A 65-year-old woman with a history of hypertension and diabetes presents with a 1.5 cm, hard, fixed breast mass with overlying skin dimpling. Core biopsy confirms ER-negative, PR-negative, HER2-positive invasive ductal carcinoma. Staging CT shows no distant metastases. What is the most appropriate neoadjuvant regimen?

• A Trastuzumab + pertuzumab + chemotherapy (THP) ✓
• B Tamoxifen alone
• C Doxorubicin + cyclophosphamide alone
• D Aromatase inhibitor

Explanation

HER2-positive breast cancer is treated with dual anti-HER2 therapy (trastuzumab + pertuzumab) combined with chemotherapy in the neoadjuvant setting. This approach achieves high pathological complete response rates. Tamoxifen and aromatase inhibitors are for hormone receptor-positive disease, and chemotherapy alone without anti-HER2 therapy is suboptimal.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.