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 07, 2025

Expiration: February 06, 2026

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

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?