Breast cancer
UPDATED --- Adjuvant systemic treatment of luminal A/B early breast cancer in premenopausal women

Samira (46 years old)

Samira is a 46-year-old wedding planner. She was diagnosed with early breast cancer after detecting a lump in her right breast on self-examination.

Assessment summary

  • Premenopausal
  • No relevant medical history
  • No family history of cancer
  • Stage and tumour biology (core biopsy) at diagnosis:
    • cT2N1M0, 35 mm, 1 invaded lymph node
    • G3, invasive carcinoma of NST, ER 100%, PgR 25%, HER2 IHC 0, Ki67 40%
  • Neoadjuvant chemotherapy: 4x ddEC q2w with G-CSF support followed by 12x paclitaxel q1w
  • BCS + ALND
  • Pathology report:
    • G3 invasive carcinoma of NST, ER 100%, PgR 25%, HER2 IHC 0, Ki67 40%
    • Unifocal, 18 mm, ypT1c
    • Cellularity: 30%
    • LVI or perineural invasion absent
    • ypN1a (3/12): 3 positive lymph nodes
  • Multidisciplinary board meeting: postoperative RT and systemic therapy

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