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Breast Cancer, Non-metastatic   

Questions discussed in this category

In patients with localized triple-negative breast cancer and residual disease at time of surgery following neoadjuvant KEYNOTE-522 regimen, when would you recommend adding adjuvant capecitabine or another agent to pembrolizumab?
Patient is BRCA 1/2 wild type; completed four cycle of Carbo/paclitaxel and two cycles of AC with pembrolizumab in the neoadjuvant setting.  
2 Answers available
Would you offer endocrine therapy to a patient who developed a new contralateral pT1b pN0 ER/PR+ HER2- breast IDC 1 year after coming off 10 years of anastrozole for prior invasive breast cancer?
2 Answers available
Would you offer neoadjuvant chemotherapy to cT1c N0 triple negative breast cancer with metaplastic features in a young patient?
2 Answers available
For premenopausal patients with ER/PR+ Her2 negative breast cancer and lymph node micrometastases, would recurrence score be most appropriately interpreted based on TAILORx data, given such patients were excluded from RxPONDER?
1 Answer available
When would you use adjuvant abemaciclib in patients with clinically high-risk ER+, HER2-negative breast cancer, but pCR following neoadjuvant chemotherapy?
Patient is a post-menopausal woman with 4 lymph node mets that was strongly ER+/PR+, HER2-negative invasive ductal carcinoma with a high Ki-67 w...
1 Answer available
What would be your adjuvant treatment approach for patients with hormone receptor-positive breast cancer who have not responded to neoadjuvant aromatase inhibitor endocrine therapy?
Would you use a different endocrine therapy treatment? Would you use indicators other than Oncotype to guide the need for chemotherapy?
1 Answer available
Do you advocate for dose dense AC instead of every 3 week dosing in neoadjuvant TNBC as done in KEYNOTE 522?
2 Answers available
What are your top takeaways in Breast Cancer from ASCO 2022?
What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...
12 Answers available
What is your process for assessing the "high risk" clinical features in gBRCA+ breast cancer in order to offer olaparib, given varying definitions of risk and recent changes in staging guidelines?
Definitions for "high risk" differ by whether patients receive neoadjuvant chemo and across other contemporary studies. Does the change in AJCC stagin...
3 Answers available
Will you offer adjuvant olaparib to patients with somatic BRCA mutated breast cancer given that OlympiA only enrolled germline BRCA+?
Do you perceive a difference between somatic vs germline BRCA mutations? 
2 Answers available
What is the appropriate timeline to start post mastectomy chest wall/regional nodal XRT (+/- reconstruction) after surgery?
What if Medical Oncology wants to give more systemic therapy and further delay XRT start date?What should we be telling the Breast/Plastic surgeon/Med...
1 Answer available
Would you offer anti-HER2 therapy to a patient found to have heterogenous HER2+ residual disease after original treatment for TNBC using the Keynote522 regimen?
63y/o F who was originally diagnosed with cT2N0 TNBC , completed KN522 regimen ->ypT1cN0, markers from her surgical path showed ER0PR0 HER2 2+ and ...
1 Answer available
What neoadjuvant regimen would you give a patient with multicentric IDC consisting of TNBC and concurrent ER/PR- HER2+ breast cancer with ER/PR- HER2+ axillary LN mets?
2 Answers available
If you have a high risk HR+, BRCA+ breast cancer patient who qualifies for adjuvant olaparib and abemaciclib, which one would you give and why?
Would you ever consider using these in sequence?
4 Answers available
What is your approach to adjuvant hormone therapy for HR+ breast cancer in post-menopausal women with pre-existing osteoporosis?
Would you consider omitting treatment if small tumor and early stage? Or would you use tamoxifen?
2 Answers available
How would you approach a locally recurrent HER2 positive breast cancer patient previously treated with TCHP, lumpectomy, and a year of adjuvant TDM-1?
Patient was initially ER positive, HER2 positive. Currently she is on letrozole. Recurrence is ER/PR negative and HER2 positive and developed almost 2...
1 Answer available
Would you be comfortable starting tamoxifen for a HR+ breast cancer patient with a history of early stage endometrial cancer treated via hysterectomy?
1 Answer available
Should we start performing universal germline mutation testing for all newly diagnosed breast cancer?
Given OlympiA trial with olaparib benefit for gBRCA+ patients?What are barriers that you foresee? In your practice who performs mutation testing and w...
5 Answers available
Are there any recommendations regarding dosage and schedule for leuprolide for ovarian suppression alongside endocrine therapy for the treatment of breast cancer?
Some payors prefer leuprolide acetate injectable suspension (eligard) for ovarian suppression. This is not the preparation that was used in SOFT/Text ...
1 Answer available
Would you consider adjuvant olaparib in a patient with HER2+, high-risk, early stage breast cancer with germline BRCA mutation?
OlympiA trial did not include her2+ breast cancer. 
3 Answers available
Would you offer OS/AI alone or the addition of chemotherapy to a premenopausal female with T3 N1mi ER+/PR+ breast cancer with an OncotypeDx score <11?
1 Answer available
In the neoadjuvant setting, how would you treat a premenopausal woman with a 3 cm ER+, PR weakly positive, Her-2 negative, grade 3 breast cancer with clinical N1 node which shows basal type on Mammaprint?
3 Answers available
Would you recommend adjuvant olaparib in a premenopausal BRCA1+ woman with stage IA pT1bN0 ER/PR+ HER2- breast cancer and a high OncoType score?
The OncotypeDx score was 51 in this scenario. 
3 Answers available
Would you offer PMRT to a perimenopausal female with a single positive LN with microscopic ENE who has otherwise low risk features?
2 Answers available
Would you provide the KEYNOTE-522 regimen for a patient with ER low, PR+, HER2- stage IIIb breast cancer?
ER low being 1-9% (<10%), PR 20%
1 Answer available
How do you approach the discussion of omission vs. inclusion of adjuvant radiation in patients with low to intermediate grade DCIS?
For additional reading, see JCO OGR 11/2021 by @Laura Warren and @Jennifer R. Bellon reviewing landscape of adjuvant treatment after lumpectomy for DC...
7 Answers available
What is your preferred adjuvant therapy for a patient with triple negative breast cancer and has a BRCA germline mutation who had minimal to no response to neoadjuvant chemotherapy?
Young patient, germline BRCA carrier with cT1cN0 to ypT2N0 disease after docetaxel/ cyclophosphamide x 4.
2 Answers available
What treatment would you provide for a patient with bilateral synchronous locally advanced cT4dN0 TNBC and cT1b ER+ HER2+ breast cancer?
Would you proceed with KEYNOTE 522 regimen and add anti-HER2 targeted therapy adjuvantly?
2 Answers available
Would you provide abemaciclib to a premenopausal women with cT2 cN1 ER+ breast cancer and Ki67 of 80% who achieves pCR following neoadjuvant AC-T?
What would you offer a premenopausal woman with clinical T2N1 ER positive breast cancer for adjuvant therapy after she achieves a pathologic complete ...
1 Answer available
Do you prefer using an anthracycline or non-anthracycline adjuvant regimen in BRCA+ premenopausal patients with T2N0 HR+ breast cancer?
-premenopausal -T2N0 -BRCA1 germline PV -ER+ (Allred 7/8) and negative for PR/HER2?
1 Answer available
Would you give chemotherapy to a post menopausal woman with ER/PR positive HER2 negative breast cancer, T2N1 with 3+ lymph nodes, Ki-67 30% and OncoType RS of 10?
4 Answers available
How would you adjust therapy for a HER2+ breast cancer patient found to have elevated LFTs while on TCHP?
What do you do if LFTs are elevated after one dose of neoadjuvant TCHP (highest ALT >13 times upper limit of normal, normal bilirubin) with prior n...
1 Answer available
Would you offer adjuvant chemotherapy to a post menopausal woman with T1-T3 primary tumor with 4 positive axillary LNs and OncotypeDX score less than 15?
2 Answers available
How would you approach a patient who has developed neutropenia with the combination of trastuzumab/pertuzumab in the adjuvant setting?
Would you consider the discontinuation of either anti-HER2 agent or both?
1 Answer available
Is Oncotype testing useful in variant histologies such as micropapillary breast cancer?
2 Answers available
What adjuvant therapy would you offer a post-menopausal CHEK2+ patient with HR+ HER2+ T1bN1 breast cancer and concurrent HR+ HER2- T1N0 disease?
I have a patient in her 60s with CHEK2 mutation, diagnosed with bilateral breast cancer. Lumpectomy showed b/l tumors <10mm both ER/PR+, HER2-, but...
1 Answer available
How does the potential for a patient to accept or forego adjuvant tamoxifen factor into your recommendations on adjuvant RT for DCIS?
Are there specific patient populations in which you may feel comfortable with a patient selecting only one adjuvant therapy approach (tamoxifen vs RT)...
3 Answers available
How would you approach treatment for a post-menopausal woman with HR+ HER2- stage 3 papillary carcinoma of the breast?
Would you give neoadjuvant chemo or hormonal therapy or go with surgery first? What chemotherapy would you use? 
1 Answer available
How do you approach the decision to boost patients diagnosed with DCIS?
What factors do you consider?Is your thought process at all different from your approach to boost with IDC? Do you apply TROG 7.01 data (age <...
4 Answers available
What resection margins are required for DCIS with a component of invasive disease?
What resection margins are required for pure DCIS with adjuvant RT? What resection margins are required for pure DCIS without RT? For additi...
5 Answers available
How would you approach treatment for a pre-menopausal patient with PR-positive, ER-negative, HER2-negative cT1c N1 breast cancer?
Should these cancers be treated like hormone positive breast cancer or triple negative breast cancer? She is pre menopausal with cT1c grade 2 disease...
1 Answer available
Would you consider avoidance of AC and proceeding to surgery in a cT2N0 TNBC patient who achieves a significant clinical response to carboplatin, paclitaxel, and pembrolizumab as part of the KEYNOTE-522 regimen?
What scenarios would you do second neoadjuvant treatment vs surgery?
1 Answer available
Would you give chemotherapy and trastuzumab to a patient with multifocal high grade, microscopic (<5mm) HR-, HER2+ IDC embedded in extensive DCIS, staged as pTis pT1a(m) N0?
1 Answer available
For a patient with breast cancer s/p lumpectomy found to have a heterozygous RAD50 mutation, is adjuvant radiation appropriate therapy or would you recommend completion mastectomy?
1 Answer available
How are you using predictive tests such as DCISionRT (PreludeDx) or OncotypeDX DCIS in the management of DCIS?
What advantages/disadvantages are there between assays or over traditional clinical pathologic factors? What other concerns do you have?For additional...
4 Answers available
What adjuvant chemotherapy regimen do you recommend for a patient with T1cN0 TNBC?
If said patient was known to be gBRCA mutated, would you use neoadjuvant chemotherapy to enable adjuvant olaparib for those that did not have a pCR? &...
4 Answers available
Would you offer adjuvant chemotherapy to a woman in her 40's s/p TAHBSO with T2N1 ER+/PR+ breast cancer with oncotype score 21-25?
How much of the benefit of adjuvant chemotherapy do you expect to be due to ovarian function suppression due to the chemotherapy?
2 Answers available
Given new OS data in the OlympiA trial, would you offer adjuvant olaparib to a pT1bN0 TNBC patient?
1 Answer available
What adjuvant treatment would you recommend for a patient with node positive TNBC who did not receive neoadjuvant chemotherapy?
2 Answers available
Can docetaxel be safely given to patients with hyperbilirubinemia from Gilbert’s syndrome?
Is dose modification of docetaxel necessary with Gilbert's when giving TCHP?
1 Answer available
Do you offer adjuvant bisphosphonates to high-risk premenopausal women on ovarian suppression for early-stage breast cancer who would want to consider pregnancy in the future?
Which agents would you select and for how long would you treat them?
1 Answer available
In which situations do you offer neoadjuvant chemotherapy for a nodal recurrence alone of ER/PR positive, HER2 negative breast cancer?
Patient is young and reoccurrence is one year after initial diagnosis of T1cN0 ER/PR positive, HER2-negative breast cancer treated with mastectomy, bu...
1 Answer available
Would you recommend tamoxifen x 5 years following mastectomy in a male with pure DCIS?
1 Answer available
What additional benefit does radiation offer for a patient <65 years old with T1aN0 ER+ invasive carcinoma (tubular histology) of the breast?
1 Answer available
Do you plan to offer adjuvant olaparib to all gBRCA+ breast cancer whether TNBC or HR+?
In subset analyses of OlympiA there seems to be smaller magnitude of benefit among HR+ patients. In your opinion, should adjuvant olabarib be offered ...
3 Answers available
Would you offer adjuvant hormonal therapy for premenopausal woman with positive margin HR+ DCIS after a bilateral mastectomy?
ER 95%
1 Answer available
How would you treat a post-menopausal woman found to have a node-negative ipsilateral HR+ breast cancer recurrence with pectoral muscle invasion following a prior mastectomy, radiation, and AI therapy completed > 5 years ago? 
1 Answer available
How would you approach adjuvant therapy for a post-menopausal women with cT2 cN0 TNBC on biopsy s/p neoadjuvant chemotherapy and mastectomy who is later found to have RCB2 HR+ breast cancer on surgical pathology?
HR+ = ER 34%, PR 0% RCB2 = no nodal involvement
1 Answer available
Would you restart endocrine therapy for a patient with new contralateral LCIS diagnosed 2 years following completion of AI therapy for stage 1A HR+ IDC?
Would you restart hormonal therapy in a patient with a new diagnosis of LCIS 2 years after they have completed 5 yrs of AI for stage 1A IDC in the oth...
1 Answer available
What is your approach to chemoprevention for HR+ DCIS in the ipsilateral breast in a patient who already completed 7 years of an AI for a prior HR+ invasive breast cancer?
Patient underwent mastectomy for DCIS in the setting of previous lumpectomy and adjuvant radiation for the invasive breast cancer. 
2 Answers available
How would you approach treatment for a HR+ HER2+ clinical T1c N0 male breast cancer?
3 Answers available
For patients with prior HR+HER2- localized breast cancer currently receiving adjuvant endocrine therapy, is there a time period in which you would no longer recommend adding adjuvant abemaciclib?
(assuming they meet MonarchE criteria) For example, if the patient is in year 2, 3, 4, or 5 of adjuvant endocrine therapy versus 9 months out, would ...
3 Answers available
Would you utilize OncotypeDX to guide decision making for a male with ER+ HER2- breast cancer and 1-3 positive sentinel lymph nodes?
3 Answers available
Would you consider giving neoadjuvant therapy using a KEYNOTE-522 regimen to someone with cT1c cN0 TNBC?
How would you proceed given that cT1c didn't meet the study criteria? 
1 Answer available
How would you approach a patient whose stage II TNBC tumor is visibly progressing on the KN-522 neoadjuvant regimen?
Currently on C2 of doxorubicin/cylophosphomide/pembro. Would you expedite surgery?
2 Answers available
In patients who receive neoadjuvant pembrolizumab and chemotherapy for TNBC, how will you manage adjuvant treatment if they have a germline BRCA mutation?
Would you continue pembrolizumab? Would you introduce olaparib? If using both, how would you sequence? 
5 Answers available
How and on which specimens will you perform Ki-67 testing in newly diagnosed breast cancer?
Should this be sent on initial biopsy or on surgical pathology? What if an initially high risk patient has good risk findings post-operatively?What ha...
4 Answers available
How would you treat an elderly patient with borderline cardiac dysfunction who has stage 3 HR+ HER2- breast cancer?
2 Answers available
What adjuvant therapy would you offer an elderly but healthy patient with T2N1 HR+ HER2+ breast cancer who is not willing to receive cytotoxic chemotherapy?
1 Answer available
How do you incorporate oncotype Dx recurrence score when planning adjuvant CDK 4/6 inhibitor for high risk early stage HR+ breast cancer?
1 Answer available
How would you treat an elderly female with residual TNBC following surgery and neoadjuvant Carboplatin and Paclitaxel?
Assume normal cardiac function and no obvious co-morbidities. No anthracycline previously due to age alone. The patient’s BRCA status is unknown...
1 Answer available
Would you consider dual anti-HER2 therapy for a perimenopausal woman found to have multifocal pT1mic pN1mic HER2+ HR- breast cancer following a bilateral mastectomy for DCIS?
For instance, the foci found were pN1mi (0.5 mm) deposit in 1st SNL (1/13 LN) and mpT1mi (8 foci). Would you consider single or dual anti-HER2 blockad...
3 Answers available
How do you adjust Tamoxifen use in HR+ patients with a history of gastric bypass?
Is there any utility in monitoring serum tamoxifen levels?
1 Answer available
Would you offer adjuvant abemaciclib to node-positive patients with low ER expression?
For instance, ER/PR >1% but <10% and Ki67 >50%
3 Answers available
What adjuvant therapy would you offer a TNBC patient with residual disease after receiving the neoadjuvant KEYNOTE-522 regimen?
1 Answer available
How do you sequence capecitabine and olaparib, if at all, in patients with BRCA+ TNBC and residual disease after neoadjuvant chemotherapy?
5 Answers available
How would you approach systemic therapy for a pre-menopausal woman with ER+/PR+/HER2 positive breast cancer who had a local recurrence 6 months after completing adjuvant TCH and a year of trastuzumab + tamoxifen?
Would you consider neoadjuvant or adjuvant treatment and if so, which therapies? Patient initially had pT2N0 disease and recurrent disease is also ER+...
1 Answer available
How would you approach systemic therapy for a young post-menopausal woman with locoregional TNBC chest wall recurrence treated with definitive radiation?
Patient previously received neoadjuvant ddAC-T with residual disease at surgery, followed by adjuvant capecitabine which was completed 2 months prior ...
1 Answer available
Would you consider adjuvant olaparib in a premenopausal female with TNBC with high risk features and germline BRCA1 mutation who achieved pCR after neoadjuvant chemotherapy?
Does not meet Olympia trial indication
1 Answer available
Is there a role for adjuvant capecitabine in sequence with abemaciclib for high risk HR+ breast cancer with residual disease?
In high-risk, node-positive HR+ Her-2 neg breast cancer patients who received neoadjuvant chemotherapy with residual disease, would you give capecitab...
1 Answer available
Would you still obtain Ki-67 prior to use of adjuvant abemaciclib in a patient who has otherwise met MonarchE treatment criteria, such as 1-3 positive LNs, grade 3 and/or tumor >5 cm?
Patient is pre-menopausal and has cT3cN1, grade 2, ER positive, Her 2 negative IDC. Metastatic disease to axillary LNs was biopsy-proven. Patient was ...
1 Answer available
For women with HR+ breast cancer and low libido due to endocrine therapy, would you consider flibanserin therapy?
How do you manage low libido in women with breast cancer on endocrine therapy? Other than managing vaginal dryness/dyspareunia, if just a desire/libid...
1 Answer available
Do you send OncotypeDx testing in breast cancers with mucinous histology?
3 Answers available
How do you approach treatment in premenopausal patients who develop a contralateral HR+ breast cancer while already on tamoxifen and ovarian function suppression?
How would you manage endocrine therapy 7 years after the original ER+/PR+/HER2- IDC, while on adjuvant tamoxifen/OFS develops a contralateral ER+/PR+/...
2 Answers available
Would OncotypeDx impact your decision to provide adjuvant chemotherapy for node-negative HR+ breast cancer with dermis or chest wall involvement?
Would you recommend adjuvant chemotherapy for pT4 disease regardless of Oncotype score?
1 Answer available
How do you view the use of adjuvant CDK4/6 inhibitors overall given discordant results between MonarchE and PALLAS?
Are there factors to explain why MonarchE was a positive study and PALLAS was not? 
4 Answers available
How far can you dose reduce abemaciclib for a patient who is having toxicity at starting doses?
Can you use 50mg BID if intolerant to 150mg and 100mg dosing?  Any tips for side effect management to help patients stay on full duration?
5 Answers available
How do you counsel post-menopausal patients with HR+ breast cancer who are interested in taking medroxyprogesterone?
1 Answer available
Will you offer adjuvant abemaciclib to breast cancer patients with high Ki-67 who are unable to receive perioperative chemo due to comorbidities or who decline chemotherapy?
Majority of patients on MonarchE received neoadjuvant/adjuvant chemo.  Does the availability of abemaciclib impact your decision to offer chemo ...
3 Answers available
Does the magnitude of benefit with 2 years of adjuvant abemaciclib outweigh side effects, given that many patients will receive CDK 4/6 inhibitors at breast cancer recurrence, precluding OS benefits?
MonarchE shows statistically significant improvement in IDFS and DRFS, but the magnitude of absolute benefit is modest (3-year IDFS and DRFS rates = 5...
5 Answers available
In a premenopausal HR+ patient with pT2 pN0(i+) disease and RS<16, does the presence of isolated lymph node tumor cells affect your decision to avoid chemotherapy?
Oncotype score in this case was 14. 
1 Answer available
Would you offer adjuvant abemaciclib + an aromatase inhibitor to a patient with a local HR+HER- breast cancer reoccurrence while on tamoxifen that meets high-risk criteria?
High-risk criteria meaning >4 positive nodes and Ki67 >20%
3 Answers available
Is there any role for neoadjuvant chemotherapy for low grade adenosquamous metaplastic TNBC?
Original question: Would you offer neoadjuvant chemo + keytruda for metaplastic breast adenosquamous low grade?
1 Answer available
Is there any adjunct therapy to help with tamoxifen-induced leg cramps?
1 Answer available
How have you been incorporating Abemaciclib into the adjuvant management of high risk node positive HR+ breast cancer?
Given arguments exist between the FDA and ASCO, where do you stand?
1 Answer available
Should we be performing sentinel lymph node biopsies for HR+ patients ≥70 years of age?
In light of updated monarchE trial data, it seems a SLNB would help delineate adjuvant treatment options in this population. However, Choosing Wisely ...
1 Answer available
Would you offer adjuvant hormonal therapy to elderly men with strongly HR+ DCIS after mastectomy?
Grade 2 DCIS, post mastectomy with negative margins, sentinel nodes negative
1 Answer available
Would you send Oncotype Dx for a premenopausal patient with a pT2N0 ER/PR+ lobular breast cancer that was diagnosed during the first trimester of pregnancy?
2 Answers available
Would you order an OncotypeDX test on a <50 year old woman with T2 N1mi HR+ HER2- breast cancer?
1 Answer available
How would you treat an isolated ipsilateral axillary recurrence in a BRCA+ HR+ HER2+ breast cancer?
BRCA mutant, ER/PR positive and HER2 positive T2N0M0 breast cancer diagnosed 5 years ago, treated with bilateral mastectomy, BSO, 1 year of adjuvant a...
1 Answer available
Do you use breast cancer index (BCI) in patients with 1-3 node positive ER+/HER2- IDC?
1 Answer available
Would you provide TDM1 or capecitabine for residual disease in HR negative patients with HER2 positivity based on copy number alone?
For patients with hormone negative breast cancer and HER2 positive only by copy number, do you give TDM1 for residual disease or capecitabine?
1 Answer available
Would you use OncoType Dx to guide adjuvant therapy recommendations in the context of locally recurrent, node-negative, ER+ breast cancer previously treated with endocrine therapy alone?
No oncotype was sent on the original breast cancer.
1 Answer available
Would you consider hormone replacement therapy in young women with germline BRCA1 mutation and history of triple negative breast cancer who underwent bilateral mastectomy and prophylactic bilateral salpingo-oophorectomy?
This situation can feel uncomfortable.  Would this feel safer if patient is s/p mastectomy and had TNBC?
1 Answer available
What neoadjuvant chemotherapy will you give to a premenopausal woman with cT2N0 metaplastic triple negative breast cancer?
3 Answers available
How do you modify TNBC neoadjuvant chemotherapy in patients with multiple sclerosis?
1 Answer available
How would you manage adjuvant treatment of a premenopausal woman with HER2 positive, ER/PR negative multifocal micro-invasive node-negative breast cancer?
Largest invasive focus is 0.4mm
1 Answer available
Do you need to wait for estradiol and FSH levels to normalize before you can switch from tamoxifen to an AI for a pre-menopausal woman with ER+ breast cancer?
What steps should be taken when switching premenopausal women from tamoxifen to AI? In this case, the change is due to newly discovered endometrial th...
1 Answer available
Is there a role for extended adjuvant neratinib with pCR after neoadjuvant chemotherapy in triple positive breast cancer?
1 Answer available
How do you manage trastuzumab emtansine peri-operarively?
 If blood counts are sustained, do you continue or delay?
1 Answer available
Would you consider adding pembrolizumab to adjuvant chemotherapy in a patient with stage 3 TNBC who did not receive neoadjuvant treatment?
TNBC diagnosed in 2nd trimester. Neoadjuvant rx not given due to complicated pregnancy and went straight to surgery due to HR+ biopsy. Surgical pathol...
3 Answers available
Are CHEK2 mutations a contraindication for breast conservation therapy with lumpectomy + RT?
Should patients with moderate penetrance pathogenic variants be managed similar to BRCA patients and consider risk reducing contralateral mastectomy?&...
4 Answers available
Do you avoid teriparatide in previously irradiated breast cancer patients with osteoporosis given the black box warning for potential risk of osteosarcoma?
1 Answer available
Would you add neoadjuvant pembrolizumab to chemotherapy in a premenopausal female with T2N1 breast cancer that is weakly ER or PR positive?
1 Answer available
Would concurrent endocrine therapy and PARPi maintenance be safe and appropriate after surgical treatment/adjuvant chemotherapy for a patient with BRCA1 mutated synchronous early stage HR+ breast CA and Stage IIA Fallopian tube carcinoma?
1 Answer available
For an otherwise healthy post-menopausal woman with early stage HR+ BC and persistent AI intolerance, is there an age cutoff above which you would consider avoiding adjuvant tamoxifen therapy?
The patient has an intact uterus and has failed all available AI therapies due to multiple intolerances. 
1 Answer available
In the case of a peri-menopausal woman on adjuvant tamoxifen, would you consider switching endocrine therapies solely due to an estradiol level if this was checked and found to be significantly elevated?
Patient had estradiol level checked by her gynecologist due to recent irregular bleeding. Estradiol level was markedly elevated on initial testing (90...
2 Answers available
What is your approach to the management of hot flashes in a patient who wants to use herbal medicine?
Do you allow patients with breast cancer on tamoxifen to use black cohosh?
2 Answers available
Which chemotherapy regimen would you recommend for locally recurrent TNBC several years after therapy with docetaxel + cyclophosphamide for four cycles?
1 Answer available
Would you use aspirin 81 mg for VTE prophylaxis in patients on adjuvant tamoxifen/SERMs?
Is there data that it actually helps ?
1 Answer available
For patients with triple negative breast cancer, currently undergoing neoadjuvant dd AC, would you consider adding pembrolizumab to weekly paclitaxel based on recent KEYNOTE-522 and continue as adjuvant?
2 Answers available
In light of RxPonder results for postmenopausal women with early stage node positive HR+HER2- breast cancer, when is there a role for full axillary LN dissection to confirm degree of nodal involvement and when would sentinel LN evaluation be sufficient?
How would this affect adjuvant radiation plan in breast conservation therapy patients and mastectomy patients?
1 Answer available
In a patient with localized TNBC, how would you decide in whom to perform breast MRI prior to starting neoadjuvant systemic therapy?
1 Answer available
What chemotherapy backbone will you use with pembrolizumab in the neoadjuvant setting for triple negative breast cancer?
Will you incorporate carboplatin into the backbone as it was done in the KEYNOTE trial?
2 Answers available
What treatment options would you provide a HER2+/HR+ patient with significant residual disease s/p TCHP if they go on to develop severe neuropathy following adjuvant T-DM1 therapy?
Patient had an initial tumor response to TCHP, but still had significant residual disease present, including positive lymph nodes and residual breast ...
1 Answer available
How does age factor into your planning whether to give a high risk pre-menopausal patient with breast cancer ovarian function suppression?
Do you have a specific age cutoff?
2 Answers available
Would you consider using OncoType Dx testing in a patient with breast cancer if nodal evaluation is not performed?
No sentinel lymph node biopsy was performed 
1 Answer available
Would you use OncoType in a postmenopausal female with HR+/HER2- with LN involvement who clinically meets RxPONDER criteria of 1-3 LN to guide the use of neoadjuvant chemotherapy?
How would the use of Oncotype guide your management in the neoadjuvant setting?
2 Answers available
Would you modify the dose of aromatase inhibitors or selective estrogen receptor modulators in patients who have a history of gastric bypass or other malabsorptive conditions/surgeries?
1 Answer available
How late after completion of adjuvant capecitabine and radiation would you consider adjuvant olaparib for a patient with gBRCA mutated TNBC?
Given that olaparib was given within 12 weeks of completion of standard adjuvant therapy on the trial, will you still offer it to patients outside tha...
1 Answer available
How would you manage a premenopausal female with cT2cN0 HR+/HER2-negative breast cancer who received neoadjuvant TC for high OncoType, had no pathologic response to therapy and upstaged to pT2N1 on surgery?
What adjuvant therapies would you recommend?
2 Answers available
In a patient with HR+ breast cancer who is not able to tolerate adjuvant AI or standard dose tamoxifen due to side effects, would you consider a lower dose of tamoxifen?
1 Answer available
What adjuvant chemotherapy would you recommend in a premenopausal patient with pT1cN1 HR+ breast cancer who previously received an anthracycline and cyclophosphamide 30 years prior?
The patient was diagnosed with Ewing’s Sarcoma at the age of 10 and completed 6 cycles of vincristine, ifosfamide, etoposide, adriamycin 75mg/m2...
2 Answers available
Would you consider the use of ctDNA as part of surveillance in high risk TNBC patients?
In patients who have completed all adjuvant therapy. Similar test to what is available for stage 2 and 3 colon cancer patients by Natera.
2 Answers available
What endocrine therapy would you recommend for a perimenopausal female with a low risk Oncotype, HR+, HER2-negative, SLNB negative breast cancer who is clinically postmenopausal but with FSH, LH and estradiol that are not in the postmenopausal range?
1 Answer available
What is your approach for adjuvant endocrine therapy in a female with HR+ breast cancer with history of provoked DVT while on OCPs?
Would your approach differ if patient is premenopausal or postmenopausal?
1 Answer available
How would you manage adjuvant therapy for a premenopausal female with a T1cN1mi breast IDC that is HR+ HER2 positive on biopsy, but HR+ HER2 negative on lumpectomy surgical specimen?
<40y/o female w/ initial biopsy showing G3 IDC with 80% ER+, 90% PR+, and HER2 positive (IHC 2+; 1.6 HER2/CEP17 ratio and 6.3 HER2 copies/nucleus.)...
2 Answers available
Do you incorporate carboplatin into the treatment for triple negative breast cancer?
The GeparSixto, CALGB 40603, and more recently Prospero support doing it; however, it is not currently endorsed by NCCN and the latter Prospero s...
1 Answer available
Is there a role for the neoadjuvant use of CDK 4/6 inhibitors with endocrine therapy in patients with well differentiated and/or invasive lobular histology who desire breast conservation?
The use of neoadjuvant CDK 4/6 inhibitors is not standard of care, but there are clinical trials looking at this question and patients who are chemoth...
1 Answer available
How do you choose a neoadjuvant therapy regimen for a patient with a triple negative breast cancer and a synchronous ER-/Her2+ breast cancer?
3 Answers available


Papers discussed in this category

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-03-01
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.
Cancers (Basel), 2021 Dec 03
Prognostic Risk Assessment and Prediction of Radiotherapy Benefit for Women with Ductal Carcinoma In Situ (DCIS) of the Breast, in a Randomized Clinical Trial (SweDCIS).
J Clin Oncol, 2021 Aug 18
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