Risk of Recurrence
Stephanie Graff, MD, describes her impression of the case and discusses the risk for recurrence in this particular patient.
EP: 1.Clinical Case 1: High-Risk Early-Stage HR+ Breast Cancer
EP: 2.Risk Factors and the Treatment Plan
EP: 3.Endocrine Therapy for Early-Stage Breast Cancer
EP: 4.Key Findings from the monarchE Trial
EP: 5.Individualizing Care with CDK 4/6 Inhibitors
EP: 6.Age-Dependent Results With CDK 4/6 Inhibitors
EP: 7.Dosing CDK 4/6 Inhibitors
EP: 8.Implementing Trial Data to Our Practice
EP: 9.Selecting Endocrine Therapy in BRCA1/BRCA2+ Breast Cancer
EP: 10.Clinical Case 2: High-Risk Early-Stage HR+ Breast Cancer
EP: 11.Risk of Recurrence
EP: 12.Key Findings from the NATALEE Trial
EP: 13.Impact of Trial Data on Clinical Practice
EP: 14.Managing Toxicities and Adverse Events of CDK 4/6 Inhibitors
EP: 15.What is on the Horizon for Adjuvant Therapy in Early-Stage Breast Cancer?
Transcript:
Rachel Layman, MD: How would you approach this patient in regard to classifying her risk of recurrence?
Stephanie Graff, MD, FACP: This is another great case of a premenopausal patient who is at high risk for disease recurrence. One of the interesting and great things that’s happening in breast cancer, if you look across the history of the disease, is that we’re lucky to live in a time when there is an overwhelming number of patients participating in screening in the United States, so most patients [receive] breast cancer [diagnoses] early, but that doesn’t necessarily mean that they do not have biologically aggressive disease. It means that they have screen-detected disease. We also live at a time when our surgical colleagues have been accelerating the pace of surgical research and have advanced surgical research to the place where, more often, our patients are not having axillary lymph node dissections. They’re having sentinel lymph node biopsies alone, or sometimes even omission of sentinel lymph nodes for [older] patients. Many patients with hormone receptor–positive breast cancers have early anatomic stage disease that may not correlate with a biologically low-risk disease. So, one of the nice things about the NATALEE [NCT03701334] trial was that broader eligibility criteria than what was included in monarchE [NCT03155997], which allows us to think about CDK4/6 inhibitors in a slightly wider group of patients.
Transcript edited for clarity.
