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Case Challenge: Select Neo/Adjuvant Treatment for a 42-Year-Old Woman With Moderate Renal Dysfunction and HER2+ Early Breast Cancer

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

Released: October 06, 2026

Expiration: April 05, 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 the treatment options based on initial disease burden, treatment tolerability, HER2 reassessment, response to neoadjuvant treatment, and currently available trial evidence.

Patient Case Neoadjuvant 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 60-year-old woman has newly diagnosed HER2-positive (IHC 3+), hormone receptor–negative breast cancer with a 6-cm primary tumor and no involved lymph nodes. She has normal cardiac and renal function. Which neoadjuvant regimen would be appropriate for this patient and demonstrated a significantly higher pathologic complete response (pCR) rate than dose-dense doxorubicin plus cyclophosphamide (ddAC) followed by taxane plus trastuzumab and pertuzumab (THP) in a phase III trial?

4.

A 50-year-old woman with node-negative (cT2N0), hormone receptor–negative, HER2-positive stage II breast cancer receives neoadjuvant TCHP. At surgery, she has 8 mm of residual invasive disease in the breast and no involved lymph nodes. You plan to treat the patient with T-DM1. A pathology report reveals the residual tumor is now HER2 negative (IHC 0). How do you proceed with adjuvant treatment?