K Questions
A K question has four possible answers, each of which may be true or false.
Example:
Which statements apply to the estrogen receptor?
A. It is a good predictive marker for response to endocrine treatment in patients with breast cancer
B. The expression of the estrogen receptor is confined to breast tissue
C. It is located on the outer cell surface of breast cells
D. Estrogen receptor status is associated with specific sites of metastatic spread in breast cancer patients
A: true
B: false
C: false
D: true
Explanation:
A: The estrogen receptor status strongly predicts the response to hormonal treatment in patients with breast cancer, both in the adjuvant ( absolute risk reduction of 10-15% with regard to breast cancer mortality) and metastatic setting (approximately 50-60% response in first line treatment).
B: Estrogen expression is not confined to breast tissue. E.g.: Also endometrial cells, ovarian cancer cells can express the receptor.
C: The estrogen receptor belongs to the nuclear hormone receptor family, is located at the nuclear membrane in the cytosol of the cell ( not on the outer membrane)
D: ER positive breast cancers are more likely to cause apparent metastatic disease in bones, genital tract and soft tissue than ER negative tumours. (Insa et al. Breast Cancer Res Treat. 1999;56:67)
Literature:
All cancer handbooks, www.uptodate.com