A 42-year-old woman with breast cancer.
This premenopausal women has a T1c, N1 (two nodes positive) ER-positive, PR weakly positive, HER2 FISH-positive, grade 3 invasive ductal carcinoma. She has been treated with lumpectomy and axillary node dissection. The recommendation of the panel is for her to join one of the randomized trials studying the role of trastuzumab in node-positive breast cancers. Off protocol, we would recommend adjuvant chemotherapy with doxorubicin/cyclophosphamide followed by docetaxel, although numerous options are available. Chemotherapy would be followed by radiation therapy and hormonal treatment. At this point, we recommend tamoxifen, with consideration to adding goserelin (Zoladex) if the patient does not remain amenorrheic. The patient chose to enter the Intergroup trastuzumab trial.
Crawford
E David
ED
University of Colorado Health Sciences Center, Denver, Colorado, USA.
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008327:Mammography; D015412:Mastectomy, Segmental; D017697:Premenopause; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D011960:Receptors, Estrogen / Q000032:analysis; D012017:Referral and Consultation; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy; D013629:Tamoxifen / Q000008:administration & dosage; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D013629:Tamoxifen