Case 1: Eva (46 years old)

Eva is a 46-year-old sales agent who fell during her last summer vacation. 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.

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
• Genetic panel analysis due to family history: pathogenic variant in BRCA1 gene
• Tumour analysis for PD-L1 status: CPS 3, IC score 0%
• No relevant comorbidities
• ECOG PS: 0