Talia (46 years old)

Talia, 46 years old and the biggest gossip in town, works as a hairdresser. Her clients love to come to her salon, not for a new haircut, but to get an update on the latest scandals. She was diagnosed with early breast cancer after detecting a lump in her right breast on self-examination.

Assessment summary

• Premenopausal
• Medical history: deep venous thrombosis, pulmonary embolism, 2 miscarriages (>5 years ago), but no coagulopathy
• 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
  • ypN2a (4/12): 4 positive lymph nodes
• Multidisciplinary board meeting: postoperative RT and systemic therapy