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Breast Cancer — SCE Medical Oncology MCQ

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HardBreast CancerBreast CancerSCE Medical Oncology

A patient with a pathogenic germline BRCA1 variant and HER2-negative triple-negative breast cancer has residual invasive cancer after anthracycline- and taxane-containing neoadjuvant chemotherapy and definitive surgery. Which BRCA-directed adjuvant treatment and duration are supported by NICE and the UK product information?

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Correct answer: C — Olaparib 300 mg twice daily for 1 year, stopping earlier for recurrence or toxicity

TA886 recommends adjuvant olaparib for germline BRCA1/2-mutated, HER2-negative high-risk early breast cancer after neoadjuvant or adjuvant chemotherapy. The Lynparza SmPC gives 300 mg twice daily for up to 1 year, stopping earlier for recurrence or unacceptable toxicity. The appraisal is specific to olaparib and germline mutation; separate indications for pembrolizumab and olaparib do not by themselves prove that concurrent combination is mandatory or evidence-based.

Reference: NICE TA886 olaparib after chemotherapy for BRCA-mutated HER2-negative high-risk early breast cancer (Published May 2023): https://www.nice.org.uk/guidance/ta886/chapter/1-Recommendations; Lynparza 150 mg UK summary of product characteristics (Updated December 2025): https://www.medicines.org.uk/emc/product/9488/smpc