EDITOR
Neil Love, MD
FACULTY
Mark D Pegram, MD
COMMUNITY ONCOLOGIST
William N Harwin, MD
Case 1
A 60-year-old woman underwent a mastectomy five years ago for
a locally advanced, multiple node-positive, hormone receptor-positive, HER2-negative, infiltrating lobular carcinoma and
received dose-dense AC 
paclitaxel, anastrozole and radiation
therapy. After approximately four years, she presented with
thrombocytopenia and a rising CA27.29 level. Bone marrow biopsy
revealed an adenocarcinoma consistent with the breast primary.
Case 2
An 84-year-old woman was treated with radiation therapy and
trastuzumab for a postmastectomy chest wall recurrence of an
ER-negative, PR-negative, HER2-positive adenocarcinoma. After
two years on trastuzumab, she developed a 3-cm axillary mass.
Case 3
A 67-year-old woman with a history 20 years ago of hormone
receptor-positive breast cancer was diagnosed with bone and liver
metastases. Biopsy revealed an ER-positive, PR-positive, HER2-
negative adenocarcinoma consistent with the breast primary.
The patient was treated on a clinical trial evaluating fulvestrant
combined with bevacizumab.
Case 4
A 55-year-old woman with extensive prior anti-HER2 treatment
including trastuzumab, lapatinib and the combination developed
progressive abdominal pain and anorexia after receiving
stereotactic radiation therapy for an isolated, progressive liver
metastasis.
Case 5
A 48-year-old woman with hormone receptor-positive, HER2-
negative breast cancer presented with extensive bone metastases,
which were initially treated with hormonal therapy followed by
nanoparticle albumin-bound (nab) paclitaxel/bevacizumab.
