I would start chemotherapy because of the triple-negative status of the metastasis. This is a patient who initially presented with hormone receptor-positive breast cancer and subsequently developed an isolated bone metastasis that was triple negative. The question of systemic therapy post-localized ...

Would confirm that discordance is a true change in receptor status and not a function of assessment of receptors on the bone which can lead to false negative results.

I would use caution when applying CALOR to this patient. The old saying is "biology is king" (and I've been told appropriately "stage is queen"). CALOR examined the benefit of chemotherapy following a local recurrence of disease. That is a different biology than the development of distant metastatic...

I would not favor giving 'adjuvant' chemotherapy in this situation. First, the ER status of bone biopsies can be unreliable due to decalcification giving false negative results; I have had ER+ patients with multiple bone metastases and 'ER-' results on bone biopsies who clearly benefited from endocr...

In addition to many of the above comments, I would confirm with an expert/multidisciplinary path review that it is TNBC and not metastasis from another primary site.