Breast cancer
Theragnostic testing – choosing the right therapy in mTNBC

Maya (67 years old)

Maya is 67 years old and felt extremely tired lately. She went to the GP and elevated liver enzymes were detected. Further diagnostic work-up was initiated and resulted in a diagnosis of primary metastatic breast cancer.

Assessment summary

  • Postmenopausal
  • Grandmother (father’s mother): TNBC at the age of 52
  • Germline BRCA testing: pathogenic BRCA2 mutation
  • Diagnostic work-up
    • Mammogram and sonography: cT2 (4 cm) cN1 (3 suspicious axillary lymph nodes) breast cancer (left side)
    • CT scan chest/abdomen and bone scan: 3 liver lesions and 2 lesions in left lung
    • Biopsy (breast and liver)
      • Breast cancer, ER 0%, PgR 0%, HER2 IHC 0, G3
      • PD-L1 status: CPS 1, IC score 0%
    • Lab values: ALT 1.5x ULN, AST 1.3x ULN, bilirubin normal
  • No relevant medical history
  • ECOG PS: 1

Which of the following treatment options would you choose for this patient?