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Pathology · Breast: receptor status
Sample itemA 48-year-old woman has invasive ductal carcinoma that is ER-positive, PR-positive and HER2 amplified on FISH. Which therapeutic combination is directly guided by these results?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Tamoxifen or an aromatase inhibitor for ER, with trastuzumab for HER2
Hormone receptor positivity predicts benefit from endocrine therapy (tamoxifen, or an aromatase inhibitor after menopause), while HER2 overexpression predicts response to anti-HER2 antibodies such as trastuzumab. Triple-negative tumours lack all three markers and rely on chemotherapy. The combination is guided by receptors, not by histological type.
Option by option
A. Platinum chemotherapy alone
Platinum alone ignores receptor-directed therapy that improves survival.
B. Trastuzumab for ER and tamoxifen for HER2
This swaps the targets: trastuzumab acts on HER2 and tamoxifen on ER.
C. Radiotherapy alone as no targeted therapy exists
Targeted therapies exist for both markers, so radiotherapy alone is incorrect.
D. Tamoxifen or an aromatase inhibitor for ER, with trastuzumab for HER2 (correct)
Correct. Endocrine therapy targets ER, and trastuzumab targets HER2.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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