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Living with cancer· Appointment prep

Appointment sheet: High-risk early HR-positive breast cancer

One page to bring and write on: your details, the questions for High-risk early HR-positive breast cancer plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

High-risk early HR-positive breast cancer

Prepared with OnCo (onco.cc/prep/hr-positive-early-high-risk/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

24 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Oestrogen and progesterone receptor percentage, HER2-negative status, Tumour grade and Ki-67, Nodal stage and tumour size, Oncotype DX recurrence score), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Deciding on chemotherapy
  1. 5.For my situation (deciding on chemotherapy), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Oncotype DX, MammaPrint (70-gene signature), and what side effects should I expect?
  3. 7.How do the results of TAILORx and RxPONDER (SWOG S1007) apply to someone like me?
Endocrine therapy
  1. 8.For my situation (endocrine therapy), which of the standard options do you recommend and why?
  2. 9.Am I a candidate for Letrozole (and other aromatase inhibitors), Exemestane, Tamoxifen or related drugs, and what side effects should I expect?
  3. 10.How do the results of SOFT & TEXT apply to someone like me?
Adjuvant CDK4/6 inhibitor
  1. 11.For my situation (adjuvant cdk4/6 inhibitor), which of the standard options do you recommend and why?
  2. 12.Am I a candidate for Abemaciclib, Ribociclib, and what side effects should I expect?
  3. 13.How do the results of monarchE and NATALEE apply to someone like me?
Germline BRCA carriers
  1. 14.For my situation (germline brca carriers), which of the standard options do you recommend and why?
  2. 15.Am I a candidate for Olaparib, and what side effects should I expect?
  3. 16.How do the results of OlympiA apply to someone like me?
Local therapy
  1. 17.For my situation (local therapy), which of the standard options do you recommend and why?
Bone protection
  1. 18.For my situation (bone protection), which of the standard options do you recommend and why?
  2. 19.Am I a candidate for Zoledronic acid, Denosumab, and what side effects should I expect?
Any stage
  1. 20.Are there clinical trials I could join, for example of lidERA, CAMBRIA-1 & CAMBRIA-2, Study of Pembrolizumab (MK-3475) Versus Placebo in Combination With Neoadjuvant Chemotherapy & Adjuvant Endocrine Therapy in the Treatment of Early-Stage Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative (ER+/HER2-) Breast Cancer (MK-3475-756/KEYNOTE-756), Giredestrant?
  2. 21.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 22.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 23.I read that “No test yet identifies the women whose relapse will come after ten years, when endocrine therapy has stopped”. How does that affect my plan?
  5. 24.I read that “Two to three years of a CDK4/6 inhibitor is costly and its overall survival benefit is not yet proven”. How does that affect my plan?

The words I may hear

  • Lumpectomy (breast-conserving surgery): Removing only the tumour with a rim of normal breast, keeping the breast; almost always followed by radiotherapy.
  • Mastectomy: Removing the whole breast, either for cancer or preventively in BRCA1/2 carriers, where bilateral risk-reducing mastectomy cuts breast cancer risk by 90% or more.

Tests and results to bring

Biomarker results to ask for: Oestrogen and progesterone receptor percentage, HER2-negative status (HER2-low noted for later lines), Tumour grade and Ki-67, Nodal stage and tumour size (monarchE and NATALEE eligibility), Oncotype DX recurrence score (TAILORx, RxPONDER), MammaPrint 70-gene risk (MINDACT), Menopausal status and oestradiol during ovarian suppression, Germline BRCA1 and BRCA2 (OlympiA eligibility).

Scans and tests linked to this cancer: Companion diagnostics, Germline (hereditary) testing, Liquid biopsy (ctDNA), Digital pathology & AI, MRD / molecular residual disease testing, RNA sequencing & expression profiling.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call