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How would you treat an isolated ipsilateral axillary recurrence in a BRCA+ HR+ HER2+ breast cancer?
BRCA mutant, ER/PR positive and HER2 positive T2N0M0 breast cancer diagnosed 5 years ago, treated with bilateral mastectomy, BSO, 1 year of adjuvant anti-HER2 therapy on adjuvant endocrine therapy for nearly 5 years, and now has ipsilateral axillary recurrence. Restaging scans negative for systemic disease and the axillary node resected and again triple positive. Radiation naive.
Answer from: Medical Oncologist at Academic Institution
I would use olaparib for 12 months (OlympiA trial) in combination with endocrine therapy after surgery and radiation. Then continue the endocrine therapy with abemaciclib times 24 months and TDM1 for 12 months. Then only endocrine therapy for a total duration of 5-10 years. This is the most comprehe...
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