Open AccessTrastuzumab for Small HER‐2+ Breast Cancer: Small Tumor, Big Decision
Author(s) -
Connolly Roisin M.,
Bardia Aditya
Publication year - 2012
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2012-0077
Subject(s) - medicine , lumpectomy , trastuzumab , breast cancer , oncology , biopsy , sentinel lymph node , lymphovascular invasion , sentinel node , breast ultrasound , estrogen receptor , hormonal therapy , cancer , mastectomy , mammography , metastasis
Presentation of the Case A 53‐year‐old postmenopausal woman was found to have a new area of microcalcification at the 10 o'clock position of her right breast during a routine screening mammogram. Ultrasound‐guided core biopsy revealed a grade 2 invasive ductal carcinoma, estrogen receptor (ER)+ (90%), progesterone receptor positive (20%), and human epidermal growth factor receptor (HER)‐2+ (3+ by immunohistochemistry). A right breast lumpectomy and sentinel node biopsy were performed. The invasive tumor measured 0.7 cm, no lymphovascular space invasion was identified, surgical margins were uninvolved, and the sentinel lymph nodes were negative for tumor. She was evaluated postoperatively in the medical oncology clinic to discuss an adjuvant treatment strategy. The question for our colleagues is: should she be offered adjuvant chemotherapy and trastuzumab prior to adjuvant radiation and 5 years of hormonal therapy?