Breast Cancer — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardBreast CancerBreast CancerSCE Medical Oncology

A 55-year-old woman with HER2-positive early breast cancer (T1c N0, 18 mm) undergoes breast-conserving surgery. What is the recommended adjuvant anti-HER2 approach for this low-risk HER2-positive tumour?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Weekly paclitaxel plus trastuzumab completed over one year

For an 18-mm node-negative HER2-positive tumour, twelve weekly paclitaxel doses with trastuzumab completed to one year is a standard de-escalated approach. Weekly paclitaxel plus trastuzumab for six months of HER2 treatment: the low-risk regimen completes a full year of trastuzumab. Weekly paclitaxel plus trastuzumab-pertuzumab for one treatment year: dual HER2 blockade is disproportionate for this node-negative 18-mm tumour. Docetaxel-carboplatin plus trastuzumab for one treatment year: this more intensive backbone adds toxicity not required for the stated low-risk anatomy. Trastuzumab monotherapy for one treatment year after surgery: the evidence-based de-escalated regimen still includes paclitaxel.

Reference: Adjuvant paclitaxel and trastuzumab for node-negative HER2-positive breast cancer (Published January 2015): https://pubmed.ncbi.nlm.nih.gov/25564897/; NICE NG101 early and locally advanced breast cancer: recommendations (Updated April 2025; link maintenance March 2026): https://www.nice.org.uk/guidance/ng101/chapter/Recommendations