Breast Cancer, Non-metastatic   

Questions discussed in this category



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...

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...

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

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...

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

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

What factors do you consider? Is your thought process at all different from your approach to boost with IDC?  Do you apply TROG 7.01 data (age ...

What resection margins are required for pure DCIS with adjuvant RT?  What resection margins are required for pure DCIS without RT? 

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

What advantages/disadvantages are there between assays or over traditional clinical pathologic factors? What other concerns do you have?

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? &...

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. 

(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 ...

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...

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...

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 ...

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+/...

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

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

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

Original question: Would you offer neoadjuvant chemo + keytruda for metaplastic breast adenosquamous low grade?

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

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?

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...

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

TNBC diagnosed in 2nd trimester. Neoadjuvant rx not given due to complicated pregnancy and went straight to surgery due to HR+ biopsy. Surgical pathol...

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

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

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

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.

<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.)...

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

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...


Papers discussed in this category


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Cancers (Basel), 2021 Dec 03

J Clin Oncol, 2021 Aug 18

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

N. Engl. J. Med.,

Lancet Oncol., 2014-06-01

The Lancet. Oncology, 2018-04

JAMA Oncol,

Nat. Med.,

Lancet Oncol., 2013 Dec 19

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J. Clin. Oncol., 2020 Sep 20

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Annals of Oncology, 2021 Sep 29

J Clin Oncol, 2021 Feb 04

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

Thromb Haemost,

J Clin Oncol, 2020 Oct 29

N Engl J Med, 2021 Jun 03

Ann Surg Oncol, 2019 Jul 24

J Clin Oncol, 2020 Mar 03

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-02-20

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-08-20

J Clin Oncol, 2015 Nov 1

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

Annals of oncology : official journal of the European Society for Medical Oncology, 2019-04-01

BMC Cancer, 2018 Mar 07

N Engl J Med,

JCO Oncol Pract, 2022 Jan 07

N. Engl. J. Med.,

J Clin Oncol, 2019 Apr 11

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

JAMA Oncol,

JAMA, 2011-02-09

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

Ann Oncol,

J Clin Oncol, 2021 Jun 06

JAMA oncology, 2017-11-01

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

Lancet Oncol, 2020 Aug 06

Clin Cancer Res,

J Natl Cancer Inst, 2011 Jul 09

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Am J Surg Pathol, 2021 Jun 10

Breast Cancer Res, 2020 Nov 04

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

PLoS One, 2013 Oct 09

Clin Breast Cancer, 2020 Oct 06

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

J. Clin. Oncol., 2018 May 30

Clin Cancer Res, 2017 Mar 07

Lancet Oncol, 2019 Dec 11

Ann Oncol,

The Lancet. Oncology, 2014-02

Ann. Oncol.,

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

Journal of the National Cancer Institute, 2011-11-16

Archives of pathology & laboratory medicine, 2016-01

Lancet Oncol,

J Clin Oncol, 2009 Apr 20

Clin Cancer Res,

Biomark Med, 2018 Dec 19

Biomark Med, 2019 Jun 25

The New England journal of medicine, 2004-09-02

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N Engl J Med,

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

Annals of oncology : official journal of the European Society for Medical Oncology, 2012-06

Br J Cancer, 2019 Jan 17

American journal of clinical oncology, 2016-10

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Annals of surgical oncology, 2013-05

Clinical breast cancer, 2016-04

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

International journal of radiation oncology, biology, physics, 2017-06-01

Oncology (Williston Park), 2021 Aug 13

Eur J Cancer, 2016 Dec 08

Oncologist,

J Clin Oncol, 2021 Aug 03

JAMA,

Acta Radiol Open, 2021 Apr 30

Lancet Oncol, 2021 Apr 20

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J. Clin. Oncol., 2014 Feb 10

J. Clin. Oncol., 2016-11-20

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Ann Surg, 2019 Jan

Anticancer Res,

Cancer, 2018-04-01

Breast cancer research and treatment, 2010-08

Breast cancer research and treatment, 2017-11

Front Genet, 2018 Dec 17

N Engl J Med, 2015 Jan 8

Front Oncol, 2020 Dec 03

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

JAMA Oncol,

J Clin Oncol, 2015 Sep 28

Lancet Oncol., 2015-03-01

Radiother Oncol, 2021 Jan

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

N Engl J Med, 2021 Dec 01

Clin Cancer Res, 2019 Nov 20

J Clin Oncol, 2020 Sep 16

Pharmacotherapy, 2010-02

Obes Surg,

BMC Cancer, 2020 Feb 20

N. Engl. J. Med.,

Cancer Sci,

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Lancet,

J Clin Oncol, 2022 Jan 18

Expert review of anticancer therapy, 2009-01

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

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Lancet, 2019 Dec 12

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

Lancet Oncol, 2010 Dec 07

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

Lancet Reg Health West Pac, 2021 May 13

J Clin Oncol, 2021 Jan 28

JAMA Oncol, 2020 Aug 13

J Clin Oncol, 2017 Jun 29

Pharmacotherapy, 2017 Jun 28

Annals of surgical oncology, 2019-10

Sci Rep, 2022 Jan 20

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

J Clin Oncol, 2022 Jan 19

Int J Cancer, 2021 Mar 18

Cancer Commun (Lond), 2019 Oct 21

Lancet Oncol., 2012-01-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-03-01

Annals of oncology : official journal of the European Society for Medical Oncology, 2014-05

Annals of oncology : official journal of the European Society for Medical Oncology, 2017-10-01

N Engl J Med,

Front Oncol, 2020 Sep 25

N Engl J Med,

Lancet, 2019 Feb 08

N Engl J Med,

N Engl J Med, 2022 Jun 05

J Natl Compr Canc Netw, 2021 Mar 24