Early HER2+ Breast Cancer
Early HER2+ Breast Cancer
Case: A 52-Year-Old Woman withHER2+ Breast Cancer
H & P
- A 52-year-old, postmenopausal woman presented with a mass in her left breast at her annual gynecologic exam; was referred to oncology
- 2 children, menopause at age 49
- No history of cardiovascular disease, no family history of breast cancer
- PE: reveals a slightly overweight woman (BMI = 26 kg/m2), with palpable masses in left breast and left axillary nodes
Imaging
- Mammogram reveals 2.5-cm tumor in left breast
- CT: confirms tumor in left breast and left axillary node involvement (2.6-mm metastasis in 1 node)
Biopsy and labs:
- Histology: invasive ductal adenocarcinoma
- Histologic grade: G2
- ER (-)/ PR (-)
- HER2IHC, 3+
- BRCA1/2status: unknown
Treatment
- She received neoadjuvant TCH-P (docetaxel + carboplatin + trastuzumab + pertuzumab) and achieved pathologic complete response
- Developed grade 3 diarrhea during second cycle of chemotherapy, which required a one-level dose reduction of paclitaxel
- Diarrhea resolved to grade 1/2
- Underwent breast-conserving surgery and removal of left axillary lymph nodes; no residual disease
- Currently completing adjuvant therapy; trastuzumab + pertuzumab (total 18 cycles)
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