How would you manage a premenopausal patient with HER-2 positive DCIS in the setting of a prior HER-2 positive contralateral breast cancer?

The patient had a prior right-sided ER+ HER2-ve breast cancer, treated with neoadjuvant chemotherapy, MRM with ALND, and PMRT

They recently developed contralateral left-sided DCIS that was accidentally checked for HER2 and found to be positive (3+)

Would your management of the patient's DCIS differ based on their prior contralateral breast cancer diagnosis or HER-2 positivity?

Answer from: Radiation Oncologist at Community Practice

NSABP B-43 looked at the combination of post-op RT + trastuzumab vs RT alone in HER2+ DCIS and while there was a numerically lower number of IBTR events in the trastuzumab arm, this did not reach statistical significance. At this time, we do not manage our HER2+ DCIS patients differently than HER2-....

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Radiation Oncologist at Mon Health
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Radiation Oncologist at Varian Medical Systems/Allegheny health network
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How would you manage a premenopausal patient with HER-2 positive DCIS in the setting of a prior HER-2 positive contralateral breast cancer?

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