DR LOVE: So I want to just run through a couple of cases to get a better idea of exactly what you do in your practice. These are cases that actually were patients of Dr Joyce O’Shaughnessy’s. We presented this at ASCO during a satellite meeting. So now I’m going to see what you would think about it.

First is a 45-year-old patient, status post breast-conserving surgery, T2N1M0. ER 100%, PR 10%, HER2-negative. IDC, 3 of 15 nodes positive. Okay? So the question is, would you think about some type of genomic assay in a patient like this?

DR DICKLER: So she’s young. She’s otherwise healthy. And she’s premenopausal?

DR LOVE: Yes, premenopausal.

DR DICKLER: Yes. With 3 positive nodes. So no, I actually would not. Typically in this patient, I think that there’s enough data to suggest that chemotherapy, and particularly an anthracycline and taxane-containing regimen, adds benefit, adds disease-free and overall survival benefits and I would typically offer this patient chemotherapy followed by antiestrogen treatment.

DR LOVE: So just to clarify, same situation in a younger patient like this or even an older patient where you have 1 node involved, does that change your thought?

DR DICKLER: Yes it does, particularly if she’s older and has any comorbid medical conditions. I think Kathy Albain’s data looking at the 21-gene Recurrence Score in patients with node-positive disease suggests that if you find a patient in that low-risk group, she may not benefit from chemo. And I think it needs to be considered. We’re all awaiting prospective data from the RxPONDER trial. But yes, I do consider that data. And I do selectively do Oncotype in node-positive patients.

Early-stage breast cancer (BC) in the adjuvant and neoadjuvant settings

Genomic assays and (neo)adjuvant treatment decision-making

Management of metastatic BC (mBC)

CDK4/6 inhibitors for the treatment of BC

Novel approaches under investigation in BC