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INDUCTIONBC

Dec 05, 20232 min read

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🌱來自: snippets

INDUCTIONBC

Left breast cancer, IDC, dx on on 2020/00/00, cT3(xcm)N1(f)M0, NG3, ER/PR/HER2-neu: 8/8/3+, DISH?, Ki-67: ?%, liver sono, CXR, and bone scan negative

  • Initial presentation: palpable left/right breast masss since ?
  • Menopause, Premenopause
  • Induction chemotherapy: Docetaxel + cisplatin (60/60mg/m2, escate to 75/75 if no grade 3/4 AEs) for 6 cycles and reevaluate for operation, herceptin NHI reimbursed, +- pertuzumab (self-paid) to improve pCR rate but not 100%
  • Induction chemotherapy: AC4 ⇒ DC4 or vice versa, (DC dosage: 60/60mg/m2, escate to 75/75 if no grade 3/4 AEs) and reevaluate for operation to improve pCR rate but not 100%
  • 2023/00/00: explain purpose of induction treatment is to reduce tumor size and make surgery feasible, but not 100% response rate. @ Arrange #1 TCHP (pertuzumab 840 loading, herceptin 8mg/kg loading then 6mg/kg in subsequent cycles, 60/60mg/m2) on 00/00, arrange admission on 00/00 and check lab for prechemotherapy evaluation. NHI reimbursed for herceptin. Sign PSP for pertuzumab/herceptin. @ Self-paid olanzapine HS use for 4 days for emesis. Imodium for diarrhe prevention. @ Vascular assessment (refer to NS), nutritional assessment during admission, dental check during admission, and pharmacist education before chemotherapy @ Arrange 2-D echo under herceptin, F/u Q4-5M (2023/00/00: EF?%) @ Consider clip deployment if breast conservation surgery is considered.

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