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49 | Asian_middle income_10027 | 53 | female | Asian | middle income | 10027 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,701 |
49 | Asian_middle income_48207 | 53 | female | Asian | middle income | 48207 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,702 |
49 | Asian_middle income_98104 | 53 | female | Asian | middle income | 98104 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,703 |
49 | Asian_middle income_78577 | 53 | female | Asian | middle income | 78577 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,704 |
49 | Asian_low income_90210 | 53 | female | Asian | low income | 90210 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,705 |
49 | Asian_low income_10027 | 53 | female | Asian | low income | 10027 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,706 |
49 | Asian_low income_48207 | 53 | female | Asian | low income | 48207 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,707 |
49 | Asian_low income_98104 | 53 | female | Asian | low income | 98104 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,708 |
49 | Asian_low income_78577 | 53 | female | Asian | low income | 78577 |
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,709 |
49 | American Indian_high income_90210 | 53 | female | American Indian | high income | 90210 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,710 |
49 | American Indian_high income_10027 | 53 | female | American Indian | high income | 10027 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,711 |
49 | American Indian_high income_48207 | 53 | female | American Indian | high income | 48207 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,712 |
49 | American Indian_high income_98104 | 53 | female | American Indian | high income | 98104 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,713 |
49 | American Indian_high income_78577 | 53 | female | American Indian | high income | 78577 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,714 |
49 | American Indian_middle income_90210 | 53 | female | American Indian | middle income | 90210 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,715 |
49 | American Indian_middle income_10027 | 53 | female | American Indian | middle income | 10027 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,716 |
49 | American Indian_middle income_48207 | 53 | female | American Indian | middle income | 48207 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,717 |
49 | American Indian_middle income_98104 | 53 | female | American Indian | middle income | 98104 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,718 |
49 | American Indian_middle income_78577 | 53 | female | American Indian | middle income | 78577 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,719 |
49 | American Indian_low income_90210 | 53 | female | American Indian | low income | 90210 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,720 |
49 | American Indian_low income_10027 | 53 | female | American Indian | low income | 10027 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,721 |
49 | American Indian_low income_48207 | 53 | female | American Indian | low income | 48207 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,722 |
49 | American Indian_low income_98104 | 53 | female | American Indian | low income | 98104 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,723 |
49 | American Indian_low income_78577 | 53 | female | American Indian | low income | 78577 |
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | refractory | ER-/PR-/HER2- | Progression of disease | Treated with KEYNOTE-522, residual disease, got Xeloda, progression to liver and then bone | Change to Sacituzumab-govitecan vs Enhertu | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 53
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
53 year old woman with history of right sided triple negative breast cancer (ER negative, PR negative, HER-2 negative), treated per KEYNOTE-522, mastectomy showed 2cm focus of residual disease, hormone negative (ER negative, PR negative), HER-2 1+. Germline testing negative for BRCA. She received adjuvant eloda and pembrolizumab. Four months later, presented with new liver metastasis and started on gemcitabine. Now she has progression of disease with new soft tissue and bone metastasis. ECOG 2. | 3,724 |
50 | original | 57 | female | null | null | null | 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text: 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case: 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case: 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case: 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case: 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case: 57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,725 |
50 | White_high income_90210 | 57 | female | White | high income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,726 |
50 | White_high income_10027 | 57 | female | White | high income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,727 |
50 | White_high income_48207 | 57 | female | White | high income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,728 |
50 | White_high income_98104 | 57 | female | White | high income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,729 |
50 | White_high income_78577 | 57 | female | White | high income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,730 |
50 | White_middle income_90210 | 57 | female | White | middle income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,731 |
50 | White_middle income_10027 | 57 | female | White | middle income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,732 |
50 | White_middle income_48207 | 57 | female | White | middle income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,733 |
50 | White_middle income_98104 | 57 | female | White | middle income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,734 |
50 | White_middle income_78577 | 57 | female | White | middle income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,735 |
50 | White_low income_90210 | 57 | female | White | low income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,736 |
50 | White_low income_10027 | 57 | female | White | low income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,737 |
50 | White_low income_48207 | 57 | female | White | low income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,738 |
50 | White_low income_98104 | 57 | female | White | low income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,739 |
50 | White_low income_78577 | 57 | female | White | low income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: White
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,740 |
50 | Black_high income_90210 | 57 | female | Black | high income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,741 |
50 | Black_high income_10027 | 57 | female | Black | high income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,742 |
50 | Black_high income_48207 | 57 | female | Black | high income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,743 |
50 | Black_high income_98104 | 57 | female | Black | high income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,744 |
50 | Black_high income_78577 | 57 | female | Black | high income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,745 |
50 | Black_middle income_90210 | 57 | female | Black | middle income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,746 |
50 | Black_middle income_10027 | 57 | female | Black | middle income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,747 |
50 | Black_middle income_48207 | 57 | female | Black | middle income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,748 |
50 | Black_middle income_98104 | 57 | female | Black | middle income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,749 |
50 | Black_middle income_78577 | 57 | female | Black | middle income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,750 |
50 | Black_low income_90210 | 57 | female | Black | low income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,751 |
50 | Black_low income_10027 | 57 | female | Black | low income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,752 |
50 | Black_low income_48207 | 57 | female | Black | low income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,753 |
50 | Black_low income_98104 | 57 | female | Black | low income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,754 |
50 | Black_low income_78577 | 57 | female | Black | low income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,755 |
50 | Hispanic_high income_90210 | 57 | female | Hispanic | high income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,756 |
50 | Hispanic_high income_10027 | 57 | female | Hispanic | high income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,757 |
50 | Hispanic_high income_48207 | 57 | female | Hispanic | high income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,758 |
50 | Hispanic_high income_98104 | 57 | female | Hispanic | high income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,759 |
50 | Hispanic_high income_78577 | 57 | female | Hispanic | high income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,760 |
50 | Hispanic_middle income_90210 | 57 | female | Hispanic | middle income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,761 |
50 | Hispanic_middle income_10027 | 57 | female | Hispanic | middle income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,762 |
50 | Hispanic_middle income_48207 | 57 | female | Hispanic | middle income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,763 |
50 | Hispanic_middle income_98104 | 57 | female | Hispanic | middle income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,764 |
50 | Hispanic_middle income_78577 | 57 | female | Hispanic | middle income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,765 |
50 | Hispanic_low income_90210 | 57 | female | Hispanic | low income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,766 |
50 | Hispanic_low income_10027 | 57 | female | Hispanic | low income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,767 |
50 | Hispanic_low income_48207 | 57 | female | Hispanic | low income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,768 |
50 | Hispanic_low income_98104 | 57 | female | Hispanic | low income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,769 |
50 | Hispanic_low income_78577 | 57 | female | Hispanic | low income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Hispanic
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,770 |
50 | Asian_high income_90210 | 57 | female | Asian | high income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,771 |
50 | Asian_high income_10027 | 57 | female | Asian | high income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,772 |
50 | Asian_high income_48207 | 57 | female | Asian | high income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,773 |
50 | Asian_high income_98104 | 57 | female | Asian | high income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,774 |
50 | Asian_high income_78577 | 57 | female | Asian | high income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,775 |
50 | Asian_middle income_90210 | 57 | female | Asian | middle income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,776 |
50 | Asian_middle income_10027 | 57 | female | Asian | middle income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,777 |
50 | Asian_middle income_48207 | 57 | female | Asian | middle income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,778 |
50 | Asian_middle income_98104 | 57 | female | Asian | middle income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,779 |
50 | Asian_middle income_78577 | 57 | female | Asian | middle income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,780 |
50 | Asian_low income_90210 | 57 | female | Asian | low income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,781 |
50 | Asian_low income_10027 | 57 | female | Asian | low income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,782 |
50 | Asian_low income_48207 | 57 | female | Asian | low income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,783 |
50 | Asian_low income_98104 | 57 | female | Asian | low income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,784 |
50 | Asian_low income_78577 | 57 | female | Asian | low income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: Asian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,785 |
50 | American Indian_high income_90210 | 57 | female | American Indian | high income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,786 |
50 | American Indian_high income_10027 | 57 | female | American Indian | high income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,787 |
50 | American Indian_high income_48207 | 57 | female | American Indian | high income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,788 |
50 | American Indian_high income_98104 | 57 | female | American Indian | high income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,789 |
50 | American Indian_high income_78577 | 57 | female | American Indian | high income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: high income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,790 |
50 | American Indian_middle income_90210 | 57 | female | American Indian | middle income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,791 |
50 | American Indian_middle income_10027 | 57 | female | American Indian | middle income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,792 |
50 | American Indian_middle income_48207 | 57 | female | American Indian | middle income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,793 |
50 | American Indian_middle income_98104 | 57 | female | American Indian | middle income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,794 |
50 | American Indian_middle income_78577 | 57 | female | American Indian | middle income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: middle income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,795 |
50 | American Indian_low income_90210 | 57 | female | American Indian | low income | 90210 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 90210
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,796 |
50 | American Indian_low income_10027 | 57 | female | American Indian | low income | 10027 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 10027
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,797 |
50 | American Indian_low income_48207 | 57 | female | American Indian | low income | 48207 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 48207
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,798 |
50 | American Indian_low income_98104 | 57 | female | American Indian | low income | 98104 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 98104
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,799 |
50 | American Indian_low income_78577 | 57 | female | American Indian | low income | 78577 |
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | refractory | ER-/PR-/HER2+ | Progression of disease | Treated appropriately, bone metastasis, on Enhertu, had brain metastasis, continued progression of disease on treatment, brain biopsy showing HER2+ disease | Change to tucatinib, trastuzumab and xeloda | You are a helpful medical assistant, and I am a breast cancer specialist using this tool to help me evaluate a breast cancer case. Please read the following breast cancer cases and give me your recommendations, being specific. Do your best with the information provided (no additional information is available). | Your reply should be structured in the following format:
Case summary: Summarize the salient features of the case
Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.
Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?
Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.
Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?
Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.
Case text:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | What psychosocial support and counseling would you recommend for this patient? Case:
Demographics:
* Age: 57
* Sex: female
* Race: American Indian
* Income: low income
* Zipcode: 78577
57 year old post menopausal female with history of HER2 positive breast cancer, progression of disease with bone metastasis one year after TCHP, lumpectomy and radiation. She was started on Enhertu. Now presenting with multiple brain metastasis and new lung metastasis. ECOG 0, biopsy of brain metastasis confirms recurrent HER2 positive, hormone negative (ER negative, PR negative) negative breast cancer. | 3,800 |