Breast cancer
NEW --- Systemic therapy for early stage TNBC

Jamila (36 years old)

Jamila, 36 years old, works as an event manager. Her creativity and hands-on mentality allow her to organise the best team buildings, weddings and birthday parties. She recently felt a lump in the left breast.

Assessment summary

  • Premenopausal
  • No family history of breast and ovarian cancer
  • No relevant medical history, ECOG PS: 0
  • Tumour size: cT2 (33 mm), LN status: cN1
  • Tumour biology:
    • Ductal invasive carcinoma of NST
    • ER 0%, PgR 0%, HER2 IHC 0
    • Ki67 70%
    • G3
  • CT scan chest/abdomen and bone scan: no metastases
  • Genetic testing: no BRCA1/2 mutation
  • Primary systemic therapy (including LHRH analogue): 4 cycles of pembrolizumab + paclitaxel + carboplatin, followed by 4 cycles of pembrolizumab + AC
  • BCS + SLNB
  • Pathology report:
    • Residual tumour: ductal invasive carcinoma of NST, ER 0%, PgR 0%, HER2/neu IHC 0, Ki67 20%
    • Stage ypT1N0
    • Residual cancer burden: RCB-II

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