Adjuvant Treatment of HR Positive HER2 Negative EBC

CE / CME

Integrating the Evidence on Adjuvant Therapy for High-risk HR-Positive/HER2-Negative Early Breast Cancer

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Nurses: 0.50 Nursing contact hour

Pharmacists: 0.50 contact hour (0.05 CEUs)

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

ABIM MOC: maximum of 0.50 Medical Knowledge MOC point

Released: February 05, 2025

Expiration: February 04, 2026

Activity

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Introduction

In this module, Aditya Bardia, MD, MPH, FASCO, reviews the available evidence, current guidelines, and optimal individualized approaches to integrate adjuvant therapy into the treatment algorithm for patients with hormone receptor (HR)–positive/HER2-negative, high-risk early breast cancer (EBC).

The key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slideset, including slidenotes, which can be found here

Clinical Care Options (CCO) plans to measure the educational impact of this activity. A few questions will be asked twice: once at the beginning of the activity and then again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions.

How many people with breast cancer do you provide care for in a typical month?

A 58-year-old woman who is postmenopausal presents with a 5-cm right breast mass with a suspicious node. Initial breast biopsy reveals invasive ductal carcinoma (IDC), grade 3, with the following biomarkers: estrogen receptor (ER) 80%; progesterone receptor 30%; HER2 negative by immunohistochemistry. Fine-needle aspiration of a palpable right axillary lymph node (ALN) reveals adenocarcinoma of the breast and germline BRCA (gBRCA) testing is negative.


The patient receives neoadjuvant doxorubicin, cyclophosphamide, and paclitaxel and then undergoes bilateral mastectomy. Right mastectomy specimen reveals a 4-cm IDC with minimal chemotherapy effect and 4/15 positive nodes. She returns to the clinic now to discuss adjuvant treatment options.

Based on the patient’s tumor characteristics and predictive biomarkers, which of the following would you recommend as the most appropriate systemic adjuvant therapy for this patient?