HER2neg EBC

CE

Applying Evidence-Based Strategies to Improve Outcomes in HER2-Negative Early Breast Cancer

Pharmacists: 1.00 contact hour (0.1 CEUs)

Released: May 21, 2024

Expiration: May 20, 2025

Allison Butts
Allison Butts, PharmD, BCOP
Jordan Hill
Jordan Hill, PharmD, BCOP

Pretest

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

Patient Case


Your patient is a 51-yr-old female found to have clinical stage IIIA (T2N2M0) grade 3 TNBC on routine screening mammogram



  • She was treated neoadjuvantly with pembrolizumab in addition to carboplatin/paclitaxel followed by doxorubicin/cyclophosphamide

  • She underwent right mastectomy with SLNB and prophylactic left mastectomy

    • Final pathology: 4 mm of residual disease (ypT1aN0)



When designing a treatment plan, what additional testing should be completed to ensure optimal treatment of this patient’s early breast cancer? 

2.

Patient Case: Newly Diagnosed HR+/HER2- BC Receiving Neoadjuvant Chemotherapy



  • 56-yr-old female who presented with a right palpable breast mass and new nipple inversion x 1 mo

  • Diagnostic mammogram and ultrasound showed a 45-mm mass with multiple abnormal lymph nodes

  • Biopsy of mass revealed grade 3 IDC that was ER >90%, PR 1%-10%, HER2- (IHC 0)

  • Staging studies negative for metastatic disease

  • She has no significant past medical history

  • Plan undergoes mastectomy with ALND

    • Final pathology reveals 50-mm mass with 6 positive lymph nodes



  • Patient initiated on adjuvant ddAC followed by T

Additional testing reveals a gBRCA2 pathogenic variant and Ki-67 30%. In addition to endocrine therapy, which of the following treatments would you recommend based on its overall survival benefit in the adjuvant setting? 

3.

Your patient with TNBC receiving adjuvant pembrolizumab has pretreatment labs revealing a TSH of 0.1 mIU/mL with free T4 of 4.2 ng/dL. She is asymptomatic. What would you recommend for the management of this patient’s thyroid dysfunction? 

4.

Your patient with triple-negative breast cancer and a gBRCA1 pathogenic variant will be initiating adjuvant olaparib. Given the potential toxicity, which of the following supportive medications should your patient have available?