Case 1: Telma (60 years old)

Telma is a 60-year-old pianist. She presents with headache and nausea, which she experiences since the last 2 months.

Medical history: diagnosed with early breast cancer almost 2 years ago
- ER 0%, PgR 0%, HER2 IHC 3+
- Received adjuvant anthracycline/taxane and trastuzumab + pertuzumab (completed 6 months ago)
No relevant comorbidities
Brain CT: limited number of suspicious spots
Neurological clinical exam: normal
PET scan: single liver lesion and pleural effusion
Brain MRI: 3 brain lesions
Tumour biology (biopsy liver lesion): confirmation of metastasis of breast origin, invasive ductal carcinoma, ER 0%, PgR 0%, HER2 IHC 3+
ECOG PS: 0