207_Combined course Presentations

Systemic treatment

• Indication – extrapolate from histology (breast adenoCa) – N+, LVSI+ - in breast Ca, would offer systemic treatment • What systemic treatment? – Consider therapeutic indices AND economic cost – ER positive - give tamoxifen (benefit U/K, toxicity low, cost low) – HER-2 positive – do not give Herceptin (benefit U/K, toxicity high, cost very high) – Chemo - ??? (benefit U/K, toxicity high, cost high)