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Breast Cancer Case Studies

Case Studies: Neoadjuvant Therapy for HER2+ Early Breast Cancer

In this case-based interview series, Hope S. Rugo, MD, discusses the management of a 53-year-old woman with stage II HER2-positive, node-positive invasive ductal carcinoma of the breast.

Neoadjuvant Therapy for HER2+ Early Breast Cancer

  • A 53-year-old woman was referred to a breast surgeon after finding a mass in her left breast
    • PMH: unremarkable
    • FH: no history of cancer in first-degree relatives
    • PE: revealed a 6 X 5-cm, non-fixed mass in the left inferior breast without skin changes or nipple discharge, and palpable lymphadenopathy in the left axilla
    • ROS: clear
  • Mammogram confirmed a left-sided, poorly defined spiculated mass. Ultrasound shows a 5.3-cm solid mass and enlargement of 2 left axillary nodes with thickened cortex
  • Pathology results:
    • Core needle biopsy from the breast mass confirmed grade 3 invasive ductal carcinoma
      • ER–, PR–, HER2 IHC 3+
      • FISH, HER2 copy number, 15; HER2:CEP17 ratio, 7
    • Fine-needle aspiration of one left axillary lymph nodes was positive for carcinoma
  • Staging: T2bN1M0
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