Miscellaneous

Question 1

Management of herceptin in patient with reduced EF

Answer 1

IF decline by 16 or more percentage points from baseline or 10 to 15 percentage points from baseline to below the lower limit of normal, hold trastuzumab for four weeks and repeat TTE in 1 month
IF no improvement, permanent discontinuation
IF improvement, repeat again in another month

Question 2

Indications for germline testing in breast

Answer 2

• metastatic disease
• Age <50
• TNBC at any age
• male
• Ashkenazi Jewish ancestry

Question 3

Sequencing of treatment modalities for adjuvant breast

Answer 3

• chemo -> radiation -> ET

Question 4

metastatic HER2 breast with elevated bili from liver disease

Answer 4

taxol + HP