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Breast Cancer

Recurrent/metastatic

Chemotherapy + targeted therapy

Docetaxel + carboplatin + trastuzumab +/- pertuzumab Q21 days x6 cycles (TCH or TCHP)

Doxorubicin + Cyclophosphamide Q14/21 days x4 cycles

paclitaxel + trastuzumab +/- pertuzumab x 1 year

SERM if premenopausal AI if postmenopausal

Early (Stage I/IIA/IIB)

TNBC

Pembrolizumab + paclitaxel + carboplatin

pembrolizumab + AC

pembrolizumab as maintenance

Dose dense AC

taxane

Surgery

HR+

Endocrine therapy +/- Chemotherapy

Chemotherapy + anti-HER2 therapy + Endocrine therapy

Chemo + anti-HER2 options

Docetaxel + carboplatin + trastuzumab +/- pertuzumab Q21 days x6 cycles (TCH+/-P)

trastuzumab +/- pertuzumab x1 year

paclitaxel + trastuzumab +/- pertuzumab x 1 year (pertuzumab if node positive)

Endocrine options

CD4K inhibitors

Ribociclib Abemaciclib palbociclib

Ovarian ablation/suppression

Oophorectomy LH releasing agents

Goserelin leuprolide triptorelin

AI (POSTmenopausal)

Anastrozole Letrozole Exemestane

SERM

Tamoxifen(PREmenopausal)

HR-

HER2+

Chemotherapy + Anti-HER2 therapy

HER2-

Chemotherapy

Chemotherapy options

Taxane based

Docetaxel + Cyclophosphamide Q21 days x4 cycles (TC)

Anthracycline based

Doxorubicin + Cyclophosphamide Q14/21 days x4 cycles (AC)

paclitaxel weekly x12 weeks