CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2 - Clinical Problem Solving EMQ Exam

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A 48-year-old female undergoes a left lumpectomy and sentinel lymph node biopsy for an invasive ductal carcinoma. Pathology reveals a 2.2 cm tumor with clear surgical margins. Immunohistochemistry shows Estrogen Receptor (ER) negative, Progesterone Receptor (PR) negative, and Human Epidermal Growth Factor Receptor 2 (HER2) strongly positive (3+ by immunohistochemistry). The sentinel node biopsy is negative for metastatic disease (0/2 nodes). What adjuvant systemic therapy regimen is most appropriate for this patient?

Adjuvant chemotherapy combined with Trastuzumab followed by Trastuzumab monotherapy for a total of 1 year Adjuvant endocrine therapy with Tamoxifen for 5 years Adjuvant Trastuzumab emtansine (T-DM1) monotherapy for 14 cycles No adjuvant systemic therapy is required given the lymph node-negative status

Correct Answer:

Adjuvant chemotherapy combined with Trastuzumab followed by Trastuzumab monotherapy for a total of 1 year

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