Medical Oncology

University of Iowa

Questions discussed in this category

Would you still obtain Ki-67 prior to use of adjuvant abemaciclib in a patient who has otherwise met MonarchE treatment criteria, such as 1-3 positive LNs, grade 3 and/or tumor >5 cm?

Patient is pre-menopausal and has cT3cN1, grade 2, ER positive, Her 2 negative IDC. Metastatic disease to axillary LNs was biopsy-proven. Patient was ...

1 Answer available

What is your preferred adjuvant chemotherapy regimen for a patient with local recurrence of TNBC two years after completing neoadjuvant ddAC-T who declined prior adjuvant capecitabine?

Had mastectomy resulting in ypT1cN1a. Post menopausal female with good PS.

1 Answer available

In which situations do you offer ovarian suppression with chemotherapy to prevent the development of premature menopause in premenopausal women with ER negative breast cancer?

Fertility preservation already complete with embryo cryopreservation

1 Answer available

In which situations do you consider post-mastectomy radiation therapy when the patient has a localized node-positive breast cancer with a complete nodal response and minimal residual disease in the breast post-neoadjuvant chemotherapy?

1 Answer available

How would you manage adjuvant treatment of a premenopausal woman with HER2 positive, ER/PR negative multifocal micro-invasive node-negative breast cancer?

Largest invasive focus is 0.4mm

1 Answer available

Would you consider surgical management of a TNBC primary after a patient has had radiographic resolution of oligometastatic disease?

Patient with T2N1 disease and isolated liver metastases. Axilla and liver completely responded to chemo + IO, but limited residual breast enhancement ...

2 Answers available

How do recent RxPonder results affect your adjuvant therapy choice for premenopausal women with HR+/HER2 negative breast cancer with 1-3 positive LNs?

Would you consider an Oncotype or Mammaprint? Would your management change if the patient had 1-3 positive LNs on SLNBx (as opposed to ALND)?

1 Answer available

What systemic therapy would you consider, if any, for an isolated but multifocal CNS recurrence of HER2+ HR negative breast cancer treated with local therapy (>4 lesions treated with resection and SRS)?

Patient completed neoadjuvant therapy with TCH 2 years prior, and has no evidence of disease outside the CNS on PET/CT.

1 Answer available

For a post-menopausal patient with a pT2N0 HR+/HER2- breast cancer at surgery after 4 months of neoadjuvant anastrozole with minimal clinical or pathologic response, would you utilize genomic testing to guide decision about adjuvant chemotherapy?

Would you test initial core biopsy (prior to neoadjuvant anastrozole) or surgical specimen? Any preference for Oncotype vs. Mammaprint?

1 Answer available

How do you approach a stage IIIC triple positive IDC, s/p neoadjuvant TCH and P, lumpectomy, and ALND with significant residual disease at the time of surgery?

Would you recommend additional cytotoxic chemotherapy and/or switch her anti-Her therapy to T-DM1?

5 Answers available

What neoadjuvant therapy would you choose for a post menopausal woman with ER negative, PR positive high grade node negative breast cancer?

Would you consider genomic assays before neoadjuvant chemotherapy? How would you modify your treatment given the COVID-19 pandemic?

5 Answers available

Would you choose neoadjuvant endocrine therapy for a low grade, node negative, ER/PR positive, breast cancer given delays in definitive surgery due to the COVID-19 pandemic?

Would your choice vary based on the patient's gender?

1 Answer available

Does mucinous histology impact your recommendations for neoadjuvant therapy in a postmenopausal patient with HR+ HER2- breast cancer with multiple positive lymph nodes?

Being that this is a favorable histology would you use Oncotype Dx to help decide on neoadjuvant chemotherapy? Would you recommend neoadjuvant endocri...

1 Answer available

Would you offer contralateral prophylactic mastectomy in an older BRCA1 + woman who is getting treated for newly diagnosed BC with mastectomy and SLNB?

Knowing that benefit of contralateral mastectomy is lower in older women who has already manifested BRCA related cancer and 10-20 % mastectomy related...

1 Answer available

How would you approach adjuvant chemotherapy and radiation options in a patient with locally advanced TNBC and Diamond-Blackfan Anemia s/p lumpectomy?

Given that DBA is associated with increased incidence of MDS, AML and other solid tumors, would this modify your treatment recommendations?

1 Answer available

Will you consider additional capecitabine in a patient with TNBC, residual disease after neo-adjuvant chemo, before getting adjuvant pembrolizumab or placebo on SWOG 1418 clinical trial?

3 Answers available

Do you offer neoadjuvant therapy to a postmenopausal cT1cN0 , HER2+, ER/PR+ breast IDC or recommend surgery first?

4 Answers available

Do you consider omitting adjuvant radiation therapy in an older patient with node positive TNBC who achieve pCR to neoadjuvant chemotherapy?

2 Answers available

What systemic therapy would you offer to a postmenopausal patient with an unresectable local recurrence of HER2+/ER weakly + IDC?

In a patient with who had undergone neoadjuvant TCH-P, lumpectomy, and RT and is currently on AI, pertuzumab, and trastuzumab, how do you think about ...

1 Answer available

What is the most appropriate adjuvant chemotherapy regimen for pre-menopausal, pT1bN0, TNBC?

Would you forego anthracycline?

1 Answer available

What would be your next line of therapy for a postmenopausal metastatic ER+/Her 2- BC, s/p anastrazole and palbociclib/fulvestrant who has progressive disease and ESR1 mutation on ctDNA?

2 Answers available

After partial mastectomy, would you consider Oncotype for an older male with HR +/Her 2- IDC, T1cN0, Grade 2 disease?

Do you see a role for adjuvant radiation therapy?

1 Answer available