Moffitt Cancer Center&nbsp;&nbsp;&nbsp;

How would you approach adjuvant systemic therapy for a pT3N0(i+) HR+/HER2 negative breast cancer with an intermediate oncotype in a post-menopausal woman?

How does age factor into your planning whether to give a high risk pre-menopausal patient with breast cancer ovarian function suppression?

Do you have a specific age cutoff?

What is your approach for endocrine therapy in young women (<35 years old) with HR+/HER2+ breast CA with residual disease after TCHP who will start adjuvant T-DM1?

How do you manage adjuvant endocrine therapy for pre-menopausal women with locally advanced, weakly positive ER/PR, HER2 negative breast cancer?

Would a pCR to neoadjuvant chemotherapy change your management? (ER <5%, PR <5%)

How do the new RxPONDER results affect your choice of adjuvant therapy for postmenopausal women with HR+/HER2 negative breast cancer and 1-3 positive lymph nodes?

Would you send an Oncotype RS to determine the role of adjuvant chemotherapy and/or endocrine therapy?

How do you manage ovarian suppression for premenopausal patients with HR+/HER2 positive breast cancer?

Does lymph node positivity change your management?

How would you council a woman in her 50s with Stage I HR+/HER2- breast cancer with a high risk Mammaprint but intermediate OncotypeDx regarding adjuvant chemotherapy?

How do you counsel patients with a curable breast cancer that there is no indication for additional surveillance imaging after treatment other than continuing annual mammograms?

4 Answers available

What changes, if any, would you make to a patient’s endocrine therapy for a patient with DCIS on tamoxifen for risk reduction who develops a new lesion (LCIS) while on tamoxifen?

Would your answer change if the new lesion is ALH/ADH?

How would you manage a young patient with newly recurrent metastatic triple negative breast cancer less than a year after completing adjuvant chemotherapy and worsening liver function due to intrahepatic disease?

Patient completed adjuvant AC-T 8 months prior to recurrence. BRCA negative, foundation medicine NGS pending.

How would you manage a patient who develops pleural and skin metastases shortly after completing neoadjuvant ddAC-T and surgery for a locally advanced triple negative breast cancer?

PD-L1 is low and she has residual neuropathy from neoadjuvant paclitaxel.

5 Answers available

Would weak PR positivity make you consider adjuvant endocrine therapy for a young pre-menopausal woman with a HER2 positive, ER negative breast cancer?

If yes, would you offer tamoxifen or ovarian suppression plus AI?

Would you recommend PMRT for a patient with a right breast mastectomy with closest margin less than 0.1cm?

How long after lumpectomy for DCIS in a premenopausal patient can tamoxifen be started and still retain the benefit?

This patient is interested in conceiving and therefore would like to wait to start the tamoxifen.

How would you manage a postmenopausal female with a history of early stage invasive ductal ER+/HER2- breast cancer s/p mastectomy who has a local recurrence of ER+/Her2 - lobular carcinoma while on letrozole?

Would you finish neoadjuvant TC in a postmenopausal stage I TNBC patient who transferred care to your practice after 1 cycle or would you proceed with surgery and finish chemo adjuvantly?

If finished adjuvantly, what would you do -- continue TC or change chemotherapy?

How would you manage a patient with newly diagnosed synchronous triple positive and metaplastic triple negative breast cancers?

For early stage disease in a single breast, would you consider neoadjuvant chemotherapy or upfront surgical staging followed by adjuvant therapy? What...

How would you manage a patient with synchronous breast and ovarian cancer, s/p neoadjuvant chemotherapy and surgery for ER+/HER2- breast cancer and found to have an ER+ ovarian cancer nodal metastases at TAH/BSO?

RP node with treatment related changes and surgical specimen from TAH/BSO no other foci of malignancy found.

For patients with HER2+ breast cancer with a resectable HER2+ local relapse within 12 months of completion of standard adjuvant therapy including 1 year of trastuzumab, what adjuvant therapy would you recommend?

Does hormone receptor status impact your decision?

How would your treat a pregnant woman (2nd trimester) with multifocal HER2+ ER- early stage breast cancer?

greatest measuring 1.0cm.

How would you manage an elderly patient with a history of stage I CLL and newly diagnosed metastatic ER+/HER2+ breast cancer?

Would you perform an oncotype DX in a patient with a 0.5cm ER positive breast cancer with one lymph node positive for macrometastatic disease?

How do you manage a newly diagnosed locally advanced ER+/HER2- breast cancer with synchronous diagnosis of metastatic melanoma?

How do you manage a patient with newly diagnosed stage IIA triple negative breast cancer with a history of renal transplantation on immunosuppressive therapy?

What adjuvant treatment would you use in a pT1miN0M0 ER -/HER2 IDC of the breast after bilateral mastectomies?

Patient did not receive neoadjuvant therapy.