Adjuvant HR+/HER2- EBC Therapy

CE / CME

Individualizing the Current Adjuvant Therapy Algorithm for Patients With HR+/HER2- EBC

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

ABIM MOC: maximum of 0.50 Medical Knowledge MOC point

Released: December 06, 2024

Expiration: August 06, 2025

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

A 58-year-old woman who is postmenopausal presents with a 5-cm right breast mass with 1 suspicious node. Initial breast biopsy reveals ILC, grade 2, with the following biomarkers – ER+ 80%, PgR+ 30%, HER2- by IHC. Fine-needle aspiration of a palpable right axillary lymph node reveals adenocarcinoma of the breast. BRCA testing is negative; PIK3CA mutation is identified as part of clinical trial. She receives neoadjuvant TC x 6 cycles and then undergoes bilateral mastectomy. The right mastectomy specimen reveals a 3-cm ILC with minimal chemotherapy effect and 4/15 positive nodes. She returns to the clinic now to discuss adjuvant treatment options.

Which of the following would you select as adjuvant therapy for this patient?

2.

A 42-year-old premenopausal woman with a right breast 3.2 cm, grade 2 IDC s/p lumpectomy and SLNB with the following biomarkers – ER+ 95%, PgR+ 50%, HER2 1+ by IHC, HER2 FISH negative, Ki-67 35%. One of 3 nodes is positive for isolated tumor cells (pT2pN0i+). BRCA testing is negative. She receives ACT x 6 cycles and radiation and is ready to start endocrine therapy.

Which therapy would you recommend?