The Fellow on Call: The Heme/Onc Podcast Episode 057: Breast Cancer Series,Pt. 6-ER+, Early Stage Breast Cancer
May 24, 2023
Dive into the intricacies of early-stage ER+/HER2- breast cancer as experts discuss essential factors like tumor size and grade. The role of chemotherapy is examined, along with varying treatment regimens and their trade-offs. Key insights into endocrine therapy highlight how menopausal status affects treatment choices. Discover the implications of ovarian suppression in high-risk cases, making this a must-listen for anyone interested in advanced cancer care strategies.
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Key Data To Gather Upfront
- Always confirm HER2 status, tumor size, grade, nodal involvement, and menopausal status before planning systemic therapy.
- These factors drive chemo selection, endocrine choice, and duration of adjuvant therapy.
When To Use Neoadjuvant Chemotherapy
- Consider neoadjuvant chemotherapy to downstage tumors that are inoperable or to enable breast-conserving surgery.
- Also use neoadjuvant chemo in premenopausal node-positive patients to potentially avoid axillary dissection.
pCR Is Prognostic, Not A Perfect Surrogate
- Pathologic complete response (pCR) is prognostic but not validated as a universal surrogate for survival in HR+ disease.
- Fewer HR+ tumors achieve pCR with chemo, so neoadjuvant benefit differs by subtype and biology.