A 58-Year-Old Woman With Recurrent HR+ Breast Cancer

December 2013

• A 58-year-old postmenopausal woman was referred for further evaluation of a suspicious left-sided lesion found incidentally on routine mammogram
  • MRI revealed a 4.3-cm lesion in her left breast
  • PMH unremarkable
• She underwent lumpectomy with axillary staging
• Biopsy findings:
  • Histology: lobular carcinoma, grade 2
  • Hormone receptor status: ER+/ PR (-)
  • HER2,IHC 1+
  • OncotypeDx RS, 19
• Staging, T2N0M0
• ECOG 0
• She was started on adjuvant anastrozole

September 2018

• On routine follow-up, the patient reports increasing fatigue and intermittent bouts of abdominal pain with nausea
• CT with contrast showed several small lesions in the liver; biopsy confirmed metastatic disease.
  • The patient was started on ribociclib; anastrozole was changed to fulvestrant
  • Imaging at 3 and 6 months showed a partial response