Management of Recurrent and Metastatic Breast Cancer - Flowchart

Management of Recurrent and Metastatic Breast Cancer - Flowchart

Management of Recurrent and Metastatic Breast Cancer - Flowchart Breast Cancer Breast Cancer

Flowchart

Determine hormone receptor and HER2status

Determine hormone receptor and HER2status

Determine hormone receptor and HER2status

HER2 HER2

ER+

ER+

ER+

ER–

ER–

ER–

Chemotherapy + trastuzumab + endocrine therapy

Chemotherapy + trastuzumab + endocrine therapy

Chemotherapy + trastuzumab + endocrine therapy

Chemotherapy + trastuzumab

Chemotherapy + trastuzumab

Chemotherapy + trastuzumab

"Triple negative" disease

"Triple negative" disease

"Triple negative" disease

Endocrine therapy

Endocrine therapy

Endocrine therapy

Endocrine therapy

Consider multigene assay

Consider multigene assay

Consider multigene assay

Consider multigene assay

Chemotherapy

Chemotherapy

Chemotherapy

Chemotherapy

End

End

End

Evaluate clinicopathologic features

Evaluate clinicopathologic features

Evaluate clinicopathologic features

Features favoring endocrine therapy alone

Features favoring endocrine therapy alone

Features favoring endocrine therapy alone

Indeterminate features

Indeterminate features

Indeterminate features

Features favoring chemotherapy

Features favoring chemotherapy

Features favoring chemotherapy

ER, Estrogen receptor; HER2, human epidermal growth factor receptor 2.

ER, Estrogen receptor; HER2, human epidermal growth factor receptor 2.

ER, Estrogen receptor; HER2, human epidermal growth factor receptor 2.

ER HER2

HER2+

HER2+

HER2+ HER2+ HER2+

HER2–

HER2–

HER2– HER2– HER2–

HER2+

HER2+

HER2+ HER2+ HER2+

HER2–

HER2–

HER2– HER2– HER2–