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Before decision regarding SLND, what is the metastatic work up and KI67, chronic diseases and PS ?
Not necessary,as cancer may be in lungs or viseral. CT or MRI more useful.
Adjuvant aromatase inhibitor if luminalA..tamoxifen is contraindicated
21 recurrent score might be beneficial for decision making about chemo therapy
69 years old may not need alnd but radiation therapy to whole breast and regional nodes
Alnd is still an option
I would start hormone treatment with aromatase inhibitor identifying a measurable lesion to evaluate response. After 90 days of medication and attending especially the evolution of his thromboembolic disease, I would think about the locoregional actinic treatment if I have response. I do not see any usefulness of the ALND.
Was it enough to have targeted axillary lymph node dissection only?
She has ER +ve HER2 _ve T2 N1 disease.Being a luminal A type ALD may be avoided. She needs adj AI.she may be candidate for adjuvant radiation as 3 LN are
+ VE ONE with ene
JOSE FERNANDO ROBLEDO
Given that a metastatic lymph node was proven positive upfront she would not qualify por Z0011 or Amaros trials. I think she had an indication por lumpectomy + lymph node dissection or to enrole in a neoadjuvant primary systemic therapy trial like the Alliance
First of all,PS,metastatic work up and ki67 are necessary
Pending Moderator approval.
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