Breast cancer
Theragnostic testing – choosing the right therapy in mTNBC

Melissa (46 years old)

Melissa, 46 years old, fell off the ladder during window cleaning. Although it was a mild trauma, she broke her thigh bone. An X-ray showed a fracture due to suspected bone metastases. Further diagnostic work-up revealed mTNBC with bone metastases.

Assessment summary

  • Premenopausal
  • Cancer family history
    • Aunt (father’s sister): unilateral breast cancer at the age of 45 years
  • Medical history
    • 3 years ago: diagnosis early stage TNBC (cT2N0M0, left side)
    • Neoadjuvant anthracycline-taxane chemotherapy
    • BCS + SLNB (pCR: ypT0 ypN0)
    • Radiation therapy
  • Present diagnostic work-up including CT scan chest/abdomen and bone scan
    • Multiple bone lesions. Biopsy (bone lesion left femur): breast cancer, ER 0%, PgR 0%, HER2 IHC 0, Ki67 40%, G3
    • 2 suspicious lesions in left lung
  • No relevant comorbidities
  • ECOG PS: 0

Which of the following biomarkers do you consider appropriate to investigate to determine treatment for this patient?