Would you offer adjuvant chemotherapy for 1-3 node positive HR+, HER2 negative breast cancer with Mammaprint low risk to a young, pre-menopausal patient?

Topics: Breast Cancer • Medical Oncology • HR+

Based on MINDACT update from 2020, a 5% difference in DMFS for patients 50 years or younger was noted, favoring treatment with chemotherapy (93.6%; 95% CI, 89.3% – 96.3% vs 88.6%; 95% CI, 83.5 – 92.3%)

Answer from: Medical Oncologist at Academic Institution

Until we have the results from the RxPONDER trial (which used Oncotype, not Mammaprint, but addresses this question more directly than MINDACT), we cannot rule out a potential benefit from adjuvant chemotherapy in node-positive patients like these, and thus, I would offer it while saying that the be...

Comments

Medical Oncologist at Presbyterian Healthcare Services
Wondering why TC x 6, not 4 cycles in that case? T...

Medical Oncologist at Rocky Mountain Cancer Centers
Agree with further discussion/question regarding T...

Medical Oncologist at Florida Cancer Specialists and Research Institute
We just do not have any evidence to show that TC x...

Medical Oncologist at Clinical Instructor
For more on TC x 4 instead of TC x 6, you can look...

Answer from: Medical Oncologist at Community Practice

I do not recommend chemotherapy for low biological risk ER+ breast cancer, including in 1-3+ lymph nodes. In premenopausal women, one can make a case for chemotherapy for its indirect endocrine effect through ovarian ablation, but in this day and age, this is a crude way to achieve ovarian suppress...

Comments

Medical Oncologist at Augusta Oncology Associates
Will the plan be different for patients younger th...

Medical Oncologist at Private Practice and Digital Health
Same approach to older premenopausal patients with...

Related Questions