How would you treat a patient with a small (<0.5 cm) node negative, grade 3 BRCA1 mutated triple negative breast cancer?
An article (BRCA mutation and outcome in BC. Ellen Copson, et al. Lancet Oncol. 2018) showed G3, BRCA+ breast cancer had poorer prognosis compared to BRCA- breast cancer in a subgroup analysis.
This is not a typical case for oncotype but is it worthwhile to obtain oncotype or Mammaprint to further guide the decision?
Answer from: Medical Oncologist at Academic Institution
In the recently published POSH trial by Copson et al (Lancet Oncology), the investigators examined outcomes in a cohort of women age 40 or younger newly diagnosed with breast cancer. In the overall cohort of 2733 women, 12% had BRCA mutations. After a median follow-up of 8.2 years, there was no sign...
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Answer from: Medical Oncologist at Academic Institution
As the POSH trial included very few patients with tumors this size (median size was 2.2 cm, 95% 1.5-3.1 cm) and very few (2%) TNBC patients who did not receive chemotherapy (adjuvant or neoadjuvant), its results are applicable to this case only to reassure us (and the patient) th...