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HR-Positive/HER2-Negative EBC

CE / CME

High-Risk HR-Positive/HER2-Negative EBC With and Without gBRCAm

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Pharmacists: 1.00 contact hour (0.1 CEUs)

ABIM MOC: maximum of 1.00 Medical Knowledge MOC point

Physicians: maximum of 1.00 AMA PRA Category 1 Credit™

Nurse Practitioners/Nurses: 1.00 Nursing contact hour

Released: May 26, 2026

Expiration: November 25, 2026

Tanya Gupta
Tanya Gupta, MD
CME/CE Information

Pretest

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1 2 3
Course Completed
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1.

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

2.

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

3.

A 40-year-old premenopausal woman presented to her primary care provider 2 months ago with a progressively enlarging lump in her right breast. On examination, she had a 5-cm right breast mass and 3 palpable right axillary lymph nodes, which were confirmed by ultrasound and mammogram. Biopsy of the breast mass and lymph nodes demonstrated grade 3 invasive ductal carcinoma that was ER positive (60%), progesterone receptor–positive (20%), HER2-negative (immunohistochemistry [IHC] 0) breast cancer. PET-CT imaging showed no evidence of distant disease. She subsequently underwent lumpectomy and axillary surgery, with pathology demonstrating a 5.2 cm invasive ductal carcinoma and involvement of 3 out of 5 lymph nodes. Her Oncotype DX recurrence score was 35, consistent with high genomic risk.  Germline mutation testing was negative for BRCA1, BRCA2, and PALB2 mutations.

In this premenopausal patient with resected HR-positive/HER2-negative high-risk EBC and negative germline BRCA status, in addition to ovarian function suppression, which adjuvant systemic strategy is most appropriate?

4.

A 42-year-old woman presented to her primary care provider 2 months ago with a progressively enlarging lump in her left breast. On examination, she had a 5.5-cm left breast mass and 3 palpable left axillary lymph nodes, which were confirmed by ultrasound and mammogram; no other systemic disease was identified. Pathology demonstrated ER-positive (80%), progesterone receptor–positive (30%), HER2-ultralow breast cancer. Germline testing was positive for a deleterious BRCA1 mutation. She received neoadjuvant anthracycline-based chemotherapy before surgery but did not achieve a pathologic complete response (pCR). Her Ki-67 score was 20%, and her Oncotype DX recurrence score was 30, consistent with high genomic risk.

In addition to ovarian function suppression for premenopausal status, which of the following would you recommend as the optimal adjuvant systemic treatment for this patient with HR-positive/HER2-negative, high-risk EBC, a deleterious gBRCA1m, residual disease after neoadjuvant chemotherapy, and a CPS + EG score of 4?

5.

Your patient is concerned about staying on abemaciclib for the planned 2 years because diarrhea keeps recurring. In addition to starting antidiarrheal therapy promptly, which expert- and guideline-aligned strategy is most likely to support adherence and persistence while maintaining safety?

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