How would you approach adjuvant systemic therapy for a pT3N0(i+) HR+/HER2 negative breast cancer with an intermediate oncotype in a post-menopausal woman?

Topics: Breast Cancer • Medical Oncology • NCI-CCC Tumor Board Question • Moffitt Cancer Center • HR+ • NCI-CCC Breast Tumor Board Question

Answer from: Medical Oncologist at Community Practice

This is a great question that I ponder a lot. I've asked countless colleagues informally "what's the largest tumor you'll trust oncotype on"? The only true “prediction” data we have comes from the original B-20 trial, which included T3 tumors. Although the publication only breaks out tum...

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Medical Oncologist at H Lee Moffitt Cancer Center, University of South Florida
Great discussion and comments! Biology is king but...

Medical Oncologist at Siri Onclogy and hematology Infusion Service
I would validate the biology by say, performing an...

Answer from: Medical Oncologist at Academic Institution

There is limited data on T3 patients mostly from retrospective registry data. Risk does increase as T size increases. The most conservative approach is to offer chemotherapy like TCx4 to all of them. However, there is some interesting data from a SEER study (including about 1000 T3 cases, 4.2% of al...

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Medical Oncologist at Wellstar West Georgia Onc Center
By definition, this patient would have qualified f...

Medical Oncologist at H Lee Moffitt Cancer Center, University of South Florida
The TAILORx protocol eligibility was restricted to...

Answer from: Medical Oncologist at Community Practice

Consider MammaPrint. MINDACT had larger tumors, and tumors with high clinical risk and low genomic risk on 70 gene signature is less likely to derive chemo benefit.

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