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Breast Cancer, Non-metastatic   

Questions discussed in this category

What would be your treatment approach in a premenopausal BRCA2+ patient with cT2N0 grade 2-3, ER negative, PR variably positive (30%; staining weak to high), HER2 negative breast cancer?
Would you still treat with neoadjuvant KEYNOTE-522? 
3 Answers available
Do you offer adjuvant radiation therapy for a breast cancer patient with dermatomyositis?
If so, what dose-fractionation do you utilize? What other factors do you take into consideration?
2 Answers available
How do you approach the discussion of omission vs. inclusion of adjuvant radiation in patients with low to intermediate-grade DCIS?
For additional reading, see JCO OGR (11/2021) by Drs. @Warren and @Bellon reviewing the landscape of adjuvant treatment after lumpectomy for DCIS and ...
7 Answers available
What is the goal of estradiol levels on ovarian suppression and AI for breast cancer?
Would you recommend aiming for the postmenopausal range as per the lab reference range or do you have a specific goal?
1 Answer available
Do you discontinue an aromatase inhibitor in a patient if they have a cardiac event while on the drug?
Does the presence of other cardiac risk factors change your recommendation?
2 Answers available
What systemic therapy would you recommend for axillary recurrence of triple negative secretory breast cancer previously treated with mastectomy alone?
Initial path was T1cN0, and recurrence shows 2/21 ALN  involved with ENE, what would you recommend for therapy?
1 Answer available
How would you approach treatment for a post-menopausal woman with HR+ HER2- stage 3 papillary carcinoma of the breast?
Would you give neoadjuvant chemo or hormonal therapy or go with surgery first? What chemotherapy would you use? 
1 Answer available
What is your treatment approach in a patient with cT2 ER+HER2+ who refuses neoadjuvant chemotherapy?
2 Answers available
How do you incorporate DCISionRT testing in the setting of close (<2 mm) or positive DCIS margins?
3 Answers available
Would you offer neoadjuvant chemoimmunotherapy per KEYNOTE 522 for a patient with clinical stage IIB triple-negative breast cancer with apocrine histology or recommend surgery first?
2 Answers available
Would you consider omission of radiotherapy in patients 70 years and older with invasive ductal carcinoma who had initially positive lumpectomy margins, but had no residual disease upon re-excision?
2 Answers available
Should we start performing universal germline mutation testing for all newly diagnosed breast cancer?
Given OlympiA trial with olaparib benefit for gBRCA+ patients?What are barriers that you foresee? In your practice who performs mutation testing and w...
5 Answers available
Would you give chemotherapy to a post menopausal woman with ER/PR positive HER2 negative breast cancer, T2N1 with 3+ lymph nodes, Ki-67 30% and OncoType RS of 10?
4 Answers available
Would you drop carboplatin/paclitaxel weeks or considering shortening duration of treatment in a BRCA1+ patient with synchronous TNBC (left 2.4 cm tumor, right 9 mm tumor) who has complete response on interim breast ultrasound?
Would you offer adjuvant radiation therapy if pCR is confirmed? 
1 Answer available
Would you send Oncotype for pre-menopausal women with HR+, HER2(-) breast cancer with a small tumor (pT1b) and micrometastatic LN involvement or recommend adjuvant chemotherapy without sending Oncotype?
1 Answer available
Would you treat a patient with cT2 ER+/HER2+ breast cancer with neoadjuvant HER2 directed therapy if HER2 positivity is group 3?
Group 3 being ratio < 2, copy # >6, and IHC 2+
1 Answer available
How do you respond to a patient who asks "Why do I still need breast radiation after chemotherapy if chemotherapy treats the whole body?"
This patient had a T1N0, ER/PR negative, HER2 negative breast cancer
6 Answers available
For patients with triple negative breast cancer who have a minimal response to neoadjuvant chemotherapy, do you do additional testing to sub-categorize the cancer and find a potential target (e.g. androgen receptor, etc)?
7 Answers available
How strict are you about adhering to the eligibility criteria required for entry onto the OlympiA trial in considering a year of adjuvant olaparib as adjuvant therapy for BRCA mutated, node positive, ER positive breast cancer?
If a patient had a CPS-EG of 2 after neoadjuvant therapy, would you offer that patient olaparib even though she wouldn't have met entry criteria? If t...
2 Answers available
Do you treat early stage multifocal breast cancer similarly to single site lesion?
How does it affect your calculation of risk stratification? 
1 Answer available
How should we think about endocrine resistance in patients with inherited germline mutations such as BRCA, CHEK2, etc.?
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...
1 Answer available
In which scenarios do you stage breast cancer using CT and nuclear bone scans versus PET-CT?
3 Answers available
How would you manage a premenopausal patient with HER-2 positive DCIS in the setting of a prior HER-2 positive contralateral breast cancer?
The patient had a prior right-sided ER+ HER2-ve breast cancer, treated with neoadjuvant chemotherapy, MRM with ALND, and PMRT They recently developed...
1 Answer available
Would you consider administration of neoadjuvant anthracycline for cT2N1 ER+/PR+/HER2- patients given that this may be excessive for N1 disease, or do you wait until nodal status is confirmed on surgical pathology? 
How do you stage and evaluate premenopausal patients with >= cN1 ER+ PR+ HER2- breast cancer prior to surgery to avoid this pitfall?
1 Answer available
In which scenarios do you use vaginal estrogen in patients with history of HR positive breast cancer?
Do you feel differently about using these in patients with a history of HR-negative breast cancer?
1 Answer available
When would you feel comfortable with patients who have a history of hormone-receptor positive breast cancer using hormonal IUDs (e.g. Mirena)?
2 Answers available
How do you treat a patient with TNBC, BRCA WT, who received KEYNOTE 522 with residual disease post neoadjuvant therapy?
Would you offer adjuvant Pembrolizumab combined with Capecitabine?
3 Answers available
How would you approach a postmenopausal patient on Letrozole who developed cataracts within the first six months of treatment?
1 Answer available
What is your treatment approach in patients with early breast cancer with axillary soft tissue involvement, with or without concurrent lymph node involvement?
2 Answers available
Would you ever consider managing HR+ DCIS non-surgically?
If so, in what situations?
1 Answer available
Do you consider post-NAC isolated tumor cells in LNs to be residual disease in TNBC to justify capecitabine?
Would clinical stage or nodal status affect your decision?
2 Answers available
Are there any scenarios you would use CDK 4/6i to treat HR-positive HER2-positive breast cancer in combination with anti-HER2 agents?
1 Answer available
How would you approach a cT4 cN2 (22 cm in size) TNBC that shrank to 9 cm with KN-522 regimen but remains inoperable at the end of treatment?
Both sets of CT scans pre and post- chemoimmunotherapy show no evidence of distant mets.
4 Answers available
In light of the NSABP B51 data presented at SABCS, will you defer RNI in all patients with negative nodes after chemotherapy?
Are there any subgroups that would still benefit from RNI?
4 Answers available
In a patient with early stage HER2+ breast cancer s/p surgery, would you consider a noncytotoxic chemotherapy approach with anti-Her2 therapy alone if the PS is borderline and/or patient declines chemotherapy?
1 Answer available
If a patient is unable to tolerate one CDK 4/6 inhibitor, do you switch to a different one?
For example, a patient has had multiple dose reductions for neutropenia and required an admission for infection while on palbociclib. Would you switch...
3 Answers available
What are your top takeaways from SABCS 2023?
4 Answers available
What is your cut off on ER percent positivity to treat breast cancer as functional triple negative cancer?
Do you take PR percent into account?
2 Answers available
How do you decide whether to offer tamoxifen or OFS + AI in premenopausal patients with metastatic ER+ HER2+ breast cancer as your endocrine therapy?
What data may support the routine escalation of endocrine therapy? Should HER2 therapy be prioritized instead?
1 Answer available
Would you offer OFS 5 years out from diagnosis in a young patient whose menses have returned with previously treated IDC?
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 ...
1 Answer available
Is there a role for adjuvant pembrolizumab/capecitabine in a patient with TNBC who receives neoadjuvant AC-T with residual disease found at time of surgery?
3 Answers available
Would you recommend axillary lymph node dissection in a pre-menopausal woman with ER+ PR+ HER2- IDC, s/p lumpectomy and SLN with pT1c pN1 cM0 disease, where 2 sentinel nodes are positive for macrometastasis and 1 SN is positive for micrometastasis?
1 Answer available
How do you approach a breast cancer patient with outside pathology returning as HER2 positive on FISH but internal pathology review showing conflicting results and HER2 negative on FISH on same sample?
1 Answer available
What are your top takeaways from ESMO 2023?
9 Answers available
Are you offering chemotherapy for premenopausal patients with HR+ node-positive breast CA with OncoType dx scores in the intermediate range of 11-25?
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...
3 Answers available
For which patients, if any, do you typically order additional imaging workup for staging in early-stage breast cancer?
3 Answers available
Is it okay to send an Oncotype solely for prognostic purposes to a patient who doesn't want chemotherapy or an elderly patient with poor PS?
Would you consider doing this in patients with adverse features such as grade 3 or PR negative status? 
1 Answer available
How would you manage a HR+/HER2+ breast cancer patient with no response during neoadjuvant TCHP?
1 Answer available
Which chemotherapy is preferred between TC and AC-T in a young patient with ER+/PR+/HER2- node negative breast cancer, intermediate grade, with high OncoType score? 
3 Answers available
How long would you recommend a woman with HR+ node-positive breast cancer treated with surgery and chemotherapy during pregnancy can breastfeed, prior to starting adjuvant endocrine therapy?
2 Answers available
What alternate neo-adjuvant backbone chemotherapy would you recommend in a patient with ER+ HER2+ clinical stage II breast CA with severe pan-colitis following a cycle of TCHP with docetaxel?
3 Answers available
What neoadjuvant regimen would you consider using for a healthy patient with node positive TNBC who is refusing anthracycline?
2 Answers available
How would you manage a patient who develops acute stroke during neoadjuvant chemotherapy with KEYNOTE-522 for Stage III triple negative breast cancer?
Would you continue KEYNOTE-522 neoadjuvant therapy? The patient has a PMH of sarcoidosis with no stroke risk factors. No residual deficits. 
1 Answer available
Would you recommend adjuvant abemaciclib for ER+ HER2 neg inflammatory breast cancer who do not achieve pCR with neoadjuvant chemotherapy?
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...
2 Answers available
Would you consider chemoimmunotherapy (CP-Pembro-AC) in triple negative breast cancer if tumor is not palpable on physical exam?
If yes, how do you assess the tumor response and how frequently while on neoadjuvant chemoimmunotherapy?
1 Answer available
Would you still obtain Ki-67 prior to use of adjuvant abemaciclib in a patient who has otherwise met MonarchE treatment criteria, such as 1-3 positive LNs, grade 3 and/or tumor >5 cm?
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 ...
1 Answer available
How would you manage a premenopausal woman with DCIS who has a contraindication to tamoxifen?
Would you consider offering ovarian suppression?
1 Answer available
How would you treat a post-menopausal woman with recurrent breast cancer, T1bN0 HR+ (ER/PR > 90%), HER2- s/p lumpectomy and adjuvant RT with low oncotype of 6?
Is deferring chemotherapy based on low oncotype acceptable in setting of recurrence?    Would you recommend using a different AI, Tam...
2 Answers available
How would you approach adjuvant systemic therapy in a HR+ premenopausal patient over the age of 50?
Would you recommend using chemotherapy based on RxPonder regardless of Oncotype score in a premenopausal patient? Or would you hold chemotherapy since...
2 Answers available
How would you treat a patient with T1c HR-, HER2+ breast cancer, stage IV, with involvement of multiple bilateral axillary nodes and no evidence of distant metastasis?
2 Answers available
Would you consider giving hormone replacement therapy to a patient with atypical ductal hyperplasia with no alternative options to manage postmenopausal symptoms?
1 Answer available
How would you treat a patient with TNBC with a residual strongly PR+, ER- breast mass on mastectomy after neoadjuvant KEYNOTE 522 based chemoimmunotherapy?
Would you consider using endocrine therapy, pembrolizumab, capecitabine, or CDK 4/6 inhibitor?
1 Answer available
Can you safely proceed with breast irradiation during treatment with immunotherapy?
For a node positive, triple negative patient that underwent neoadjuvant chemotherapy followed by breast conservation with a complete pathologic respon...
2 Answers available
In a patient with local recurrence of breast cancer after mastectomy, how would you sequence adjuvant treatment after wide local resection?
Assuming the patient had no prior radiation and has no evidence of metastatic disease, would you start with adjuvant radiotherapy or adjuvant systemic...
1 Answer available
Do you recommend axillary dissection for women with ER+ breast cancer and low risk Oncotype or Mammaprint if single node positive with only 1-2 SLN removed, to ensure <4 nodes positive?
4 Answers available
In a patient with ER+/HER2+ breast cancer with significant residual disease post neoadjuvant TCHP, is there a role of using CDK4/6i in the adjuvant setting with T-DM1?
1 Answer available
What is your approach for adjuvant therapy when a patient has discordant Oncotype RS (e.g. <20) and MammaPrint (e.g. high risk Luminal B) in node negative HR+Her2- breast cancer?
2 Answers available
Would you offer adjuvant olaparib to a male patient with HR+, HER2- T2N0 breast cancer with a BRCA2 germline mutation following mastectomy who is not a candidate for adjuvant chemotherapy?
2 Answers available
In which patients do you offer adjuvant bisphosphates in breast cancer treatment?
1 Answer available
Would you give adjuvant endocrine therapy to a premenopausal woman with early stage node positive breast cancer that was ER negative, PR positive (60%) and HER2 positive?
She achieved PCR with NAC with TCHP and is now on adjuvant HP. 
2 Answers available
Do you use Oncotype to predict chemo benefit on all localized HR+ patients per TAILORx criteria or do you use your judgement and skip it in T1b-c grade 1 or grade 2 tumors?
3 Answers available
How do you approach adjuvant therapy to minimize cardiotoxicity in early stage node negative HER2+ HR+ breast cancer with history of chest wall radiation and previous cardiotoxic agents for Hodgkin Lymphoma?
1 Answer available
What are your top takeaways in Breast Cancer from ASCO 2023?
4 Answers available
What chemotherapy regimen would you use for a woman with pre-existing neuropathy causing imbalance, who now has a T1N0 ER+ and Her2+ breast cancer?
1 Answer available
Would you offer adjuvant Abemciclib to ER positive HER2 negative with 1 LN positive, Ki-67 >20%, and low Oncotype?
Tumor 3 cm, grade 2 with Ki-67 25%
1 Answer available
How do you interpret the EBCTCG meta-analysis analyzing the magnitude of benefit of anthracyclines in early stage ER+ breast cancer?
How do you reconcile these findings with the ABC trials?
3 Answers available
For patients with prior HR+HER2- localized breast cancer currently receiving adjuvant endocrine therapy, is there a time period in which you would no longer recommend adding adjuvant abemaciclib?
(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 ...
3 Answers available
What adjuvant treatment approach would you choose for a premenopausal woman with lymph node positive poorly differentiated metaplastic breast cancer that is ER low+, PR+, HER2 negative?
Is there a role for KEYNOTE-522 since ER + metaplastic breast cancer have similar behavior to triple negative metaplastic breast cancer? 
1 Answer available
How do you approach the discussion with a patient who is seeking proton therapy for early stage breast cancer?
What is your approach to try to persuade her that photons would be a better option?
6 Answers available
What alternative regimens would you consider to neoadjuvant TCHP in setting of national carboplatin shortage for locally advanced HER2+ breast cancer?
1 Answer available
What dose and formulation of GnRH agonist do you use for ovarian suppression in young breast cancer patients?
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?
1 Answer available
Would you offer OFS/AI alone or with the addition of chemotherapy in a premenopausal female with ER+/PR+ breast cancer with microscopic LN involvement and an OncoTypeDx score <11?
1 Answer available
In what scenarios do you consider omitting adjuvant endocrine therapy after lumpectomy for DCIS?
How strongly would you recommend it for a grade 1, < 1 cm DCIS?
2 Answers available
Do you modify your choice of systemic therapy for localized early stage ER+/PR+ HER2- breast if Mammaprint shows basal subtype?
2 Answers available
In an early stage breast cancer post neoadjuvant chemotherapy, do you repeat ER/PR and HER2 status on the surgical specimen if there is residual disease?
The surgeons at our institution are asking for repeat markers but I am not aware of any data or guidelines to support this. 
4 Answers available
Would you offer endocrine therapy to a patient who developed a new contralateral pT1b pN0 ER/PR+ HER2- breast IDC 1 year after coming off 10 years of anastrozole for prior invasive breast cancer?
2 Answers available
Would you offer adjuvant abemaciclib plus endocrine therapy for favorable histology ER+/PR+/HER2-negative tumors such as pure tubular, mucinous, cribriform, or papillary that otherwise meet MonarchE trial criteria?
MonarchE trial criteria includes "patients with four or more positive nodes, or one to three nodes and either tumor size ≥ 5 cm, histologic grade 3...
2 Answers available
How do you discuss use of tamoxifen in your stage I breast cancer patients who are > 80 years old weighing in risk of VTE with benefit from adjuvant treatment?
Assuming aromatase inhibitor is not an option due to severe osteoporosis or if it is a man with breast cancer. 
1 Answer available
In which situations do you offer ovarian suppression with chemotherapy to prevent the development of premature menopause in premenopausal women with ER negative breast cancer?
Fertility preservation already complete with embryo cryopreservation
1 Answer available
Do you utilize Mammaprint testing to determine whether or not to offer neoadjuvant chemotherapy for high risk ER+ breast cancer?
2 Answers available
In which situations do you consider post-mastectomy radiation therapy when the patient has a localized node-positive breast cancer with a complete nodal response and minimal residual disease in the breast post-neoadjuvant chemotherapy?
1 Answer available
Would you consider omitting platinum from neoadjuvant chemotherapy in women > 50 years of age with localized triple negative breast cancer?
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...
2 Answers available
Would you consider using anthracycline for treating a Stage I triple negative breast cancer in a patient with a baseline mildly reduced LVEF 50-55%?
2 Answers available
What neoadjuvant therapy will you give to a premenopausal woman with cT2N0 metaplastic triple negative breast cancer?
3 Answers available
Would you consider using Breast Cancer Index to make decisions about extending AI therapy in patients who completed 5 years of AI, given recent data presented at SABCS 2022 about validation of BCI in IDEAL trial?
If so, which patient population would you use this in? 
2 Answers available
Would you offer anti-HER2 therapy to a patient found to have heterogenous HER2+ residual disease after original treatment for TNBC using the KEYNOTE-522 regimen?
Markers from surgical path showed ER0PR0 HER2 2+ and positive via FISH in 5% of total tumor population. 
1 Answer available
What is the appropriate time to initiate adjuvant chemo/endocrine therapy for premenopausal ER/PR+, HER2 negative early stage breast cancer with moderate Oncotype following breast conserving surgery?
1 Answer available
Do you recommend prophylactic anticoagulation to pregnant women undergoing chemotherapy for breast cancer?
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...
1 Answer available
How does the potential for a patient to accept or forego adjuvant tamoxifen factor into your recommendations on adjuvant RT for DCIS?
Are there specific patient populations in which you may feel comfortable with a patient selecting only one adjuvant therapy approach (tamoxifen vs RT)...
3 Answers available
Do you ever utilize an anthracycline based regimen rather than a non-anthracycline based regimen for patients with locally advanced HER2 positive breast cancer?
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...
6 Answers available
Would you utilize OncotypeDX to guide decision making for a male with ER+ HER2- breast cancer and 1-3 positive sentinel lymph nodes?
3 Answers available
What are the current timing recommendations for initiating radiation after lumpectomy?
The prior recommendations were between 6-12 months, but also were based on chemotherapy after surgery. 
2 Answers available
Does a pathologic complete response in the breast and axilla change your radiation recommendations?
In a woman with high-grade, clinically node positive invasive ductal carcinoma who receives neoadjuvant chemotherapy and breast conserving surgery, wo...
3 Answers available
How would you continue management of a patient with clinical stage II cN+ HR+ HER2+IDC with grade 3 diarrhea after 1 cycle of neoadjuvant TCHP?
2 Answers available
Would you order an OncoType DX test on a <50 year old woman with T2 N1mi HR+ HER2- breast cancer?
1 Answer available
How do you use baby tam, low dose tamoxifen, in your practice?
1 Answer available
Would you offer neoadjuvant chemoimmunotherapy to a woman with clinical T3 N0 M0 triple negative metaplastic breast cancer?
1 Answer available
What are your top takeaways from SABCS 2022?
5 Answers available
In the neoadjuvant setting, how would you treat a premenopausal woman with a 3 cm ER+, PR weakly positive, Her-2 negative, grade 3 breast cancer with clinical N1 node which shows basal type on Mammaprint?
What subsequent adjuvant therapy would you recommend?
4 Answers available
Would you treat a Stage I ER/PR positive HER2 negative breast cancer differently if it is associated with Lynch syndrome?
3 Answers available
How are you using predictive tests such as DCISionRT (PreludeDx) or OncotypeDX DCIS in the management of DCIS?
What advantages/disadvantages are there between assays or over traditional clinical pathologic factors? What other concerns do you have?For additional...
4 Answers available
Would OncotypeDx impact your decision to provide adjuvant chemotherapy for node-negative HR+ breast cancer with dermis or chest wall involvement?
Would you recommend adjuvant chemotherapy for pT4 disease regardless of Oncotype score?
1 Answer available
Do you provide prophylactic anticoagulation with abemaciclib in the adjuvant setting given known thrombosis risk?
Would you offer it to a woman with a history of a provoked DVT?
1 Answer available
Is there value to OncoType Dx and/or NGS testing for mutations such as ESR1 in patients who have ipsilateral isolated resectable skin recurrence in ER+ positive low Oncotype breast cancer 10 years after mastectomy and adjuvant AI for 5 years?
1 Answer available
Does the magnitude of OncoType recurrence score above 26 inform decision between TC and AC/T in ER+ HER2- 1-3 node positive, postmenopausal patients with breast cancer?
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?
1 Answer available
How far can you dose reduce abemaciclib for a patient who is having toxicity at starting doses?
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?
6 Answers available
Does the magnitude of benefit with 2 years of adjuvant abemaciclib outweigh side effects, given that many patients will receive CDK 4/6 inhibitors at breast cancer recurrence, precluding OS benefits?
MonarchE shows statistically significant improvement in IDFS and DRFS, but the magnitude of absolute benefit is modest (3-year IDFS and DRFS rates = 5...
6 Answers available
What would be your preferred dosage and schedule for leuprolide for ovarian suppression alongside endocrine therapy for the treatment of breast cancer?
Some payors prefer leuprolide acetate injectable suspension (eligard) for ovarian suppression. This is not the preparation that was used in SOFT/Text ...
1 Answer available
Do you prefer using an anthracycline or non-anthracycline adjuvant regimen in BRCA+ premenopausal patients with localized HR+ breast cancer?
Assuming chemotherapy is indicated because of the Oncotype score. 
1 Answer available
Will you offer adjuvant abemaciclib to breast cancer patients with high Ki-67 who are unable to receive either neoadjuvant or adjuvant chemotherapy due to comorbidities or who decline chemotherapy?
Majority of patients on MonarchE received neoadjuvant/adjuvant chemo.  Does the availability of abemaciclib impact your decision to offer chemo ...
4 Answers available
Would you consider switching endocrine therapies for a peri-menopausal woman on adjuvant tamoxifen solely due to an estradiol level if this was checked and found to be significantly elevated?
Patient had estradiol level checked by her gynecologist due to recent irregular bleeding. Estradiol level was markedly elevated on initial testing (90...
2 Answers available
For a patient requiring adjuvant endocrine therapy for localized breast cancer, would you use fulvestrant if they were intolerant to both aromatase inhibitor and tamoxifen?
3 Answers available
What adjuvant therapy would you offer an elderly but healthy patient with T2N1 HR+ HER2+ breast cancer who is not willing to receive cytotoxic chemotherapy?
1 Answer available
Do you utilize Oncotype DX DCIS score to decide on the need and duration of endocrine therapy in patients with DCIS?
1 Answer available
How do you plan to use adjuvant denosumab in patients with hormone positive breast cancer given the survival advantage seen in the ABCSG-18 trial?
Do you look into their stage/risk to decide? Since patients can experience bone loss after stopping denosumab, how do you plan to discontinue?
1 Answer available
Do you need to wait for estradiol and FSH levels to normalize before you can switch from tamoxifen to an AI for a pre-menopausal woman with ER+ breast cancer?
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...
1 Answer available
When would you use adjuvant abemaciclib in patients with clinically high-risk ER+, HER2-negative breast cancer, but pCR following neoadjuvant chemotherapy?
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...
1 Answer available
What would be your adjuvant treatment approach for patients with hormone receptor-positive breast cancer who have not responded to neoadjuvant aromatase inhibitor endocrine therapy?
Would you use a different endocrine therapy treatment? Would you use indicators other than Oncotype to guide the need for chemotherapy?
1 Answer available
Are there any contraindications to BCS and adjuvant radiotherapy in patients with BARD1 mutation?
1 Answer available
Would you offer adjuvant AI + abemaciclib to a post-menopausal, node + luminal A breast cancer that did not require chemotherapy per Oncotype, yet still met criteria per monarchE?
- 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...
1 Answer available
Would you offer neoadjuvant chemotherapy to cT1c N0 triple negative breast cancer with metaplastic features in a young patient?
2 Answers available
For premenopausal patients with ER+ PR+ HER2 negative breast cancer and lymph node micrometastases, would recurrence score be most appropriately interpreted based on TAILORx data, given such patients were excluded from RxPONDER?
1 Answer available
Do you advocate for dose dense AC instead of every 3 week dosing in neoadjuvant TNBC as done in KEYNOTE 522?
2 Answers available
What are your top takeaways in Breast Cancer from ASCO 2022?
What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...
12 Answers available
What is your process for assessing the "high risk" clinical features in gBRCA+ breast cancer in order to offer olaparib, given varying definitions of risk and recent changes in staging guidelines?
Definitions for "high risk" differ by whether patients receive neoadjuvant chemo and across other contemporary studies. Does the change in AJCC stagin...
3 Answers available
Will you offer adjuvant olaparib to patients with somatic BRCA mutated breast cancer given that OlympiA only enrolled germline BRCA+?
Do you perceive a difference between somatic vs germline BRCA mutations? 
2 Answers available
What is the appropriate timeline to start post mastectomy chest wall/regional nodal XRT (+/- reconstruction) after surgery?
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...
1 Answer available
What neoadjuvant regimen would you give a patient with multicentric IDC consisting of TNBC and concurrent ER/PR- HER2+ breast cancer with ER/PR- HER2+ axillary LN mets?
2 Answers available
If you have a high risk HR+, BRCA+ breast cancer patient who qualifies for adjuvant olaparib and abemaciclib, which one would you give and why?
Would you ever consider using these in sequence?
4 Answers available
What is your approach to adjuvant hormone therapy for HR+ breast cancer in post-menopausal women with pre-existing osteoporosis?
Would you consider omitting treatment if small tumor and early stage? Or would you use tamoxifen?
2 Answers available
How would you approach a locally recurrent HER2 positive breast cancer patient previously treated with TCHP, lumpectomy, and a year of adjuvant TDM-1?
Patient was initially ER positive, HER2 positive. Currently she is on letrozole. Recurrence is ER/PR negative and HER2 positive and developed almost 2...
1 Answer available
Would you be comfortable starting tamoxifen for a HR+ breast cancer patient with a history of early stage endometrial cancer treated via hysterectomy?
1 Answer available
Would you consider adjuvant olaparib in a patient with HER2+, high-risk, early stage breast cancer with germline BRCA mutation?
OlympiA trial did not include her2+ breast cancer. 
3 Answers available
Would you recommend adjuvant olaparib in a premenopausal BRCA1+ woman with stage IA pT1bN0 ER/PR+ HER2- breast cancer and a high OncoType score?
The OncotypeDx score was 51 in this scenario. 
3 Answers available
Would you offer PMRT to a perimenopausal female with a single positive LN with microscopic ENE who has otherwise low risk features?
2 Answers available
Would you provide the KEYNOTE-522 regimen for a patient with ER low, PR+, HER2- stage IIIb breast cancer?
ER low being 1-9% (<10%), PR 20%
1 Answer available
What is your preferred adjuvant therapy for a patient with triple negative breast cancer and has a BRCA germline mutation who had minimal to no response to neoadjuvant chemotherapy?
Young patient, germline BRCA carrier with cT1cN0 to ypT2N0 disease after docetaxel/ cyclophosphamide x 4.
2 Answers available
What treatment would you provide for a patient with bilateral synchronous locally advanced cT4dN0 TNBC and cT1b ER+ HER2+ breast cancer?
Would you proceed with KEYNOTE 522 regimen and add anti-HER2 targeted therapy adjuvantly?
2 Answers available
Would you provide abemaciclib to a premenopausal women with cT2 cN1 ER+ breast cancer and Ki67 of 80% who achieves pCR following neoadjuvant AC-T?
What would you offer a premenopausal woman with clinical T2N1 ER positive breast cancer for adjuvant therapy after she achieves a pathologic complete ...
1 Answer available
How would you adjust therapy for a HER2+ breast cancer patient found to have elevated LFTs while on TCHP?
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...
1 Answer available
Would you offer adjuvant chemotherapy to a post menopausal woman with T1-T3 primary tumor with 4 positive axillary LNs and OncotypeDX score less than 15?
2 Answers available
How would you approach a patient who has developed neutropenia with the combination of trastuzumab/pertuzumab in the adjuvant setting?
Would you consider the discontinuation of either anti-HER2 agent or both?
1 Answer available
Is Oncotype testing useful in variant histologies such as micropapillary breast cancer?
2 Answers available
What adjuvant therapy would you offer a post-menopausal CHEK2+ patient with HR+ HER2+ T1bN1 breast cancer and concurrent HR+ HER2- T1N0 disease?
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...
1 Answer available
How do you approach the decision to boost patients diagnosed with DCIS?
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 <...
4 Answers available
What resection margins are required for DCIS with a component of invasive disease?
What resection margins are required for pure DCIS with adjuvant RT? What resection margins are required for pure DCIS without RT? For additi...
5 Answers available
How would you approach treatment for a pre-menopausal patient with PR-positive, ER-negative, HER2-negative cT1c N1 breast cancer?
Should these cancers be treated like hormone positive breast cancer or triple negative breast cancer? She is pre menopausal with cT1c grade 2 disease...
1 Answer available
Would you consider avoidance of AC and proceeding to surgery in a cT2N0 TNBC patient who achieves a significant clinical response to carboplatin, paclitaxel, and pembrolizumab as part of the KEYNOTE-522 regimen?
What scenarios would you do second neoadjuvant treatment vs surgery?
1 Answer available
Would you give chemotherapy and trastuzumab to a patient with multifocal high grade, microscopic (<5mm) HR-, HER2+ IDC embedded in extensive DCIS, staged as pTis pT1a(m) N0?
1 Answer available
For a patient with breast cancer s/p lumpectomy found to have a heterozygous RAD50 mutation, is adjuvant radiation appropriate therapy or would you recommend completion mastectomy?
1 Answer available
What adjuvant chemotherapy regimen do you recommend for a patient with T1cN0 TNBC?
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? &...
4 Answers available
Given new OS data in the OlympiA trial, would you offer adjuvant olaparib to a pT1bN0 TNBC patient?
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...
1 Answer available
Would you offer adjuvant chemotherapy to a woman in her 40's s/p TAHBSO with T2N1 ER+/PR+ breast cancer with oncotype score 21-25?
How much of the benefit of adjuvant chemotherapy do you expect to be due to ovarian function suppression due to the chemotherapy?
2 Answers available
What adjuvant treatment would you recommend for a patient with node positive TNBC who did not receive neoadjuvant chemotherapy?
2 Answers available
Can docetaxel be safely given to patients with hyperbilirubinemia from Gilbert’s syndrome?
Is dose modification of docetaxel necessary with Gilbert's when giving TCHP?
1 Answer available
Do you offer adjuvant bisphosphonates to high-risk premenopausal women on ovarian suppression for early-stage breast cancer who would want to consider pregnancy in the future?
Which agents would you select and for how long would you treat them?
1 Answer available
In which situations do you offer neoadjuvant chemotherapy for a nodal recurrence alone of ER/PR positive, HER2 negative breast cancer?
Patient is young and reoccurrence is one year after initial diagnosis of T1cN0 ER/PR positive, HER2-negative breast cancer treated with mastectomy, bu...
1 Answer available
Would you recommend tamoxifen x 5 years following mastectomy in a male with pure DCIS?
1 Answer available
What additional benefit does radiation offer for a patient <65 years old with T1aN0 ER+ invasive carcinoma (tubular histology) of the breast?
1 Answer available
Do you plan to offer adjuvant olaparib to all gBRCA+ breast cancer whether TNBC or HR+?
In subset analyses of OlympiA there seems to be smaller magnitude of benefit among HR+ patients. In your opinion, should adjuvant olabarib be offered ...
3 Answers available
Would you offer adjuvant hormonal therapy for premenopausal woman with positive margin HR+ DCIS after a bilateral mastectomy?
ER 95%
1 Answer available
How would you treat a post-menopausal woman found to have a node-negative ipsilateral HR+ breast cancer recurrence with pectoral muscle invasion following a prior mastectomy, radiation, and AI therapy completed > 5 years ago? 
1 Answer available
How would you approach adjuvant therapy for a post-menopausal women with cT2 cN0 TNBC on biopsy s/p neoadjuvant chemotherapy and mastectomy who is later found to have RCB2 HR+ breast cancer on surgical pathology?
HR+ = ER 34%, PR 0% RCB2 = no nodal involvement
1 Answer available
Would you restart endocrine therapy for a patient with new contralateral LCIS diagnosed 2 years following completion of AI therapy for stage 1A HR+ IDC?
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...
1 Answer available
What is your approach to chemoprevention for HR+ DCIS in the ipsilateral breast in a patient who already completed 7 years of an AI for a prior HR+ invasive breast cancer?
Patient underwent mastectomy for DCIS in the setting of previous lumpectomy and adjuvant radiation for the invasive breast cancer. 
2 Answers available
How would you approach treatment for a HR+ HER2+ clinical T1c N0 male breast cancer?
3 Answers available
Would you consider giving neoadjuvant therapy using a KEYNOTE-522 regimen to someone with cT1c cN0 TNBC?
How would you proceed given that cT1c didn't meet the study criteria? 
1 Answer available
How would you approach a patient whose stage II TNBC tumor is visibly progressing on the KN-522 neoadjuvant regimen?
Currently on C2 of doxorubicin/cylophosphomide/pembro. Would you expedite surgery?
2 Answers available
In patients who receive neoadjuvant pembrolizumab and chemotherapy for TNBC, how will you manage adjuvant treatment if they have a germline BRCA mutation?
Would you continue pembrolizumab? Would you introduce olaparib? If using both, how would you sequence? 
5 Answers available
How and on which specimens will you perform Ki-67 testing in newly diagnosed breast cancer?
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...
4 Answers available
How would you treat an elderly patient with borderline cardiac dysfunction who has stage 3 HR+ HER2- breast cancer?
2 Answers available
How do you incorporate oncotype Dx recurrence score when planning adjuvant CDK 4/6 inhibitor for high risk early stage HR+ breast cancer?
1 Answer available
How would you treat an elderly female with residual TNBC following surgery and neoadjuvant Carboplatin and Paclitaxel?
Assume normal cardiac function and no obvious co-morbidities. No anthracycline previously due to age alone. The patient’s BRCA status is unknown...
1 Answer available
Would you consider dual anti-HER2 therapy for a perimenopausal woman found to have multifocal pT1mic pN1mic HER2+ HR- breast cancer following a bilateral mastectomy for DCIS?
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...
3 Answers available
How do you adjust Tamoxifen use in HR+ patients with a history of gastric bypass?
Is there any utility in monitoring serum tamoxifen levels?
1 Answer available
Would you offer adjuvant abemaciclib to node-positive patients with low ER expression?
For instance, ER/PR >1% but <10% and Ki67 >50%
3 Answers available
What adjuvant therapy would you offer a TNBC patient with residual disease after receiving the neoadjuvant KEYNOTE-522 regimen?
1 Answer available
How do you sequence capecitabine and olaparib, if at all, in patients with BRCA+ TNBC and residual disease after neoadjuvant chemotherapy?
5 Answers available
How would you approach systemic therapy for a pre-menopausal woman with ER+/PR+/HER2 positive breast cancer who had a local recurrence 6 months after completing adjuvant TCH and a year of trastuzumab + tamoxifen?
Would you consider neoadjuvant or adjuvant treatment and if so, which therapies? Patient initially had pT2N0 disease and recurrent disease is also ER+...
1 Answer available
How would you approach systemic therapy for a young post-menopausal woman with locoregional TNBC chest wall recurrence treated with definitive radiation?
Patient previously received neoadjuvant ddAC-T with residual disease at surgery, followed by adjuvant capecitabine which was completed 2 months prior ...
1 Answer available
Would you consider adjuvant olaparib in a premenopausal female with TNBC with high risk features and germline BRCA1 mutation who achieved pCR after neoadjuvant chemotherapy?
Does not meet Olympia trial indication
1 Answer available
Is there a role for adjuvant capecitabine in sequence with abemaciclib for high risk HR+ breast cancer with residual disease?
In high-risk, node-positive HR+ Her-2 neg breast cancer patients who received neoadjuvant chemotherapy with residual disease, would you give capecitab...
1 Answer available
For women with HR+ breast cancer and low libido due to endocrine therapy, would you consider flibanserin therapy?
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...
1 Answer available
Do you send OncotypeDx testing in breast cancers with mucinous histology?
3 Answers available
How do you approach treatment in premenopausal patients who develop a contralateral HR+ breast cancer while already on tamoxifen and ovarian function suppression?
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+/...
2 Answers available
How do you view the use of adjuvant CDK4/6 inhibitors overall given discordant results between MonarchE and PALLAS?
Are there factors to explain why MonarchE was a positive study and PALLAS was not? 
4 Answers available
How do you counsel post-menopausal patients with HR+ breast cancer who are interested in taking medroxyprogesterone?
1 Answer available
In a premenopausal HR+ patient with pT2 pN0(i+) disease and RS<16, does the presence of isolated lymph node tumor cells affect your decision to avoid chemotherapy?
Oncotype score in this case was 14. 
1 Answer available
Would you offer adjuvant abemaciclib + an aromatase inhibitor to a patient with a local HR+HER- breast cancer reoccurrence while on tamoxifen that meets high-risk criteria?
High-risk criteria meaning >4 positive nodes and Ki67 >20%
3 Answers available
Is there any role for neoadjuvant chemotherapy for low grade adenosquamous metaplastic TNBC?
1 Answer available
Is there any adjunct therapy to help with tamoxifen-induced leg cramps?
1 Answer available
How have you been incorporating Abemaciclib into the adjuvant management of high risk node positive HR+ breast cancer?
Given arguments exist between the FDA and ASCO, where do you stand?
1 Answer available
Should we be performing sentinel lymph node biopsies for HR+ patients ≥70 years of age?
In light of updated monarchE trial data, it seems a SLNB would help delineate adjuvant treatment options in this population. However, Choosing Wisely ...
1 Answer available
Would you offer adjuvant hormonal therapy to elderly men with strongly HR+ DCIS after mastectomy?
Grade 2 DCIS, post mastectomy with negative margins, sentinel nodes negative
1 Answer available
Would you send Oncotype Dx for a premenopausal patient with a pT2N0 ER/PR+ lobular breast cancer that was diagnosed during the first trimester of pregnancy?
2 Answers available
How would you treat an isolated ipsilateral axillary recurrence in a BRCA+ HR+ HER2+ breast cancer?
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...
1 Answer available
Do you use breast cancer index (BCI) in patients with 1-3 node positive ER+/HER2- IDC?
1 Answer available
Would you provide TDM1 or capecitabine for residual disease in HR negative patients with HER2 positivity based on copy number alone?
For patients with hormone negative breast cancer and HER2 positive only by copy number, do you give TDM1 for residual disease or capecitabine?
1 Answer available
Would you use OncoType Dx to guide adjuvant therapy recommendations in the context of locally recurrent, node-negative, ER+ breast cancer previously treated with endocrine therapy alone?
No oncotype was sent on the original breast cancer.
1 Answer available
Would you consider hormone replacement therapy in young women with germline BRCA1 mutation and history of triple negative breast cancer who underwent bilateral mastectomy and prophylactic bilateral salpingo-oophorectomy?
This situation can feel uncomfortable.  Would this feel safer if patient is s/p mastectomy and had TNBC?
1 Answer available
How do you modify TNBC neoadjuvant chemotherapy in patients with multiple sclerosis?
1 Answer available
How would you manage adjuvant treatment of a premenopausal woman with HER2 positive, ER/PR negative multifocal micro-invasive node-negative breast cancer?
Largest invasive focus is 0.4mm
1 Answer available
Does a very high Oncotype score influence your approach to adjuvant treatment in a patient with ER positive breast cancer?
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...
2 Answers available
Is there a role for extended adjuvant neratinib with pCR after neoadjuvant chemotherapy in triple positive breast cancer?
1 Answer available
How do you manage trastuzumab emtansine peri-operarively?
 If blood counts are sustained, do you continue or delay?
1 Answer available
Would you consider adding pembrolizumab to adjuvant chemotherapy in a patient with stage 3 TNBC who did not receive neoadjuvant treatment?
TNBC diagnosed in 2nd trimester. Neoadjuvant rx not given due to complicated pregnancy and went straight to surgery due to HR+ biopsy. Surgical pathol...
3 Answers available
Are CHEK2 mutations a contraindication for breast conservation therapy with lumpectomy + RT?
Should patients with moderate penetrance pathogenic variants be managed similar to BRCA patients and consider risk reducing contralateral mastectomy?&...
4 Answers available
Do you avoid teriparatide in previously irradiated breast cancer patients with osteoporosis given the black box warning for potential risk of osteosarcoma?
1 Answer available
Would you add neoadjuvant pembrolizumab to chemotherapy in a premenopausal female with T2N1 breast cancer that is weakly ER or PR positive?
1 Answer available
Would concurrent endocrine therapy and PARPi maintenance be safe and appropriate after surgical treatment/adjuvant chemotherapy for a patient with BRCA1 mutated synchronous early stage HR+ breast CA and Stage IIA Fallopian tube carcinoma?
1 Answer available
For an otherwise healthy post-menopausal woman with early stage HR+ BC and persistent AI intolerance, is there an age cutoff above which you would consider avoiding adjuvant tamoxifen therapy?
The patient has an intact uterus and has failed all available AI therapies due to multiple intolerances. 
1 Answer available
What is your approach to the management of hot flashes in a patient who wants to use herbal medicine?
Do you allow patients with breast cancer on tamoxifen to use black cohosh?
2 Answers available
Which chemotherapy regimen would you recommend for locally recurrent TNBC several years after therapy with docetaxel + cyclophosphamide for four cycles?
1 Answer available
Would you use aspirin 81 mg for VTE prophylaxis in patients on adjuvant tamoxifen/SERMs?
Is there data that it actually helps?
1 Answer available
For patients with triple negative breast cancer, currently undergoing neoadjuvant dd AC, would you consider adding pembrolizumab to weekly paclitaxel based on recent KEYNOTE-522 and continue as adjuvant?
2 Answers available
In light of RxPonder results for postmenopausal women with early stage node positive HR+HER2- breast cancer, when is there a role for full axillary LN dissection to confirm degree of nodal involvement and when would sentinel LN evaluation be sufficient?
How would this affect adjuvant radiation plan in breast conservation therapy patients and mastectomy patients?
1 Answer available
In a patient with localized TNBC, how would you decide in whom to perform breast MRI prior to starting neoadjuvant systemic therapy?
1 Answer available
What chemotherapy backbone will you use with pembrolizumab in the neoadjuvant setting for triple negative breast cancer?
Will you incorporate carboplatin into the backbone as it was done in the KEYNOTE trial?
2 Answers available
What treatment options would you provide a HER2+/HR+ patient with significant residual disease s/p TCHP if they go on to develop severe neuropathy following adjuvant T-DM1 therapy?
Patient had an initial tumor response to TCHP, but still had significant residual disease present, including positive lymph nodes and residual breast ...
1 Answer available
How does age factor into your planning whether to give a high risk pre-menopausal patient with breast cancer ovarian function suppression?
Do you have a specific age cutoff?
2 Answers available
Would you consider using OncoType Dx testing in a patient with breast cancer if nodal evaluation is not performed?
No sentinel lymph node biopsy was performed 
1 Answer available
Would you use OncoType in a postmenopausal female with HR+/HER2- with LN involvement who clinically meets RxPONDER criteria of 1-3 LN to guide the use of neoadjuvant chemotherapy?
How would the use of Oncotype guide your management in the neoadjuvant setting?
2 Answers available
Would you modify the dose of aromatase inhibitors or selective estrogen receptor modulators in patients who have a history of gastric bypass or other malabsorptive conditions/surgeries?
1 Answer available
How late after completion of adjuvant capecitabine and radiation would you consider adjuvant olaparib for a patient with gBRCA mutated TNBC?
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...
1 Answer available
How would you manage a premenopausal female with cT2cN0 HR+/HER2-negative breast cancer who received neoadjuvant TC for high OncoType, had no pathologic response to therapy and upstaged to pT2N1 on surgery?
What adjuvant therapies would you recommend?
2 Answers available
In a patient with HR+ breast cancer who is not able to tolerate adjuvant AI or standard dose tamoxifen due to side effects, would you consider a lower dose of tamoxifen?
1 Answer available
What adjuvant chemotherapy would you recommend in a premenopausal patient with pT1cN1 HR+ breast cancer who previously received an anthracycline and cyclophosphamide 30 years prior?
The patient was diagnosed with Ewing’s Sarcoma at the age of 10 and completed 6 cycles of vincristine, ifosfamide, etoposide, adriamycin 75mg/m2...
2 Answers available
Would you consider the use of ctDNA as part of surveillance in high risk TNBC patients?
In patients who have completed all adjuvant therapy. Similar test to what is available for stage 2 and 3 colon cancer patients by Natera.
2 Answers available
What endocrine therapy would you recommend for a perimenopausal female with a low risk Oncotype, HR+, HER2-negative, SLNB negative breast cancer who is clinically postmenopausal but with FSH, LH and estradiol that are not in the postmenopausal range?
1 Answer available
What is your approach for adjuvant endocrine therapy in a female with HR+ breast cancer with history of provoked DVT while on OCPs?
Would your approach differ if patient is premenopausal or postmenopausal?
1 Answer available
How would you manage adjuvant therapy for a premenopausal female with a T1cN1mi breast IDC that is HR+ HER2 positive on biopsy, but HR+ HER2 negative on lumpectomy surgical specimen?
<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.)...
2 Answers available
Do you incorporate carboplatin into the treatment for triple negative breast cancer?
The GeparSixto, CALGB 40603, and more recently Prospero support doing it; however, it is not currently endorsed by NCCN and the latter Prospero s...
1 Answer available
When would you offer anthracycline based adjuvant chemotherapy for a T1cN0 TNBC?
Does tumor size impact your recommendation? High grade? Young patient age?
2 Answers available
How do you determine whether to choose a non-anthracycline neoadjuvant chemotherapy regimen in a fit patient with TNBC?
Does the KN-522 data change your decision about chemo regimen?
3 Answers available
Is there a role for the neoadjuvant use of CDK 4/6 inhibitors with endocrine therapy in patients with well differentiated and/or invasive lobular histology who desire breast conservation?
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...
1 Answer available
How do you choose a neoadjuvant therapy regimen for a patient with a triple negative breast cancer and a synchronous ER-/Her2+ breast cancer?
3 Answers available
Is it routine to check imaging during or after neoadjuvant chemotherapy for breast cancer to assess for a radiographic response?
If so, what is the ideal imaging?
1 Answer available
How do you manage a locally advanced hormone receptor-positive invasive ductal carcinoma with neuroendocrine (small cell) features?
If there is no response to neoadjuvant AC -->T, would you offer additional adjuvant chemotherapy?
1 Answer available
Do you recommend adjuvant capecitabine for a very small amount (2 mm, ypT1a) of residual invasive disease in TNBC patients following neoadjuvant chemotherapy and lumpectomy?
1 Answer available
How do you manage endocrine therapy for premenopausal women with breast cancer who are heterozygous for factor V Leiden but have no history of thrombosis?
1 Answer available


Papers discussed in this category

European radiology, 2022 May 07
Background parenchymal enhancement in contrast-enhanced MR imaging suggests systemic effects of intrauterine contraceptive devices.
The Cochrane database of systematic reviews, 2020 Dec 21
Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.
Journal of the National Cancer Institute, 2010-07-07
Factor V Leiden mutation and thromboembolism risk in women receiving adjuvant tamoxifen for breast cancer.
J Natl Cancer Inst, 2006 Jul 5
Effect of Factor V Leiden and prothrombin G20210-->A mutations on thromboembolic risk in the national surgical adjuvant breast and bowel project breast cancer prevention trial.
J. Natl. Cancer Inst., 2010-07-07
Tamoxifen and the factor V Leiden mutation.
J. Clin. Oncol., 2003-10-01
Inherited and acquired risk factors for venous thromboembolic disease among women taking tamoxifen to prevent breast cancer.
JAMA Oncol, 2021 Jul 01
Three-Year Follow-up of Neoadjuvant Chemotherapy With or Without Anthracyclines in the Presence of Dual ERBB2 Blockade in Patients With ERBB2-Positive Breast Cancer: A Secondary Analysis of the TRAIN-2 Randomized, Phase 3 Trial.
Lancet Oncol, 2022 Apr 08
De-escalated neoadjuvant pertuzumab plus trastuzumab therapy with or without weekly paclitaxel in HER2-positive, hormone receptor-negative, early breast cancer (WSG-ADAPT-HER2+/HR-): survival outcomes from a multicentre, open-label, randomised, phase 2 trial.
N. Engl. J. Med.,
Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-04-01
Long-Term Prognostic Risk After Neoadjuvant Chemotherapy Associated With Residual Cancer Burden and Breast Cancer Subtype.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-03-01
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.
Cancers (Basel), 2021 Dec 03
Prognostic Risk Assessment and Prediction of Radiotherapy Benefit for Women with Ductal Carcinoma In Situ (DCIS) of the Breast, in a Randomized Clinical Trial (SweDCIS).
J Clin Oncol, 2021 Aug 18
Randomized Phase III Trial Evaluating Radiation Following Surgical Excision for Good-Risk Ductal Carcinoma In Situ: Long-Term Report From NRG Oncology/RTOG 9804.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-01-01
Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603 (Alliance).
Lancet Oncol., 2014-06-01
Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial.
The Lancet. Oncology, 2018-04
Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial.
JAMA Oncol,
Germline Mutation Status, Pathological Complete Response, and Disease-Free Survival in Triple-Negative Breast Cancer: Secondary Analysis of the GeparSixto Randomized Clinical Trial.
Nat. Med.,
Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: the TNT Trial.
Lancet Oncol., 2013 Dec 19
Effects of the addition of gemcitabine, and paclitaxel-first sequencing, in neoadjuvant sequential epirubicin, cyclophosphamide, and paclitaxel for women with high-risk early breast cancer (Neo-tAnGo): an open-label, 2×2 factorial randomised phase 3 trial.
The New England journal of medicine, 2016-11-17
Palbociclib and Letrozole in Advanced Breast Cancer.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-11-10
MONARCH 3: Abemaciclib As Initial Therapy for Advanced Breast Cancer.
J. Clin. Oncol., 2018 Dec 06
Randomized Phase II Study Evaluating Palbociclib in Addition to Letrozole as Neoadjuvant Therapy in Estrogen Receptor-Positive Early Breast Cancer: PALLET Trial.
Trials, 2013 Aug 19
WSG ADAPT - adjuvant dynamic marker-adjusted personalized therapy trial optimizing risk assessment and therapy response prediction in early breast cancer: study protocol for a prospective, multi-center, controlled, non-blinded, randomized, investigator initiated phase II/III trial.
Ann. Oncol., 2012 Jun 06
Chemotherapy (CT) and hormonotherapy (HT) as neoadjuvant treatment in luminal breast cancer patients: results from the GEICAM/2006-03, a multicenter, randomized, phase-II study.
Cancer,
Phase 2 randomized trial of primary endocrine therapy versus chemotherapy in postmenopausal patients with estrogen receptor-positive breast cancer.
Annals of surgical oncology, 2014-10
Chemosensitivity predicted by BluePrint 80-gene functional subtype and MammaPrint in the Prospective Neoadjuvant Breast Registry Symphony Trial (NBRST).
N. Engl. J. Med.,
Pembrolizumab for Early Triple-Negative Breast Cancer.
Ann Surg Oncol, 2022 Apr 04
Age-Independent Preoperative Chemosensitivity and 5-Year Outcome Determined by Combined 70- and 80-Gene Signature in a Prospective Trial in Early-Stage Breast Cancer.
Journal of the National Cancer Institute, 2011-03-16
Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-11-20
Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-08-10
Anthracyclines in Early Breast Cancer: The ABC Trials-USOR 06-090, NSABP B-46-I/USOR 07132, and NSABP B-49 (NRG Oncology).
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-03-10
Docetaxel With Cyclophosphamide Is Associated With an Overall Survival Benefit Compared With Doxorubicin and Cyclophosphamide: 7-Year Follow-Up of US Oncology Research Trial 9735.
The New England journal of medicine, 2018-07-12
Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer.
Annals of oncology : official journal of the European Society for Medical Oncology, 2005-08
Neoadjuvant docetaxel followed by adjuvant doxorubicin and cyclophosphamide in patients with stage III breast cancer.
J. Clin. Oncol., 2020 Sep 20
Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2-, Node-Positive, High-Risk, Early Breast Cancer (monarchE).
J Clin Oncol, 2020 Oct 27
Molecular Drivers of Onco DX, Prosigna, EndoPredict, and the Breast Cancer Index: A TransATAC Study.
Annals of Oncology, 2021 Sep 29
Adjuvant Abemaciclib Combined With Endocrine Therapy for High-Risk Early Breast Cancer: Updated Efficacy and Ki-67 Analysis From the monarchE Study.
J Clin Oncol, 2021 Feb 04
Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer in the APHINITY Trial: 6 Years' Follow-Up.
The New England journal of medicine, 2018-07-12
Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer.
Thromb Haemost,
Increased risk of recurrent venous thromboembolism during hormone replacement therapy--results of the randomized, double-blind, placebo-controlled estrogen in venous thromboembolism trial (EVTET).
J Clin Oncol, 2020 Oct 29
TBCRC 048: Phase II Study of Olaparib for Metastatic Breast Cancer and Mutations in Homologous Recombination-Related Genes.
N Engl J Med, 2021 Jun 03
Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer
Ann Surg Oncol, 2019 Jul 24
Consensus Guidelines on Genetic` Testing for Hereditary Breast Cancer from the American Society of Breast Surgeons.
J Clin Oncol, 2020 Mar 03
Evaluation of Germline Genetic Testing Criteria in a Hospital-Based Series of Women With Breast Cancer.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-02-20
Underdiagnosis of Hereditary Breast Cancer: Are Genetic Testing Guidelines a Tool or an Obstacle?
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-08-20
Should All Patients With a Diagnosis of Breast Cancer Undergo Expanded Panel Testing?
Cancer, 2021 Mar 15
Germline genetic testing in breast cancer: Rationale for the testing of all women diagnosed by the age of 60 years and for risk-based testing of those older than 60 years.
J Clin Oncol, 2015 Nov 1
American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024 Jan 04
Germline Testing in Patients With Breast Cancer: ASCO-Society of Surgical Oncology Guideline.
N. Engl. J. Med., 2017 Jun 04
Olaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation.
Annals of oncology : official journal of the European Society for Medical Oncology, 2019-04-01
OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physician's choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer.
BMC Cancer, 2018 Mar 07
Prevalence of pathogenic BRCA1/2 germline mutations among 802 women with unilateral triple-negative breast cancer without family cancer history.
N Engl J Med,
Olaparib for Metastatic Germline BRCA-Mutated Breast Cancer.
JCO Oncol Pract, 2022 Jan 07
Q and A: A New Standard of Care for Germline and/or Mutation Carriers With Early-Stage Breast Cancer.
J Clin Oncol, 2019 Apr 11
Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Local and Contralateral Recurrence in Breast Intraepithelial Neoplasia.
JAMA Oncol,
Assessment of Molecular Relapse Detection in Early-Stage Breast Cancer.
JAMA, 2011-02-09
Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-04-10
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