Joan (47 years old)

Joan, 47 years old, loves knitting and crocheting cute animals for charity. She was diagnosed with HR+ HER2+ MBC 30 months ago. She has a follow-up visit today, and presents with headache.

Assessment summary

• Premenopausal
• No relevant comorbidities
• ECOG PS: 1
• Medical history:
  • 30 months ago: diagnosis de novo HR+ HER2+ MBC
  • Tumour biology (breast lesion): invasive ductal carcinoma, ER 100%, PgR 100%, HER2 IHC 2+ with amplification (ISH+)
  • First-line treatment for bone and lung metastases:
    • Paclitaxel + trastuzumab-pertuzumab for 22 months (paclitaxel stopped due to neuropathy after 18 infusions)
    • Maintenance dual blockade (trastuzumab-pertuzumab) and endocrine therapy (AI + LHRH analogue)
• Systematic PET-CT during follow-up: multiple bone progression
• Concomitant brain MRI due to headache: detection of 3 brain lesions (max 1 cm) for which local intervention is planned