Roundtable Roundup: Adjuvant Therapy for HR+, HER2- Breast Cancer

CASE SUMMARY

• A 59-year-old postmenopausal woman presented with a newly discovered lump in her left breast and palpable axillary lymph node (ALN).
• Imaging identified an 8.1-cm solid mass in the lower inner quadrant with a suspicious ALN.
• Core biopsy: positive for invasive ductal carcinoma (IDC), estrogen receptor, 80%; progesterone receptor, 30%; HER2 0 by immunohistochemistry; grade 2
• Fine-needle aspiration of ALN was positive for IDC.

• Germline testing was negative for deleterious mutations.
• Staging PET/CT was negative for distant metastasis.
• The patient received neoadjuvant doxorubicin, cyclophosphamide, and paclitaxel.
• She underwent bilateral mastectomy.
• Pathology (left breast): 5.1-cm IDC and 1/15 positive nodes
• Her 21-gene assay recurrence score: 24
• Anatomic stage: pT3 pN1a M0/stage IIIA