving ovarian suppression
  • Discuss treatment-induced bone loss in patients with HR+ early-stage breast cancer, including the role of bisphosphonate therapy in the maintenance of bone health and prevention of disease recurrence

Instructions for Participation

  1. Read the following information before beginning the educational activity.
  2. Complete the Pretest.
  3. Study the educational activity.
  4. Complete the CME test.
  5. Answer the evaluation questions.
  6. After successful completion of the CME test and evaluation, you will receive your certificate of credit online.

Successful completion is determined by a score of 67% or greater.

Read all of the conditions in the Activity Terms box below. You must accept the Activity Terms in order to continue:

Disclosure Policy

It is the policy of Physicians’ Education Resource to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Physicians’ Education Resource requires everyone who is in a position to control the content of an educational activity, including spouses/partners, to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Physicians’ Education Resource has implemented a mechanism to identify and resolve all conflicts of interest prior to the activity.

Michael Gnant, MD, PhD
Research Funding – AstraZeneca, Novartis Pharma AG, Roche Pharmaceuticals, sanofi-aventis U.S.
Paid Consultant – AstraZeneca, Novartis Pharma AG
Speaker’s Bureau – Amgen, AstraZeneca, Novartis Pharma AG, Pfizer Inc., sanofi-aventis U.S.

PER Editorial Staff
No relevant relationships to disclose

This CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the activity includes discussion of investigational and/or unlabeled uses of a drug, specific information is located on the title page. Please refer to the full prescribing information for each drug discussed in this newsletter for FDA-approved dosing, indications, and warnings.

Software Requirements

The Web pages and Web-based applications require a minimum Web browser of Microsoft Internet Explorer 5.5 or higher, Mozilla Firefox 1.0 or higher, or another compatible Web browser.

If you are not sure of the version of your browser, select Help in the menu bar of your browser, then select About.

PC Users
If you need to upgrade your Web browser, follow one of the links listed below:

Macintosh Users
Compatible Web browsers include Firefox (Outside Source) and Apple Safari (Outside Source).

Banner Illustration

Illustrator: Erin Moore

Disclaimer

The views and opinions expressed in this activity are those of the authors and do not necessarily reflect the views of the sponsor, supporter, or publisher. Although great care has been taken in compiling and checking the information given in this activity to ensure accuracy, the authors and Physicians’ Education Resource and its servants or agents shall not be responsible or in any way liable for the continued currency of the information or for any errors, omissions, or inaccuracies in this publication, whether arising from negligence or otherwise howsoever or for any consequences arising therefrom.

Please consult full prescribing information for any drugs or procedures discussed within.

Privacy Policy

Physicians’ Education Resource (PER) makes reasonable efforts to ensure that privacy issues are handled responsibly. PER does not sell or share your information with other organizations that are not directly involved in this process. If you have further concerns, you may contact us at (888) 949-0045.

All rights reserved. No part of this activity may be translated, reproduced, stored, or transmitted by any means or in any type of media form including electronic, mechanical photocopying, recording, broadcasting, or otherwise without prior permission from the publisher.

©Copyright 2008 by Physicians’ Education Resource. No material may be reproduced in whole or in part, in any form, without written permission from the publisher.

All correspondence should be directed to:
Editor, Interactive Case Study: The Impact of Bone-Sparing Therapies in a Premenopausal Patient With Stage II Breast Cancer Undergoing Adjuvant Ovarian Suppression
Physicians’ Education Resource
3500 Maple Ave.
Suite 700
Dallas, TX 75219
Phone: (214) 367-3456
Fax: (214) 367-3304
E-mail: editor@pergrouplp.com

Educational Grants

An educational grant for this activity was provided by:


  1. Novartis Oncology

Michael Gnant, MD, PhD
Professor of Surgery
Medical University of Vienna
Vienna, Austria