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CDK4/6 Inhibitors HR Positive HER2 Negative EBC

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Case Challenge: Optimizing Patient–Provider Communication About CDK4/6 Inhibitors for Treatment of HR+/HER2- EBC

Physician Assistants: maximum of 1.00 hour of AAPA Category 1 CME credit

Registered Nurses: 1.00 Nursing contact hour

Released: May 22, 2026

Expiration: November 21, 2026

Activity

Progress
1 2
Course Completed

How many people with breast cancer do you provide care for in a typical month?

For those who practice in academic or community settings, please indicate your practice setting:

A 58-year-old postmenopausal woman with estrogen receptor (ER)–positive, HER2-negative, grade 3 invasive lobular carcinoma (T2N1) and an Oncotype Dx recurrence score of 26 underwent lumpectomy with sentinel node biopsy revealing 2/3 positive nodes, followed by adjuvant docetaxel/cyclophosphamide chemotherapy and radiation. She now presents for consideration of additional adjuvant systemic therapy in the context of node-positive, high-risk hormone receptor (HR)–positive breast cancer after completing initial treatment. In addition to extended-duration adjuvant endocrine therapy (ET), what additional systemic therapy would be an appropriate treatment for this patient?

How confident are you in your answer?

While taking adjuvant abemaciclib, the patient says diarrhea is still affecting work and worries treatment is “not worth it” if this continues. What is the best next step?

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History
Your patient PK is a 61-year-old postmenopausal woman with a history of ER-positive, progesterone receptor–positive, and HER2-negative (IHC 0) right breast cancer. She is BRCA negative. She completed neoadjuvant chemotherapy and recently underwent a right breast skin-sparing mastectomy with axillary lymph node dissection. Final pathology revealed residual invasive ductal carcinoma, 4.0 cm, grade 3, with 4/14 positive lymph nodes. Her final pathologic staging is ypT2 pN2 M0 (Stage IIB).

Current Presentation
PK presents to your clinic following surgery to discuss adjuvant treatment options. She is active in her community and travels often, so she wants to make the best choice that will align with her ideal quality of life during treatment. She expresses that preventing relapse is a top priority.

Which plan would you discuss with PK as an adjuvant treatment choice that would best align with her goals of preventing relapse?