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Metastatic Breast Cancer
Center of Excellence
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Jose Caicedo
Feb 18, 2017
I think is a rare case I would consider it as a new primary tumor
I would ask for a Mammaprint test, and based on Mindact trial, if it is low risk ( Luminal A) I would not give quemo. It has a high Ki 67 score, but the genomic test would help
nagib khoury
Feb 18, 2017
i would consider this as new primary and treat it as such
based only on the clinical data at hand with LN + and ki67(high) I would consider chemotherapy
Oncotype Dx ( though there is some evidence supporting its use in N + ,there is no consensus) : I will not askfor it
As for Mindact: for the discordent categories,ie clin high molecular low or clinlow molecular high the benefit is around 1,8 % to 2,2%and the decision to treat or not to treat depends on one s interpretation of the results. I don t think the mamaprint would change my decision to use chemotherapy,,
Jason Friedman
Mar 08, 2017
High Ki67 and PR negative constitutes aggressive disease requiring chemotherapy...according to large UK study. Oncotype DX not necessary.
May 14, 2024
Pending Moderator approval.
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Sameer
Nasir
MD
Jose Caicedo
Feb 18, 2017
nagib khoury
Feb 18, 2017
Jason Friedman
Mar 08, 2017
May 14, 2024
Pending Moderator approval.