Adjuvant Therapy for HRpos HER2neg EBC

CE / CME

Individualizing the Current Adjuvant Therapy Algorithm for Patients With HR+/HER2- EBC

Physicians: Maximum of 0.50 AMA PRA Category 1 Credit

ABIM MOC: maximum of 0.50 Medical Knowledge MOC point

Released: February 18, 2025

Expiration: August 17, 2025

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Patient Case 1: Woman With Grade 2 ILC and 4 Positive Nodes



  • A 58-yr-old woman who is postmenopausal presents with a 5-cm right breast mass with 1 suspicious node

  • Initial breast biopsy reveals ILC, grade 2, with the following biomarkers

    • ER 80%, PgR 30%, HER2- by IHC



  • Fine-needle aspiration of a palpable right axillary lymph node reveals adenocarcinoma of the breast

  • BRCA testing: negative; PIK3CA mutation identified as part of clinical trial

  • Patient receives neoadjuvant TC x 6 cycles and then undergoes bilateral mastectomy

  • Right mastectomy specimen reveals a 3-cm ILC with minimal chemotherapy effect and 4/15 positive nodes

  • She returns to the clinic now to discuss adjuvant treatment options 

Which of the following would you select as adjuvant therapy for this patient?

2.

Patient Case 2: Woman With Grade 2 IDC and 1 Positive Node



  • 42-yr-old premenopausal woman with right breast grade 2 IDC s/p lumpectomy and SLNB

  • 3.2-cm grade 2 IDC

  • ER 95%, PgR 50%, HER2 1+ by IHC, FISH negative, Ki-67 35%, 1/3 SLN positive for ITCs (pT2pN0i+)

  • BRCA1/2 negative

  • Receives ACT x 6, RT, ready to start endocrine therapy 

Which therapy would you recommend?