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?
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%)
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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?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · Warren Alpert Medical School of Brown University
Answered on
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...
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Mednet Member
Medical Oncology · Private Practice and Digital Health
Answered on
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 suppressi...
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