Darlene (43 years old)

Darlene is a 43-year-old architect and goes on a city trip every 2 to 3 months to get inspired by the typical architecture of different countries. She felt a palpable mass in the right breast and palpable axillary lymph nodes and was diagnosed with breast cancer.

Assessment summary

• Premenopausal
• No family history of breast or ovarian cancer
• No comorbidities
• ECOG PS: 0
• Tumour size: cT2 (39 mm), lymph node status: cN2
• Tumour biology: ER 70%, PgR 15%, HER2 IHC 3+, Ki67 30%, G3
• CT scan chest/abdomen and bone scan: cM0
• Patient refused neoadjuvant systemic therapy and insisted on primary surgery
  • Mastectomy + ALND
  • pT2 (43 mm), pN3a (10/17), R0, LVI
• Adjuvant systemic therapy and radiation therapy
  • 4x EC, followed by 12x paclitaxel + trastuzumab + pertuzumab for 1 year
• Reconstructive surgery