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The swelling may occur in the arms, legs, hands, ankles, and feet

oestradiol (E2) bind ER or ER in mammary epithelial cells, followed by receptor dimerisation, nuclear translocation and direct transcriptional regulation of EREs in promoter regions on target genes that regulate cell proliferation cyclin D1, c-Myc -, survival Bcl-2 or survivin -, angiogenesis VEGF -, EMT Snail, Twist -, metastasis MMPs (185), as non-genomic oestrogen signalling via membrane-localized ER and G proteincoupled oestrogen receptor (GPER) leads to rapid stimulation of PI3K/Akt, MAPK/ERK and Src pathways interacting further impetus to mitogenic and anti-apoptotic effects

Additionally, patients receiving treatments affecting bone marrow function need careful monitoring during therapy