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CARCINOMA OF THE FEMALE BREAST

Guidelines by the American Society of Radiation Oncology and the European Society for Radiotherapy indicate that it is appropriate to discuss partial breast radiation for women over the age of 50 with node-negative, hormone receptor-positive, small (T1) tumors with surgical margins of at least 2 mm.

Adjuvant trastuzumab emtansine was FDA-approved in 2019 for patients with HER2-positive breast cancer with residual disease after standard trastuzumab-containing neoadjuvant therapy.

In 2019, overall survival for hormone receptor-positive, HERS-negative advanced breast cancer was shown to be significantly improved with the addition of ribociclib (MONALEESA-3) or abemaciclib (MONARCH-2) to fulvestrant, thus underscoring the importance of these agents for this disease.

The antibody-drug conjugate trastuzumab deruxtecan (DS8201), in which a HER2-targeted antibody is linked to a novel toxic payload (topoisomerase-I inhibitor), has demonstrated striking activity in heavily pretreated HER2-positive metastatic breast cancer.

A phase III trial ("HER2CLIMB") compared capecitabine plus trastuzumab plus either tucatinib or placebo in patients with pretreated, HER2-positive advanced disease and demonstrated an improved progression-free survival in the overall population, improved progression-free survival in those with CNS metastases and a significantly improved overall survival.

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