Carina (54 years old)

Carina is a 54-year-old hair stylist who had been feeling bad for weeks. She had a resistant cough, felt tired and suffered from back pain and nausea. As she was too busy with her own hair salon, she did not see a doctor until she felt so sick that she was unable to eat and could hardly breathe. A diagnostic work-up showed advanced breast cancer.

Assessment summary:

• Postmenopausal
• Medical history: smoking (40 pack years), chronic obstructive pulmonary disease
• Imaging:
  • 7 cm tumour in the left breast, multiple suspicious axillary lymph nodes
  • Multiple suspicious lesions in bones, lung, pleura, huge pleural effusion, 4 liver lesions suspicious for metastases
• Biopsy of liver lesion: breast cancer, NST, ER 30%, PgR 10%, HER2 IHC 1+, G2
• Haematology: all values normal; biochemistry: GOT 10x ULN, GPT 9x ULN, bilirubin 2x ULN, other values normal
• Germline BRCA-status: wild type
• PIK3CA-status in the tumour: wild type