Medical Oncology

Breast Cancer   

Questions discussed in this category



Since HR low-positive, HER2 neg tumors behave aggressively similar to TNBC, does the degree of HR positivity factor into your decision-making?

Would you consider administering Keytruda (pembrolizumab) concurrently with radiation therapy for the treatment of a patient with an ER-negative, PR-n...

Is there data on the long-term effects of abemaciclib on future fertility and pregnancy after its discontinuation? Does the patient's desire for futu...

Is there a role for loco-regional treatment in this scenario? If a young patient with ER/PR positive cT2N2M1 IDC presents with a single bone metastasi...

For a patient with high risk disease and a severe enough reaction that additional taxane-based therapy is contraindicated, do you consider alternate c...

If so, what dose-fractionation do you utilize? What other factors do you take into consideration?

Would you recommend aiming for the postmenopausal range as per the lab reference range or do you have a specific goal?

Initial path was T1cN0, and recurrence shows 2/21 ALN  involved with ENE, what would you recommend for therapy?

Would you give neoadjuvant chemo or hormonal therapy or go with surgery first? What chemotherapy would you use? 

Patient with stage IV ER+PR+Her2- breast cancer progressed after CDK4/6 inhibitor+AI and then on Elacestrant. Guardant 360 showed ESR1 mutation and PI...

Controlled extracranial disease on trastuzumab+pertuzumab for 2 years. Treatment options include Enhertu or WBRT. Not a candidate for SRS or neurosurg...

PFS curves appear similar between the AKT-altered vs overall study population in the trial publication. Is there any additional information available ...

In MONALEESA-2, it appears ~22% of those in the ribcociclib group received a subsequent CDK4/6 inhibitor. What was the rationale and could this have i...

Given OlympiA trial with olaparib benefit for gBRCA+ patients?What are barriers that you foresee? In your practice who performs mutation testing and w...

My understanding is that if someone isn’t medically operable, the default is to offer systemic therapy palliatively because breast cancer is tho...

Do you give first-line CDK 4/6 inhibitors with Tamoxifen or Aromatase Inhibitor (+/- GnRH analog)?

Should these patients have a different threshold for utilizing a CDK4/6 inhibitor in the front line metastatic or as part of adjuvant therapy, or SERD...

The patient had a prior right-sided ER+ HER2-ve breast cancer, treated with neoadjuvant chemotherapy, MRM with ALND, and PMRT They recently developed...

Do you feel differently about using these in patients with a history of HR-negative breast cancer?

Young healthy patient, ER/PR positive HER2 negative right breast cancer with a synchronous single site of oligometastatic disease in the right 4th rib...

For example, a patient has had multiple dose reductions for neutropenia and required an admission for infection while on palbociclib. Would you switch...

The patient previously received endocrine therapy alone and in combination with CDK 4/6 inhibitor. She does not have any targetable mutations on NGS. ...

What data may support the routine escalation of endocrine therapy? Should HER2 therapy be prioritized instead?

Would you treat with 1st line ET + CDK4/6 inhibitor if the patient is only low or moderately ER positive? 

Would you consider OFS this far out from diagnosis and treatment in a young patient with high grade IDC was treated during pregnancy with neoadjuvant ...

How do you reconcile the apparent benefit in all patients in this group as opposed to the differential effects in premenopausal HR+ node-negative pati...

What type of adjuvant chemotherapy would you offer? Would clinically positive lymph nodes or residual disease at the time of surgery change your decis...

Do you recommend observation, APBI, whole breast or whole breast with low axilla treatment?

Would you consider doing this in patients with adverse features such as grade 3 or PR negative status? 

Following SRS to the brain lesions, is it safe to closely follow the patient for recurrence?

Would you continue KEYNOTE-522 neoadjuvant therapy? The patient has a PMH of sarcoidosis with no stroke risk factors. No residual deficits. 

MONARCHE added an amendment to their protocol to exclude inflammatory breast cancer so they technically would not qualify for the trial though it's ha...

If yes, how do you assess the tumor response and how frequently while on neoadjuvant chemoimmunotherapy?

Patient is pre-menopausal and has cT3cN1, grade 2, ER positive, Her 2 negative IDC. Metastatic disease to axillary LNs was biopsy-proven. Patient was ...

The left breast cancer is an ER-negative, PR-negative, HER2-negative cT2N0 invasive ductal carcinoma, while the left lung primary is a cT2N1 squamous ...

Is deferring chemotherapy based on low oncotype acceptable in setting of recurrence?    Would you recommend using a different AI, Tam...

Would you recommend using chemotherapy based on RxPonder regardless of Oncotype score in a premenopausal patient? Or would you hold chemotherapy since...

For a node positive, triple negative patient that underwent neoadjuvant chemotherapy followed by breast conservation with a complete pathologic respon...

While I am encouraged by the results of the LUMINA trial with respect to identifying patients who are less likely to benefit from radiation therapy wh...

Assuming the patient had no prior radiation and has no evidence of metastatic disease, would you start with adjuvant radiotherapy or adjuvant systemic...

Are there any circumstances where use of T-DXd would supercede the use of CDK4/6 inhibitors or other non-chemotherapeutic options (PIK3CA etc?)

Is there any data on the efficacy of T-Dxd after progression on sacituzumab govitecan? Does your approach differ by hormone receptor status now that ...

If NGS was positive would you treat with HER2 directed therapy? How, if at all, would you incorporate T-DXd into this treatment paradigm?

In which scenarios would you consider a parp inhibitor as the first line treatment of choice? 

Please specify how your institution is allocating resources now or will be soon.

(Assuming they meet MonarchE criteria) For example, if the patient is in year 2, 3, 4, or 5 of adjuvant endocrine therapy versus 9 months out, would ...

Is there a role for KEYNOTE-522 since ER + metaplastic breast cancer have similar behavior to triple negative metaplastic breast cancer? 

What is your approach to try to persuade her that photons would be a better option?

Received neoadjuvant ddAC/T followed by adjuvant capecitabine for residual disease and found to have metastatic pulmonary nodules within months of sur...

Do you use a q4 week or q12 week formulation? If you use both in your practice, what factors into your decision making for either one?

The surgeons at our institution are asking for repeat markers but I am not aware of any data or guidelines to support this. 

The results presented by Sudeep Gupta (from the Tata Memorial Breast Group at 2022 San Antonio Breast Cancer Symposium #GS5-01) showed no benefit (pCR...

Since both pregnancy and cancer are risk factors for VTE, is there data to guide when or if we should prophylactically anticoagulate? If so, what shou...

Are there specific patient populations in which you may feel comfortable with a patient selecting only one adjuvant therapy approach (tamoxifen vs RT)...

The patient was a >70-year-old with right-sided cT3N1M0, ypT0N0 TNBC s/p NAC pembro/taxol x 4 cycles followed by mastectomy w SLN (0/4); post-opera...

Is there a subset of patients for which you consider one regimen over the other (i.e. AC-THP v.TCHP)? If using an anthracycline regimen, do you u...

With studies showing non inferiority to zoledronic acid q 3 months in support of bone metastatic disease, would you consider extrapolating this data a...

The prior recommendations were between 6-12 months, but also were based on chemotherapy after surgery. 

Would you treat this as a locally advanced breast cancer and offer surgery, radiation, and systemic therapy? Does your management change depending on ...

In a woman with high-grade, clinically node positive invasive ductal carcinoma who receives neoadjuvant chemotherapy and breast conserving surgery, wo...

If a patient with endometrial stromal sarcoma managed with fulverstrant has a single oligoprogressive lung nodule, is there any contraindication to tr...

Would you obtain baseline PFT on all patients or only selected high risk patients? Would you repeat PFTs regularly or only if clinically symptomatic?&...

Given strong TDXd efficacy in these patients is there a role to use it earlier than 2nd line? How does prior Her2-directed and/or taxane therapy...

While rare, these patients were excluded from all frontline CDK4/6 inhibitor trials. Is there any data on the efficacy of ribociclib in the CNS or abi...

Results with fulvestrant and letrozole backbone in MONALEESA and MONARCH trials seem comparable, but PALOMA data is somewhat mixed. How do these trial...

Subgroup analyses in MONALEESA-2 suggest more benefit in de novo treatment naive patients, which is in contrast to MONARCH-3 data presented at ESMO 20...

If a patient previously received taxane-based chemotherapy for the initial cancer, is additional chemotherapy recommended or can HER2-directed and hor...

Is the marginal advantage of AC/T in 1-3 node positive outweighed by toxicity such as risk of cardiotoxicity and leukemia, regardless of RS?

Can you use 50 mg BID if intolerant to 150 mg and 100 mg dosing? Any tips for side effect management to help patients stay on full duration?

MonarchE shows statistically significant improvement in IDFS and DRFS, but the magnitude of absolute benefit is modest (3-year IDFS and DRFS rates = 5...

Some payors prefer leuprolide acetate injectable suspension (eligard) for ovarian suppression. This is not the preparation that was used in SOFT/Text ...

Majority of patients on MonarchE received neoadjuvant/adjuvant chemo.  Does the availability of abemaciclib impact your decision to offer chemo ...

Patient had estradiol level checked by her gynecologist due to recent irregular bleeding. Estradiol level was markedly elevated on initial testing (90...

Patient is young. Bilirubin normalizes when tucatinib is held, but again increases to grade 2 when it is restarted. Evaluation for hemolysis was negat...

Do you look into their stage/risk to decide? Since patients can experience bone loss after stopping denosumab, how do you plan to discontinue?

What steps should be taken when switching premenopausal women from tamoxifen to AI? In this case, the change is due to newly discovered endometrial th...

For example, if the primary breast tumor was HER2 IHC 1+, but a metastatic site was HER2 IHC 0, would you still recommend using T-DXd? Will you chang...

Is there evidence that T-DXd crosses the blood-brain barrier?

Prior studies have shown that there can be significant variation between grading pathologists as to which samples are defined as HER2 IHC +1 versus HE...

Patient is a post-menopausal woman with 4 lymph node mets that was strongly ER+/PR+, HER2-negative invasive ductal carcinoma with a high Ki-67 w...

Would you use a different endocrine therapy treatment? Would you use indicators other than Oncotype to guide the need for chemotherapy?

Specifically, how do you consider T-DXd use in setting of other antibody-drug conjugates (e.g. sacituzumab vedotin)? Are there any special considerati...

Do you prophylactically start all patients on B12, B-complex, and/or omega-3? If so, what dose? What about ice mittens and booties?

If a patient has a painful breast lesion in the setting of rapidly progressing systemic disease treated with weekly taxol (60 mg/m2), would you feel c...

- monarchE included <1% Stage IA and < 5% patients with no chemotherapy.Ex: 64 yo, ER/PR 95%, Ki67 20%, cT1c N0 but pT1c N1a at lumpectomy/SLN b...

For example, are you more likely to incorporate T-DXd earlier in sequence for 2+ vs 1+? Is there any justification to change our approach in HER2-zer...

Endocrine therapy is usually not indicated for DCIS s/p bilateral mastectomy, but would the fact that residual tissue (nipple-sparing) alter your deci...

In patients with prior perioperative immunotherapy with early relapse, would re-introduction of immunotherapy be reasonable with high TMB? 

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

Definitions for "high risk" differ by whether patients receive neoadjuvant chemo and across other contemporary studies. Does the change in AJCC stagin...

What if Medical Oncology wants to give more systemic therapy and further delay XRT start date?What should we be telling the Breast/Plastic surgeon/Med...

The FDA recently approved trastuzumab deruxtecan (T-DXd) in the second line setting. Given the results of DESTINY-Breast03, what is now the role of TD...

Would you consider definitive local therapy (surgery, radiation?) if she achieved a good response to initial systemic therapy?

Would you consider omitting treatment if small tumor and early stage? Or would you use tamoxifen?

Patient was initially ER positive, HER2 positive. Currently she is on letrozole. Recurrence is ER/PR negative and HER2 positive and developed almost 2...

Which regimen is preferred in second line for these patients? What is the efficacy of TDXd vs tucatinib in CNS metastases?    

What would you offer a premenopausal woman with clinical T2N1 ER positive breast cancer for adjuvant therapy after she achieves a pathologic complete ...

What do you do if LFTs are elevated after one dose of neoadjuvant TCHP (highest ALT >13 times upper limit of normal, normal bilirubin) with prior n...

I have a patient in her 60s with CHEK2 mutation, diagnosed with bilateral breast cancer. Lumpectomy showed b/l tumors <10mm both ER/PR+, HER2-, but...

Although grade 3 toxicity rates were low, ~10.5% experience some degree of ILD, are there strategies to reduce risk before treatment starts? Are ther...

Should these cancers be treated like hormone positive breast cancer or triple negative breast cancer? She is pre menopausal with cT1c grade 2 disease...

If said patient was known to be gBRCA mutated, would you use neoadjuvant chemotherapy to enable adjuvant olaparib for those that did not have a pCR? &...

Ref: Geyer et al, Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and hi...

How much of the benefit of adjuvant chemotherapy do you expect to be due to ovarian function suppression due to the chemotherapy?

Is dose modification of docetaxel necessary with Gilbert's when giving TCHP?

Patient is young and reoccurrence is one year after initial diagnosis of T1cN0 ER/PR positive, HER2-negative breast cancer treated with mastectomy, bu...

In subset analyses of OlympiA there seems to be smaller magnitude of benefit among HR+ patients. In your opinion, should adjuvant olabarib be offered ...

Would you restart hormonal therapy in a patient with a new diagnosis of LCIS 2 years after they have completed 5 yrs of AI for stage 1A IDC in the oth...

Patient underwent mastectomy for DCIS in the setting of previous lumpectomy and adjuvant radiation for the invasive breast cancer. 

Are there contraindications to drugs like oxaliplatin or abraxane? Does chronicity or severity of the patient's underlying symptoms play a role in yo...

Should this be sent on initial biopsy or on surgical pathology? What if an initially high risk patient has good risk findings post-operatively?What ha...

Assume normal cardiac function and no obvious co-morbidities. No anthracycline previously due to age alone. The patient’s BRCA status is unknown...

For instance, the foci found were pN1mi (0.5 mm) deposit in 1st SNL (1/13 LN) and mpT1mi (8 foci). Would you consider single or dual anti-HER2 blockad...

Do you allow pre-RT treatment with the CDK 4/6i and hold during RT, vs. allow concurrent with breast/chest wall RT, vs. delay starting CDK 4/6i until ...

Patient has already received neo/adjuvant treatment with AC, paclitaxel, capecitabine, docetaxel, and carboplatin.

Would you consider neoadjuvant or adjuvant treatment and if so, which therapies? Patient initially had pT2N0 disease and recurrent disease is also ER+...

Patient previously received neoadjuvant ddAC-T with residual disease at surgery, followed by adjuvant capecitabine which was completed 2 months prior ...

In high-risk, node-positive HR+ Her-2 neg breast cancer patients who received neoadjuvant chemotherapy with residual disease, would you give capecitab...

How do you manage low libido in women with breast cancer on endocrine therapy? Other than managing vaginal dryness/dyspareunia, if just a desire/libid...

How would you manage endocrine therapy 7 years after the original ER+/PR+/HER2- IDC, while on adjuvant tamoxifen/OFS develops a contralateral ER+/PR+/...

In light of updated monarchE trial data, it seems a SLNB would help delineate adjuvant treatment options in this population. However, Choosing Wisely ...

Grade 2 DCIS, post mastectomy with negative margins, sentinel nodes negative

Many of the patients on ASCENT trial were heavily pre-treated and require growth factors. With the day 1,8 treatment cycle, is there a way to minimize...

BRCA mutant, ER/PR positive and HER2 positive T2N0M0 breast cancer diagnosed 5 years ago, treated with bilateral mastectomy, BSO, 1 year of adjuvant a...

For patients with hormone negative breast cancer and HER2 positive only by copy number, do you give TDM1 for residual disease or capecitabine?

Can patients be re-challenged after developing ILD? Is the toxicity seen with T-Dxd a potential barrier to use?  Do you feel the dosing used in...

Given seemingly improved efficacy in ASCENT patients who had less prior treatment, would you consider use after only one prior agent rather than two? ...

Are there specific patient cohorts in whom you will more preferentially use sacituzumab govitecan? Can data from ASCENT be applied to patients with C...

To what degree do you factor in patient preference when choosing among available treatments? Are there features of each regimen that you emphasize in ...

For example, does a higher recurrence score influence your choice of TC versus AC-T?  Or your choice to add ovarian suppression to a premenopausa...

 If blood counts are sustained, do you continue or delay?

What would be your approach to a patient who went straight to surgery due to HR+ biopsy, but found to be triple negative on surgical pathology? 

Should patients with moderate penetrance pathogenic variants be managed similar to BRCA patients and consider risk reducing contralateral mastectomy?&...

Genes such as ATM, CHEK2, PALB2, RAD51C/D, BRIP1 seem to show some potential increased risk of ovarian cancer. Should these patients under prophylacti...

What about a higher penetrance PV such as PALB2? See JCO OGR 8/2021 by @Mark E. Robson discussing management of non-BRCA pathogenic va...

In a scenario where patient's other clinical/familial risk does not sufficiently qualify them? See JCO OGR 8/2021 by @Mark E. Robson discussing manag...

The patient is treatment naïve and asymptomatic. She also has disease in the body (bone and liver metastases). 

The patient initially received definitive therapy with AC-T and RT to the breast as well as RT to a solitary bone lesion. She has been on AI for the l...

The patient has extensive liver metastases and a high bilirubin. She has not received any prior systemic therapy in the metastatic setting. 

Is there any role for denosumab? How do you counsel patients regarding the benefit of bisphosphonates on breast cancer outcomes?

Patient had an initial tumor response to TCHP, but still had significant residual disease present, including positive lymph nodes and residual breast ...

The patient was started on chemoimmunotherapy 3 years ago. Recent scans show small treated brain metastases (s/p RT several years ago) and no disease ...

Patient with T2N1 disease and isolated liver metastases. Axilla and liver completely responded to chemo + IO, but limited residual breast enhancement ...

Does the answer change on proximity/distance from breast (i.e. what if pelvis or lower extremity?)

Given that olaparib was given within 12 weeks of completion of standard adjuvant therapy on the trial, will you still offer it to patients outside tha...

The patient was diagnosed with Ewing’s Sarcoma at the age of 10 and completed 6 cycles of vincristine, ifosfamide, etoposide, adriamycin 75mg/m2...

In patients who have completed all adjuvant therapy. Similar test to what is available for stage 2 and 3 colon cancer patients by Natera.

Patient is on fulvestrant+CDK 4/6 inhibitor and with NED for 5 years. In which cases would you consider stopping CDK 4/6 inhibitor? 

<40y/o female w/ initial biopsy showing G3 IDC with 80% ER+, 90% PR+, and HER2 positive (IHC 2+; 1.6 HER2/CEP17 ratio and 6.3 HER2 copies/nucleus.)...

Is there an age cutoff below which you would offer adjuvant chemotherapy regardless of Oncotype results? (Example: A 35 y/o woman with T2N0, ER+, sen...

Presuming that imaging does not show distant metastatic disease, what would you offer? What about if the patient were PD-L1 negative?

Would you offer this patient chemotherapy? What are your thoughts about OFS plus AI and avoiding chemotherapy?

Would you choose to incorporate HER2-targeting agents, chemotherapy, endocrine therapy, or a mix of these?

The GeparSixto, CALGB 40603, and more recently Prospero support doing it; however, it is not currently endorsed by NCCN and the latter Prospero s...

What tumor or patient characteristics lead you to consider the use of neoadjuvant hormonal therapy without chemotherapy?

Would you recommend the patient stop testosterone upon this new diagnosis? If the patient is not amenable to stopping, would you incorporate an AI in ...

Are there particular patient characteristics (e.g. age, ER%, Ki67, grade) that make you more likely to choose neoadjuvant endocrine therapy?

Do features such as nodal involvement, Ki-67, degree of ER positivity, etc. change your management? Would you use any gene expression assays to help y...

How would you approach additional systemic therapy? Would the clinical stage of the cancer affect your management?

Is adjuvant radiation and/or adjuvant chemotherapy indicated? 

Would you consider an Oncotype or Mammaprint? Would your management change if the patient had 1-3 positive LNs on SLNBx (as opposed to ALND)?

The woman was on on a GnRH agonist + AI due to her premenopausal status at diagnosis and now wants to know if she continues to need the GnRH agonist.&...

For patients with low risk, early stage, HR+/HER2- breast cancer who initiated endocrine therapy in order to delay their surgery due to the COVID 19 e...

I know that many advocate using vaginal estrogen in this situation.  Most of the studies of vaginal estrogen in this situation have been small an...

Knowing the differential effect seen with menopausal status in RxPONDER, would you avoid chemotherapy or still offer chemotherapy, given that only 15....

Would you recommend re-excision or proceed to adjuvant therapy if the tissue margin is negative? Pathologist states that tumor foci at margin was only...

Patient had a clinical T2N0 cancer at diagnosis, completed 6 cycles TCHP, and had 0.2mm residual disease with 80% cellularity, negative sentinel node.

Do you have any experience with intra-pericardial chemotherapy administration, and if so, in what cases?

Referring to a high risk patient with cT3N1 disease and ypT2N0 disease following neoadjuvant chemotherapy.

For example, will you recommend a certain vaccination timing in relationship to their treatment? Any concerns for reduced immune response or risks of ...

Or the converse:  changing to IV formulation after starting on subcutaneous pertuzumab/trastuzumab?

Conversely, is there any situation where you would prefer the IV over the subcutaneous formulation?

ASCO 2016 guidelines specified that SLNB was not recommended for T3/T4 N0 patients but uptodate allows it.

Is there a distinction between these tumors and patients with breast cancer with neuroendocrine features?

Does tumor size impact your recommendation? High grade? Young patient age?

Would it affect your decision whether original primary tumor and treatment was hormone positive or negative?

2 populations of cells with 95% negative by FISH (ratio 1.07) and 5% positive by FISH (ratio 10)

Do you consider placing an Ommaya for IT chemo with methotrexate or cytarabine? Knowing that leptomeningeal carcinomatosis carries such...

Based on MINDACT update from 2020, a 5% difference in DMFS for patients 50 years or younger was noted, favoring treatment with chemotherapy (93.6%; 95...

Options: 1) ddAC-T- surgery- adjuvant capecitabine if residual disease 2) weekly taxol/carbo x 12 followed by dd AC x 4 3) Keynote 522- pembro/taxo...

How would your treatment change given pCR rates are reportedly much lower in triple positive patients?

Initial treatment with Taxane-Trastuzumab-Pertuzumab with then maintenance with the two anti-HER2 agents and and an aromatase inhibitor. Would you bio...

Pre-menopausal women make progesterone and their menses are typically lighter on tamoxifen because it's a mild endometrial ER stimulant blocking their...

How has your practice been impacted by the ECOG 2108 (Khan et al. ASCO 2020 Abst LBA2)? Are there sites or distribution of disease that prompt you to ...

Given the changing landscape of treatment, some patients may have already received capecitabine previously.  Would this impact your treatment rec...

Would you consider use of immunotherapy with checking PDL1? What chemotherapy agents would you consider along with mastectomy/radiation?

What do you do/say when a discussion of evidence-based information doesn't convince a patient that this is her best chance of cure? Some patients even...

Would you consider an anthracycline based substitution vs changing to nab-paclitaxel or a combination with platinum agent?

Has anyone omitted post path fracture radiation of pelvis/long bone in favor of starting endocrine treatment first? Or would one omit RT and start a C...

She had had 4 prior biopsies. Would the fact that she received 2 months of neoadjuvant tamoxifen due to COVID change your approach?

While the KATHERINE trial for HER2+ used path staging, CREATE-X for TNBC with capecitabine used the Japanese Breast Cancer Society response criteria. ...

Is there any evidence for sacituzumab govitecan (IMMU-132) in this situation with progressive systemic disease after prior anthracycline and taxane?

< 4 lymph nodes involved, initial diagnosis was 11 years ago when she was treated with mastectomy and adjuvant tamoxifen for 5 years.

Would you consider still immunotherapy even if aggressive disease vs single agent chemotherapy?

Does the SYSUCC-001 trial presented at ASCO 2020 change your practice?

This patient underwent mastectomy and ALND (10/28 positive lymph nodes). Immediately following axillary LN dissection (and prior to radiation) imaging...

Data from the SOFT/TEXT trials showed clinical benefit in ovarian suppression + aromatase inhibition for high risk, premenopausal ...

Patient previously received neoadjuvant carboplatin, anthracycline and taxane regimen and is BRCA negative.

How would this change if the patient had metastatic HR+,HER2- breast cancer and now has symptomatic pancytopenia secondary to BM involvement after TCH...

Would you consider genomic assays before neoadjuvant chemotherapy? How would you modify your treatment given the COVID-19 pandemic?

T1a - 2mm; N1 - 1 ipsilateral lymph node measured 6mm Oncotype says too small to test and NGS says too few cancer cells to determine status.

Would the recommendation differ based on HR+ vs. TNBC vs HER2+ classification? Would you recommend against immediate breast reconstruction?

Personally, my practice is to guide patients directly to surgery or to do neoadjuvant chemotherapy rather than to do neoadjuvant endocrine therapy, bu...

For example, if you had a triple positive breast cancer found on breast biopsy and repeat ER/PR/HER2 testing at the time of surgical resection showed ...

When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as sche...

ie, not a classic NTRK3-ETV6 fusion.The patient has progressed through CDk4/6 inhibitors and intolerant of alpelisib, and does not want chemotherapy.&...

She has no other site of disease progression and has been on an aromatase inhibitor (progressed in the CNS while on a study with adjuvant abemaciclib)...

The APT trial reported excellent DFS, OS and RFI for tumors <=3cm but few were smaller T2s (2-3 cm) and few were >70 years old.

This patient is interested in conceiving and therefore would like to wait to start the tamoxifen.

For example, if a patient had testosterone pellets injected, perhaps making endocrine therapy less efficacious, would that sway you to use chemo?

Being that this is a favorable histology would you use Oncotype Dx to help decide on neoadjuvant chemotherapy? Would you recommend neoadjuvant endocri...

In the absence of side effects, would you be inclined to continue beyond 10 years as chemoprevention? Would you factor an intermediate/high oncotype R...

How would you manage symptoms? How would you adjust the adjuvant regimen (dose reduce, omit paclitaxel etc)? What strategies would you consider for pr...

Data presented at the 2017 SABCS (abstract GS1-01) of the EBCTCG meta-analysis stating a benefit of dose-dense chemotherapy applies to ER positive and...

Do you offer EPO and TPO support? Do you modify your systemic therapy up front or after subsequent cycles?

Would you recommend it for a mammographically occult primary or if the patient had dense breasts?  What if a high risk patient decides not to hav...

Would you offer adjuvant chemotherapy to a post-menopausal woman with a BRCA2 mutation and a T2N0 ER positive breast cancer with an oncotype of 12?

It is included in favorable histologies on NCCN, but no mention of how to treat based off HER2 status.

She had disease progression on palbociclib and letrozole. She also has a PIK3CA mutation however did not tolerate alpelisib due to Grade 3 hyperglycem...

Knowing that benefit of contralateral mastectomy is lower in older women who has already manifested BRCA related cancer and 10-20 % mastectomy related...

Does the results of the tnAcity trial influence your decision in choosing a 1st line option?

Status post nasolacrimal stent with improvement.  Would you re-challenge or permanently discontinue docetaxel?

More generally, do absorption issues effect the efficacy of tamoxifen and/or aromatase inhibitors?

How would you figure out how to treat someone with a prior localized HR+,HER2- breast cancer treated with adjuvant AC-T (5years ago) and a recent ipsi...

Would you consider an aggressive approach with RT and/or surgery to the bone lesion and treat the primary as locally advanced breast cancer?

How would you approach a post-menopausal woman who now wishes to start adjuvant endocrine therapy more than 3 years since surgery?  

Would you prefer first-line AI/CDK 4/6 inhibitor, or first-line AI followed by 2nd-line fulvestrant/CDK 4/6 inhibitor (either abemaciclib, once availa...

If yes, would you still recommend dual HER2 directed therapy? After the TRYPHAENA trial, neoadjuvant therapy with dual HER2 directed therapy has beco...

Given that DBA is associated with increased incidence of MDS, AML and other solid tumors, would this modify your treatment recommendations?

For early stage disease in a single breast, would you consider neoadjuvant chemotherapy or upfront surgical staging followed by adjuvant therapy? What...

Do you tailor treatment to a goal response?  Do you refer to data illustrating improved prognosis if the patient develops a CR or PR?

Provided the sternal lesion was low volume and treated with curative intent and patient has been on tamoxifen for < 5 years, would you switch to AI...

PIK3CA and ESR1 mutations on NGS without other targets and who has progressed on CDK 4/6 & AI and several single agent chemotherapies.  Aside...

Tamoxifen prophylaxis has not been studied in women <35 years old, but it would be reasonable to assume they would benefit.

I have seen some advocate for this in the community, although a Cochrane metanalysis did not find an advantage to giving the taxane earlier.

In a patient with who had undergone neoadjuvant TCH-P, lumpectomy, and RT and is currently on AI, pertuzumab, and trastuzumab, how do you think about ...

Neratinib was studied following adjuvant trastuzumab. Do you extrapolate that data to give neratinib to patients who have received adjuvant T-DM1 inst...

The ABC trials (Blum, JCO, 2017) used six cycles of TC. Is it because of the superiority seen with TC x four cycles versus standard AC x four cycles (...

Often patients are referred to medical oncology for adjuvant therapy for early stage breast cancer after BCS and just before starting radiation.

She developed biopsy proven skin nodules while on paclitaxel. PDL-1 positive and BRCA negative. Would you consider atezolizumab with a different agent...

She is otherwise asymptomatic and no LFT abnormalities. Would you switch to chemotherapy or offer different endocrine therapy?

Do you follow invasive or DCIS guidelines? Would you consider re-excision in a patient with multifocal microinvasive carcinoma of the breast arising i...

Why do the NCCN guidelines suggest using neoadjuvant therapy only for patients with T2 or greater tumors?

 If so, would you treat as node + BC with  anthracycline and taxane regimen or   non-anthracycline regimen (i.e  docetaxel and cyc...

Patient defers chemotherapy. She is currently on anastrozole/Herceptin and perjeta with a response but it is suboptimal. I would like to add a CDK 4/6...

Data was presented at ASCO in 2017 that abemaciclib has brain activity in HR positive breast cancer.

Most guidelines recommended adjuvant chemotherapy if tumor size was >3cm at the time of TAILOR Rx and patients with tumors >5cm were not include...

The use of neoadjuvant CDK 4/6 inhibitors is not standard of care, but there are clinical trials looking at this question and patients who are chemoth...

AI+ CK4/6 inhibitor? Fulvestrant + CK4/6 inhibitor? AI + fulvestrant? AI + fulvestrant + CK4/6 inhibitor?

Would you proceed with modified radical mastectomy followed by systemic therapy, or would you consider neoadjuvant therapy? Would biomarker status mat...

Does the presence of N1 disease push you towards offering chemotherapy or would you continue endocrine therapy based on the PR?

In obese patients, would it make sense to switch from a GnRH agonist to an antagonist based on the data from the recent JCO study of dagrelix vs. trip...

NCCN recommendations seem to mention these patients as not candidates for preoperative systemic therapy if the invasive carcinoma extension cannot be ...

What would be the optimal sequence of surgery, radiation, and chemotherapy for this patient? This patient has an excellent performance status and...

Clinical T1c patients were included in the KATHERINE trial that often are treated with adjuvant paclitaxel and trastuzumab

Is there a point at which there may be no benefit? More than 3 months from breast surgery? 6 months? 1 year?

Would you maintain dose density of chemotherapy and use peg-filgrastim prior to delivery of the baby? Would you defer taxane and anti-HER2 therapy unt...

If so, what would be the regimen that you would consider and what factors would sway you for or against chemotherapy for such patients?

The ABC trials show a DFS advantage of anthracycline-based regimens. Would age alone procure you from using it in a patient?

This patient is a young lady with stage IV ER/PR positive, Her2 negative with oligometastatic  breast cancer undergoing a planned bilateral oophe...

Can repeating Oncotype on a locoregional recurrence show a change in the biologic behavior of the cancer over time and guide treatment decisions?

The recurrence was 2 years after treatment with ddAC + T.  If you elect for systemic therapy after local therapy, what chemotherapy would you use...

One such patient progressed through trastuzumab/pertuzumab/letrozole and TDM1 alone.  How would you combine ER+ approaches (eg CDK 4/6 inhibitor ...

Do your recommendations differ if patients are pre or postmenopausal given the data?

For instance, in stage III, would you use chemotherapy in neoadjuvant or adjuvant setting?  What regimen would you use?

And how long? According to the ABCSG-16 Trial there was no difference in extending AI beyond 2 years after an initial 5 years.  

Does the answer vary based on whether it is neo/adjuvant or metastatic setting?

One example is the original breast cancer ER high 90%, PR mod to high 40%, Her2 negative.  A liver metastasis diagnosed 2 years later showed ER l...

What are your thoughts with the new KEYNOTE-522 regimen? Would you just use carbo/paclitaxel/pembro part of the regimen or give as much doxorubicin as...

OS benefit was limited to patients with endocrine sensitivity, defined as either a documented clinical benefit (CR, PR, or SD for ≥24 weeks) f...

Does an age over 70 years, size, histology and hormone receptor status affect this decision? 

The patient only had disease involving the right breast and axillary, cervical, and supraclavicular lymph nodes. She had complete response to with ddA...

There is a gray area in clinical decision making where the practice seems to be different for borderline size tumors such as a 7 mm T1b lesion with no...

If yes, what dosage and do you use it continuously or intermittently? Regarding provera, many patients with ER/PR (+) breast cancer worry about taking...

Not to decrease recurrence risk, but for chemoprevention of new ER-positive DCIS or invasive disease based on the Gail Model. If so, is there data to ...

The patient is a pre-menopausal woman with low-grade, stage I IDC who initially could only tolerate 10 mg of tamoxifen for her first year of trea...

Young woman with Her2 positive disease involving her right breast, regional lymph nodes, and liver had a CR on PET after therapy with THP and now plan...

The NEJM 2015 paper by Tolaney et al only included 1.5% of patients with micrometastases.

If a patient has ER/PR+ and Her2 positive disease in the primary tumor while axillary lymph node core biopsy is ER/PR+ Her-2 negative, do you man...

In a patient treated over 10 years ago with mastectomy and chemo now with recurrence in the ipislateral axilla, would you offer additional with chemot...

Specifically, this patient had a new left lacrimal gland metastatic lesion that developed four years from her initial diagnosis and is currently under...

Would you do this for ER+ patients? According to the PERSEPHONE trial presented on ASCO 2018, in HER2+, non-metastatic breast cancer, 6 months Hercep...

I have a patient who will be climbing to the base camp of Mount Everest. Does a climb to 15,000 feet increase her risk? Should she wear a compression ...

Would you give neoadjuvant chemotherapy in a patient with T1 N1 M0 ER/HER-2 positive cancer if they are candidates for upfront lumpectomy?

If there is no response to neoadjuvant AC -->T, would you offer additional adjuvant chemotherapy?

High enough risk to justify anthracycline+taxane chemotherapy followed by ovarian suppression + aromatase inhibition.

Many times we encounter patients who do not have a tissue sample readily available or in whom obtaining such a sample would be hard. On a more molecul...

The PERSEPHONE trial to be presented at ASCO suggests 6 months of Herceptin is non-inferior to 12 months in early Her2 postive disease.

What is the optimal regimen for a pre-menopausal female with progression of ER+,PR+ and Her2 neu negative breast cancer while on tamoxifen for six mon...

The patient initially had a great response to THP for four months, but now with quite a bit of lung, pleural, and nodal involvement.

Do you offer additional adjuvant chemotherapy, proceed to adjuvant endocrine therapy, or search for a suitable clinical trial?

Intramammary lymph node involvement has been shown to have a poorer prognosis (Hogan, Surg Onc, 2010). Would Oncotype be useful in these patients...

Knowing that the analysis now is more detailed than it was 10 years ago. What about non-Ashkenazi Jewish breast cancer patients with suspic...

While we await the results of TailorX, what has been the experience in your practice? If the decision for adjuvant chemotherapy is made, do you f...

Patient does not qualify for breast cancer screening by annual MRI per criteria (IBIS lifetime risk<20%, no known genetic predisposition,...

Originally received anthracycline and taxane based regimen.  Would you use carbo/paclitaxel or capecitabine or a different approach?

Is there a difference among all the commercial genetic testing labs? Is there anything beyond CLIA- and CAP-certification that we should look for...

After mastectomy for the locally recurrent disease, would you consider "pseudo-adjuvant" chemotherapy for local recurrence per the CALOR trial? If so,...

Can you apply the ACOSOG Z0011 study to women who have HER2 positive disease?  

Recent NEJM study showed an increased breast cancer relative risk in longer durations of hormonal contraceptive use that could last up to 5 years. Pre...

An article (BRCA mutation and outcome in BC. Ellen Copson, et al. Lancet Oncol. 2018) showed G3, BRCA+ breast cancer had poorer prognos...

Pt has progressed on AI and Faslodex. Goal is radiation to axilla as a palliative intent and Capecitabine to control systemic disease. 

Are you using post-neoadjuvant Xeloda based on preliminary data from the CREATE-X trial? Does BRCA mutation influence your decision?

If so, when? Are there certain ERBB2 mutations that would predict response to trastuzumab and/or neratinib? 

Following the dosage guidelines based on absolute neutrophil count may cause the patient to end up receiving lower doses.

Would you consider using CKD inhibitors upfront in triple positive breast cancer previously treated with chemotherapy, endocrine therapy, and Hercepti...

This is in regards to the risk of secondary cancers after radiation therapy or cytotoxic chemotherapy (such as anthracyclines) in an immunosuppre...

Assuming the patient was initially treated with surgical resection and adjuvant chemotherapy followed by radiation and appropriate endocrine therapy.

What do you do with low grade (grade 1/3) tumors? In other words, does high grade pathology over rules?

In light of two phase III randomized trials showing duloxetine (S1202) and acupuncture (S1200) both improve AIMSS, which would you try first? Wou...

Would the exact Oncotype score guide your decision (ie closer 25-30 v. >30-35)? NCCN recommends Oncotype only for tumor size < 5mm but this case...

If Oncotype is high risk, what regimen of adjuvant chemotherapy would you recommend?

Would you use a regimen with lower incidence of neurotoxicity such as CMF or a taxane-based regimen with a low threshold to dose-reduce?

Would you consider using ckd inhibitors in triple positive breast cancer previously treated with chemotherapy, endocrine therapy, and Herceptin? NCCN ...

How do you approach treating ER/PR positive/HER-2 positive metastatic breast cancer? Do you combine hormonal therapy / chemotherapy and HER-2 directed...

We often treat elderly women with lumpectomy and adjuvant hormonal therapy without radiation. I am concerned about how to proceed after the 5 year poi...

Many women are distressed when asked to discontinue hormone replacement therapy or use intravaginal estrogen suppositories.

Some patients request chemotherapy scheduling adjustments to avoid feeling ill on major holidays. Delaying chemotherapy by a few days isn't of particu...

Example case: Patient given neoadjuvant docetaxel + cyclophophamide achieves a partial response after 3 cycles of Taxotere + cyclophosphamide but is u...

Are results of BCIRG-006 trial applicable for patients with triple positive breast cancer or only for those with HER2+? 

Tamoxifen prophylaxis is FDA-approved, but would you extrapolate from adjuvant/metatastic data for hormone receptor positive breast cancer in post-men...

In the absence of data demonstrating a clinical benefit for one strategy versus the other, what do you do in practice?  

Being that there is limited data on CNS penetration with either regimen, what would you prefer in a patient who already received whole brain RT?

The FDA recently approved neratinib based on data from the ExteNET trial; however, benefit appears modest and the risk of toxicity is not low.

Do you have a cutoff in terms of tumor size, number of LN, Oncotype score, etc that makes you choose lower vs higher intensity chemo?

There is limited data that suggests steroidal AI exemestane could be of some benefit after nonsteroidal AI failure (Lonning PE et al. J Clin Oncol 200...

I.e. either for treatment of high-risk disease or intolerance/contraindication to tamoxifen. Will you continue it for the full 5 year course?

In a patient with isolated leptomeningeal disease (no systemic disease), would you still recommend systemic therapy?

Assume good compliance with oral therapy, equivalent access to either agent, no contraindictions to either therapy, and absence of any visceral crisis...

Do you reserve this approach for only women with triple negative breast cancer or all-comers?

What would you choose if there is no response to neoadjuvant AC-T? Taxol, THP, TCHP?

Do you prefer neoadjuvant chemotherapy or proceeding directly to surgery, followed by adjuvant therapy?

Assuming cytotoxic chemotherapy is given, would you still then proceed with adjuvant endocrine therapy?  Would you switch agents or classes of en...

(For instance, TCX4 instead of AC->T for smaller tumors?)Does this affect your decision about treating with neoadjuvant versus adjuvant chemotherap...

Do you prefer this approach based on the FALCON trial showing improved PFS with frontline fulvestrant?

Do you extrapolate the results of OPTIMIZE-2 and CALGB 70604 showing that an every 12 week dosing of zolendronic acid is noninferior to ever...

Is there a select patient population that you use it for? Is it also being used in cancers other than breast cancer?

There are many options to choose from, including large gene panels with up to 80 genes at the same cost as BRCA 1/2 testing, while others offer j...

Is there a role for routine use of additional or alternative imaging modalities for these patients, such as tomosynthesis, MRI, or ultrasound?  I...

Some medical oncologists tend to hold anticoagulation in patients who develop brain metastases for fear of causing intracranial hemorrhage.  Is t...

Are there differences between palbociclib and ribociclib?  What would make you choose one over the other?

For example, if a post-menopausal patient is treated in the first line setting with docetaxel, herceptin, and perjeta, would you add an aromatase...

At what point do you send these test, and in what instances do the results influence your treatment recommendations?

If so, how do you counsel patients who are node positive with low or intermediate risk scores? How do you interpret the existing data? NCCN and ASCO g...

In a patient who underwent lumpectomy for presumed DCIS and was found to have a focus of invasive triple negative disease, would you offer chemotherap...

Is a monthly schedule x 1 year, followed by q3 months, now the the standard of care, as per the recently published OPTIMIZE-2 trial? 

This is rarely done, but recently came up in a tumor board discussion.  Which chemotherapy would you consider using, and when?

Would you send the patient to a surgeon for consideration of a mastectomy?  Would you then consider post mastectomy radiation when the risk of re...

The CALOR study showed a benefit of adjuvant chemotherapy for local recurrence but the regimens given were "physicians choice".

How do you counsel them on risk in the curative setting?  Do you approach treatment in the metastatic setting any different than patients with &g...

Does switching AIs help?  If so, is there a role for switching from a steroidal AI to a non-steroidal AI or vice versa?  Are there other adj...

Based on results from PALOMA1 and recently reported MONALEESA2, do you use a CDK4/6 inhibitor as initial therapy?  In what circumstances would yo...

The results of the 70 gene panel Mammaprint in combination with Adjuvant! Online were published in NEJM recently. How will you incorporate this data i...

Do you ever consider de-escalating or stopping therapy in this situation? What is your approach to this conversation?

The MA17R trial only included "postmenopausal women" so how do you make a decision for men and pre-menopausal women.

Do you use cytotoxic chemotherapy as first line or hormonally-targeted therapy such as letrozole + palbociclib?

Based on the CALOR trial (http://www.ncbi.nlm.nih.gov/pubmed/24439313), adjuvant chemotherapy should be considered, but what regimen is preferred?&nbs...

In a patient who recently completed NAC, TM/LND and PMRT for a hormone positive locally advanced breast cancer and is then found to have a contralater...

The recently published MA.17R trial showed a DFS benefit for extending AI therapy to 10 years in post-menopausal women.

A recent publication of the TEXT and SOFT trials http://www.ncbi.nlm.nih.gov/pubmed/27044936 showed an improvement in breast cancer-fre...

Are there any clinical or pathologic factors that lean you towards or away from giving trastuzumab?

Our Radiation Safety officer reports a higher radiation dose to the patient from the two scans vs the PET.


Papers discussed in this category


The New England journal of medicine, 2018-07-12

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-07-10

Annals of oncology : official journal of the European Society for Medical Oncology, 2011-11

N Engl J Med, 2015 Jan 8

International journal of radiation oncology, biology, physics, 2013-03-15

International journal of radiation oncology, biology, physics, 2011-05-01

International journal of radiation oncology, biology, physics, 2011-11-01

Lancet Oncol., 2012-01-01

The New England journal of medicine, 2015-02-19

Lancet Oncol., 2012-04-01

Am J Transl Res, 2019 Sep 15

N. Engl. J. Med.,

The New England journal of medicine, 2016-07-21

N. Engl. J. Med., 2015-01-29

Breast cancer research : BCR, 2009

Cancer cell, 2012-10-16

Cancer cell, 2016-03-14

Cancer discovery, 2016-07

Clinical breast cancer, 2010-12-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-08-10

The Lancet. Oncology, 2014-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-08-20

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-08-20

The breast journal, 1999-01

Annals of surgical oncology, 2010-10

Annals of surgical oncology, 2014-10

The New England journal of medicine, 2016-08-25

Cancer, 2015-12-15

Blood, 2015-07-23

The Lancet. Oncology, 2010-01

The New England journal of medicine, 2004-12-30

Lancet, 2015-10-03

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-05-10

Lancet Oncol., 2011 Jun 05

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-05-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-06-10

International journal of radiation oncology, biology, physics, 2006-02-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2003-03-15

Journal of the National Cancer Institute, 2001-12-05

International journal of radiation oncology, biology, physics, 2000-09-01

The New England journal of medicine, 2015-03-05

Lancet, 2007-05-19

Nat. Med.,

Lancet (London, England), 2016-12-17

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-02-01

Journal of the National Cancer Institute, 2008-10-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-08-10

Clinical breast cancer, 2006-12

Lancet (London, England), 2014-03-22

The New England journal of medicine, 2011-06-23

Journal of the National Cancer Institute, 2005-09-07

J. Clin. Oncol., 2018-07-01

Lancet (London, England), 2009-12-19

The Lancet. Oncology, 2014-06

The New England journal of medicine, 2012-11-08

J. Clin. Oncol.,

European radiology, 2022 May 07

The Cochrane database of systematic reviews, 2020 Dec 21

Breast Cancer Res. Treat., 2013-01-01

J Clin Oncol, 2020 Feb 14

J Clin Oncol, 2008 Jan 10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-04-20

National Cancer Institute (US),

ESMO Open, 2016-01-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-03-10

The New England journal of medicine, 2012-01-12

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-10-10

N Engl J Med,

N Engl J Med, 2019 Dec 11

N Engl J Med,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-09-01

Clinical cancer research : an official journal of the American Association for Cancer Research, 2017 May 22

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 May 19

J. Clin. Oncol., 2019 Oct 16

N. Engl. J. Med., 2017-07-13

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2015-04

Am J Case Rep, 2017-02-28

Lancet, 2017-09-09

Breast cancer research and treatment, 2014-01

Annals of oncology : official journal of the European Society for Medical Oncology, 2013-09

Oncologist, 2007-09-01

Journal of the National Cancer Institute, 2006-12-20

Medicine and science in sports and exercise, 2010-07

J Clin Oncol, 2016 Feb 20

Curr Breast Cancer Rep, 2016-01-01

Crit Rev Food Sci Nutr, 2018 Apr 19

JAMA, 2018-02-20

JAMA Oncol,

The New England journal of medicine, 2016-11-17

N. Engl. J. Med., 2016-11-03

The Lancet. Oncology, 2016-04

JAMA, 2013-10-09

JAMA, 2011-02-09

Lancet Oncol., 2013-04-01

Lancet Oncol., 2014-11-01

Breast, 2017-02-01

J. Clin. Oncol., 2015-01-20

J. Clin. Oncol., 2009 Nov 02

The New England journal of medicine, 2012-08-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-09-01

Breast cancer research and treatment, 2012-11

N Engl J Med,

British journal of clinical pharmacology, 2016-06

The New England journal of medicine, 2014-07-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-07-01

Fertility and sterility, 2016-03

Breast Cancer, 2017-09-01

Journal of the National Cancer Institute, 2010-07-07

J Natl Cancer Inst, 2006 Jul 5

J. Natl. Cancer Inst., 2010-07-07

J. Clin. Oncol., 2003-10-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-01-01

Breast Cancer Res. Treat., 2014-09-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-06-10

Lancet Oncol., 2014-06-01

Lancet Oncol., 2013-01-01

JAMA Oncol, 2021 Jul 01

Lancet Oncol, 2022 Apr 08

Annals of oncology : official journal of the European Society for Medical Oncology, 2015-01

Annals of oncology : official journal of the European Society for Medical Oncology, 2014-06

Lancet (London, England), 2013-03-09

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-04-20

Journal of the National Cancer Institute, 2013-07-17

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-09-01

The Lancet. Oncology, 2019-01

Breast Cancer Res. Treat., 2005-01-01

Breast, 2016-12-01

Zhonghua Zhong Liu Za Zhi, 2016-07-01

Breast, 2016-08-01

The New England journal of medicine, 2005-10-20

Springerplus, 2016-01-01

Lancet, 2017-03-25

N. Engl. J. Med., 2006-02-23

Lancet Oncol., 2013-07-01

Lancet Oncol., 2016-06-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-07-10

J. Clin. Oncol., 2015 Feb 17

The Lancet. Oncology, 2015-01

JAMA oncology, 2016-11-01

N Engl J Med, 2011 Oct 6

Eur. J. Cancer, 2017 Dec 08

Cancer, 2010-11-15

The breast journal, 2017-11

Lancet (London, England), 2016-02-27

JAMA Oncol, 2016 Mar

Clin Oncol (R Coll Radiol), 2016-12-01

The New England journal of medicine, 2009-05-14

Ann. Oncol., 2009-02-01

Clinical cancer research : an official journal of the American Association for Cancer Research, 2015-10-01

J. Clin. Oncol., 2011 Nov 21

J Hematol Oncol, 2015 May 17

Breast Cancer Res. Treat., 2015 Apr 08

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-07-01

J. Natl. Cancer Inst.,

J. Natl. Cancer Inst.,

Journal of the National Cancer Institute, 2014-01

Lancet Oncol., 2013 Jul 29

Ann. Oncol., 2010 May 21

Breast Cancer Res. Treat., 2010 Jul 15

J. Clin. Oncol., 2012 Feb 27

Cancer investigation, 2011-11

Clinical cancer research : an official journal of the American Association for Cancer Research, 2009-12-01

Cancer Treat. Rev., 2011-10-01

Annals of oncology : official journal of the European Society for Medical Oncology, 2015-07

Ann. Oncol., 2013-12-01

Nat Rev Clin Oncol, 2016-08-01

Acta Oncol, 2011-04-01

J. Clin. Oncol., 2011-06-01

J Clin Oncol, 2020 Oct 29

Semin Cell Dev Biol, 2011 Jul 28

Nat Med, 2019 Sep 30

N. Engl. J. Med.,

The Lancet. Oncology, 2018-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-04-01

N. Engl. J. Med., 2019 Jun 04

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-04-10

Cancer, 2018-04-15

Proc Natl Acad Sci U S A, 2015 Aug 3

Journal of the National Cancer Institute, 2018-01-01

Pediatrics, 2014-04

Vaccine, 2014 Dec 08

Ann. Oncol., 2018 Jan 19

Journal of global oncology, 2017-08

Breast cancer research and treatment, 2018-02

Cochrane Database Syst Rev, 2008 Apr 16

Eur. J. Cancer, 2013 May 22

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-09-01

Ann. Oncol.,

Clin. Cancer Res., 2018 Mar 26

Ann. Oncol.,

N. Engl. J. Med., 2017 Jun 04

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-05-10

Radiother Oncol, 2017 Sep 27

Breast Cancer, 2012 Apr 25

Annals of surgical oncology, 2018-10

Lancet Oncol., 2015 Sep 09

J Clin Oncol, 2022 Jan 07

JAMA oncology, 2019-06-01

Lancet Oncol, 2021 Jun 11

Lancet,

Cancer, 2004-10-15

The New England journal of medicine, 2018-07-12

The Lancet. Oncology, 2018-01

Lancet Oncol., 2016 Jun 23

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-02-10

BMJ, 2016 Sep 30

International journal of radiation oncology, biology, physics, 2014-03-01

Breast cancer research and treatment, 2013-11

Annals of surgery, 2016-02

Breast cancer research and treatment, 2013-08

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-03-01

The Lancet. Oncology, 2016-09

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-03-20

Clinical breast cancer, 2018-02

Breast,

Journal of the National Cancer Institute, 2017-02

The Lancet. Oncology, 2018-04

JAMA Oncol,

Eur. J. Obstet. Gynecol. Reprod. Biol.,

Br J Obstet Gynaecol,

Annals of surgical oncology, 2016-02

JAMA oncology, 2016-09-01

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2013-04

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016-07

Clinical breast cancer, 2003-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-02-01

The Lancet. Oncology, 2017-12

Annals of oncology : official journal of the European Society for Medical Oncology, 2013-09

N Engl J Med, 2021 Jun 03

The Lancet. Oncology, 2012-07

Annu. Rev. Med., 2015 Aug 28

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-06-20

Lancet,

Lancet Oncol, 2019 Feb 19

Lancet Oncol, 2019 Dec 02

Lancet Oncol, 2017 Oct 13

JNCI Cancer Spectr, 2021 May 28

Cancer research, 2008-10-01

N. Engl. J. Med.,

J. Clin. Oncol.,

NPJ breast cancer, 2016

Cancer, 2006-09-15

Breast Cancer,

N. Engl. J. Med.,

NPJ Breast Cancer, 2021 Nov 11

J Clin Oncol, 2020 Feb 25

Breast Cancer Res. Treat.,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-08-20

NPJ breast cancer, 2016

NPJ Breast Cancer,

Breast cancer research and treatment, 2011-04

Breast (Edinburgh, Scotland), 2015-11

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-04-20

Lancet Oncol., 2018 Nov 06

Lancet (London, England), 2014-07-12

J Clin Oncol, 2022 Apr 11

JAMA Oncol, 2020 Aug 13

Breast cancer research and treatment, 2017-06

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-07-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-12-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-07-20

Mol Oncol,

Semin Oncol, 2006 Apr

Lancet,

JAMA,

Eur. J. Cancer, 2017 Aug 04

The New England journal of medicine, 2010-06-03

Journal of the National Cancer Institute, 1997-11-19

Ann Surg Oncol, 2018 Jul 9

JAMA, 2017-09-12

The Lancet. Oncology, 2013-10

J Clin Oncol, 2015 Aug 20

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2005-01-01

NPJ breast cancer, 2017

N Engl J Med, 2018 Oct 20

Lancet Oncol., 2013 Dec 19

Curr Probl Cancer, 2016 Mar - Aug

Annals of surgical oncology, 2009-06

Annals of surgical oncology, 2017-02

Breast Cancer Res. Treat., 2017 Sep 15

JAMA, 2011-11-02

J. Clin. Oncol., 2018 May 30

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-11-20

Target Oncol,

The Lancet. Oncology, 2017-06

Breast cancer research : BCR, 2016-06-28

J Natl Cancer Inst, 2018 Jun 1

Oncology reviews, 2017-03-03

J Clin Oncol, 2011 Jan 10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-01-01

The New England journal of medicine, 2019-02-14

Lancet Oncol., 2017 Oct 12

The Lancet. Oncology, 2016-03

JAMA Oncol,

Liver Int., 2011 Aug 31

Lancet Oncol., 2017 Feb 24

Eur. J. Cancer, 2017 May 03

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-10-01

Clinical cancer research : an official journal of the American Association for Cancer Research, 2017-02-01

British journal of cancer, 2012-08-21

Int J Radiat Oncol Biol Phys,

JAMA Oncol,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-11-10

JAMA, 2013-10-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2000-04

The journals of gerontology. Series A, Biological sciences and medical sciences, 2001-03

Annals of oncology : official journal of the European Society for Medical Oncology, 2015-02

Medicine (Baltimore),

Int. J. Radiat. Oncol. Biol. Phys.,

Breast cancer research and treatment, 2019-05

Clinical cancer research : an official journal of the American Association for Cancer Research, 2012-12-15

JAMA oncology, 2017-07-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2003-04-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-09-01

Breast Cancer Res Treat, 2009 Jun

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019-02

Lancet (London, England), 2016-02-27

Journal of the National Cancer Institute, 2001-11-07

Breast (Edinburgh, Scotland), 2019-04

Journal of clinical pathology, 2017-03

NPJ breast cancer, 2017

PLoS ONE, 2016 Oct 14

Sci Eng Ethics, 2017 Sep 15

Lancet, 2015 Mar 02

J. Clin. Oncol., 2018 Dec 06

Journal of the National Comprehensive Cancer Network : JNCCN, 2017-04

Journal of neurosurgery, 2019-02-08

Breast cancer research and treatment, 2018-06

Trials, 2013 Aug 19

Ann. Oncol., 2012 Jun 06

Cancer,

N. Engl. J. Med.,

Ann Surg Oncol, 2022 Apr 04

Clin Transl Oncol, 2018 Mar 28

ISRN Surg, 2013 Mar 20

Ann. Surg.,

Journal of Cancer, 2017

Onco Targets Ther, 2018

Cancer cell, 2018-09-10

Cancer Discov, 2017 Mar

Mol Oncol, 2017 Nov 17

Nat Commun, 2016 May 13

JAMA oncology, 2016-10-01

Nature reviews. Cancer, 2018-06

The New England journal of medicine, 2019-06-20

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-06-01

N. Engl. J. Med.,

Breast Cancer Res Treat, 2019 Feb

Clinical cancer research : an official journal of the American Association for Cancer Research, 2018-12-01

J. Clin. Oncol., 2011 Jan 10

The New England journal of medicine, 2012-02-09

Cancer control : journal of the Moffitt Cancer Center, 2009-01

JAMA, 2015-07-07

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-11-10

Cochrane Database Syst Rev, 2013 Apr 30

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-09-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-06-15

J. Natl. Cancer Inst.,

Breast Cancer Res. Treat., 2019 May 31

PLoS ONE, 2018 May 16

Cancer discovery, 2012-11

Clin Cancer Res, 2022 Apr 14

Breast cancer research : BCR, 2016-12-13

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-01-10

Cochrane Database Syst Rev, 2019 Feb 18

JAMA oncology, 2019-01-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-08-01

International journal of radiation oncology, biology, physics, 2007-07-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-12-01

Lancet Oncol., 2015-03-01

Ann. Surg. Oncol., 2013 Nov 23

The Lancet. Oncology, 2017-10

J. Clin. Oncol., 2019 Aug 28

JAMA oncology, 2017-11-01

Oncotarget,

Breast, 2013 Dec 22

Breast, 2015 Oct 09

NPJ Breast Cancer, 2016 Nov 16

Annals of surgery, 2019-03

Lancet (London, England), 2012-02-04

Annals of oncology : official journal of the European Society for Medical Oncology, 2018-08-01

Breast cancer research and treatment, 2008-01

Cancer, 1998-02-15

Cancer, 2010-04-15

Ann. Oncol., 2010 Jan 29

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-07-20

Curr Treat Options Oncol, 2019 Mar 14

Asian J Surg, 2019 Oct 26

SA J Radiol, 2018 Oct 29

Breast cancer research and treatment, 2016-04

J. Clin. Oncol., 2005 Feb 14

N. Engl. J. Med.,

Breast cancer research and treatment, 2011-07

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-05-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2005-06-01

N Engl J Med, 2005 Jun 2

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-10-10

N Engl J Med,

Cancer, 2016-04-15

JAMA, 2013-04-03

Ann. Oncol.,

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2017-09

Springerplus, 2016 May 10

JAMA dermatology, 2018-06-01

The New England journal of medicine, 2016-07-07

J Clin Oncol. , 2019 Sep 1

Breast cancer research and treatment, 2012-11

Breast Cancer Res Treat, 2014 Apr 12

Breast cancer research and treatment, 2017-08

Ann. Oncol.,

N. Engl. J. Med., 2019 Dec 11

The American journal of surgical pathology, 2017-11

Breast Cancer, 2016 Feb 13

Oncologist, 2020 Jul 03

The Lancet. Oncology, 2018-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2003-11-15

J. Clin. Oncol., 2010 May 10

BMJ (Clinical research ed.), 2010-03-02

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-01-01

Br. J. Cancer, 2013 Feb 05

Int J Radiat Oncol Biol Phys, 2010 Aug 21

JAMA Netw Open, 2020 Feb 05

Lancet Oncol., 2020 Feb 14

JAMA Oncol, 2019 Sep 30

JAMA,

N Engl J Med, 2020 Mar 27

J. Clin. Oncol., 2019 Jul 24

The Lancet. Oncology, 2010-10

Breast Cancer Res. Treat.,

Annals of surgical oncology, 2016-05

Oncology, 2020 Jan 09

Clinical cancer research : an official journal of the American Association for Cancer Research, 2009-02-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-05-01

The Lancet. Oncology, 2018-07

Anticancer Res.,

International journal of radiation oncology, biology, physics, 2005-07-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-04-20

J. Clin. Oncol., 2019 Dec 05

J. Clin. Oncol., 2019 Oct 16

Journal of the National Cancer Institute, 1998-09-16

Lancet (London, England), 2002-09-14

Journal of the National Cancer Institute, 2007-05-02

Lancet,

Breast Cancer Res. Treat., 2006 May 11

The New England journal of medicine, 2018-08-23

Lancet Oncol., 2020 Mar 12

The Lancet. Oncology, 2017-08

Lancet Oncol., 2009 Nov 10

J Clin Oncol, 2020 Apr 10

Breast cancer research and treatment, 2014-11

Curr Oncol Rep,

Mol Clin Oncol, 2019 Nov 29

Clin. Cancer Res., 2019 Oct 24

The American journal of surgical pathology, 2006-06

J Clin Oncol, 2019 Apr 11

The oncologist, 2013

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-11-10

Cancer Treat. Rev., 2012 Nov 28

Advances in radiation oncology, 2019

Cancer, 2016-12-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-05-20

Cancer Treat Rev, 2022 Mar 12

Chest,

Interact Cardiovasc Thorac Surg, 2014 Aug 20

Breast Cancer Res. Treat., 2017 Mar 21