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IBC HER2+ Treatment — SCE Medical Oncology MCQ

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ModerateBreast CancerIBC HER2+ TreatmentSCE Medical Oncology

A 62-year-old woman with locally advanced breast cancer has inflammatory changes on clinical examination. Core biopsy confirms invasive ductal carcinoma, ER-/HER2+. What is the correct treatment sequence for inflammatory HER2+ breast cancer?

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

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Correct answer: A — Neoadjuvant chemotherapy + anti-HER2 therapy (dual blockade: trastuzumab + pertuzumab) → modified radical mastectomy → adjuvant anti-HER2 therapy to complete 1 year → post-mastectomy radiotherapy

IBC HER2+: neoadjuvant chemo + dual anti-HER2 (trastuzumab + pertuzumab per BERENICE/NeoSphere). MRM mandatory (BCS contraindicated). If non-pCR: T-DM1 adjuvant (KATHERINE). PMRT always indicated. pCR rates ~60-70% with dual anti-HER2.

Reference: NICE NG101; NeoSphere; KATHERINE; ESMO 2024