Tina (37 years old)

Tina, 37 years old, runs a cat hotel and loves to spoil the cats when their owners go on vacation. She was diagnosed with right-sided luminal B-like cT2N1M0 breast cancer after she felt a palpable lump in her right axilla.

Assessment summary

• No relevant medical history
• Premenopausal
• Genetic counselling + testing (positive family history): no BRCA1/2 germline mutations
• Tumour biology (core biopsy): G2, invasive carcinoma of NST, ER 100%, PgR 10%, HER2 IHC 2+ SISH negative, Ki67 50%
• FNAC axillary node: positive
• Tumour location: laterally in the breast
• Neoadjuvant chemotherapy: dose-dense EC q2w with G-CSF support, followed by dose-dense paclitaxel q2w
• Breast MRI at post-neoadjuvant therapy:
  • Partial response in breast (19 mm nodule) and complete response in axilla (ycT1cN0)
• 3 weeks later: BCS with minor reconstructive techniques and limited ALND
  • 19 mm foci, G2, invasive carcinoma of NST
  • Lymphovascular invasion
  • R0 resection
  • 1 macrometastasis and 1 micrometastasis (2/6 lymph nodes)
  • ypT1cN1a
• Patient will be treated with RT (whole-breast RT + boost) and hormonal therapy