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Case Challenge: Managing Adjuvant Treatment of a 43-Year-Old Woman With HER2+ Early Breast Cancer

Case Challenge
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This activity is available for 0.50 CME/CE credit(s).

Released: November 03, 2026

Expiration: May 02, 2027

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New approvals in the neoadjuvant and adjuvant settings of HER2-positive early breast cancer are increasing the complexity of selecting optimal treatment. This patient case challenges you to navigate treatment selection based on specific patient clinical presentation characteristics, including response to neoadjuvant treatment, best practices for sequencing adjuvant radiation therapy, and management through treatment-related adverse events based on the currently available evidence.

Patient Case Adjuvant HER2 Positive EBC

Pre Assessment

Assess your current knowledge and clinical approach before beginning your Case Challenge.
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 58-year-old woman presents with operable, HER2-positive (IHC 3+), hormone receptor (HR)–negative breast cancer, staged as cT2N1M0. She receives 6 cycles of neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP), followed by surgery. Pathology shows a 1.2-cm residual invasive tumor and residual disease in 2 axillary lymph nodes (ypT1cN1a). She has normal cardiac function and no history of interstitial lung disease (ILD).

Which adjuvant regimen would you recommend as the most appropriate for this patient?

4.

A 58-year-old woman with HER2-positive early breast cancer receives adjuvant T-DXd for residual node-positive disease after neoadjuvant TCHP and surgery. After 8 cycles of T-DXd, she experiences ILD requiring discontinuation of T-DXd. Corticosteroids are initiated.

Which approach would you recommend for her regarding adjuvant HER2-directed treatment as the most appropriate with the lowest risk of additional ILD?