Guangdong hospital’s international breast MDT outlines next steps for two complex cases

Guangdong Provincial People’s Hospital · 2026-11-02 · Read the original

Guangdong Provincial People’s Hospital has described how international specialists contributed to the next steps for two complex cases discussed through its Wednesday international breast cancer consultation platform. In its November 2 report, the hospital said William Gradishar, Charles Balch, Suzanne Klimberg and other experts offered opinions, which breast specialist Liao Ning used to formulate individual plans.

The platform began broadcasting in late 2019. Its Wednesday sessions run from 19:30 to 21:30 and combine difficult-case consultations with discussion of treatment standards and developments. The two cases in the latest retrospective concerned uncertainty about a tumour’s origin and the need to clarify disease stage after treatment.

Pleural tumour: identifying the origin before settling the next approach

The first patient was 41 and premenopausal. A PET/CT performed elsewhere showed a right anterior pleural nodule measuring about 2.0 × 1.5 × 1.7 cm. The patient underwent an extended thoracoscopic resection of the right pleural nodule. Pathology indicated a poorly differentiated or undifferentiated carcinoma, with a metastatic origin still possible.

The report listed HER2 as 0 and PD-L1 combined positive score as 70. Biopsies of lesions in both breasts and a right axillary lymph node found no evidence of malignancy. Liao also reviewed the genetic findings, including CDKN2A and TP53 variants.

Following the international multidisciplinary discussion, Liao’s plan focused on distinguishing breast cancer from melanoma and considering a combination treatment involving immunotherapy. These were next-step considerations; the report did not establish a final primary tumour diagnosis or describe immunotherapy as already administered.

Breast cancer: further tests to clarify the stage

The second patient was 44 and premenopausal, with invasive cancer of the left breast and HER2 3+ expression. After six cycles of TCbHP neoadjuvant treatment, the patient underwent a left modified radical mastectomy.

Surgical pathology found two invasive tumour foci, measuring 25 × 20 × 13 mm and 6 × 5 × 3 mm, alongside high-grade ductal carcinoma in situ. Lymphovascular invasion was present, and 7 of 18 lymph nodes contained metastatic carcinoma. After surgery, multiple lymph nodes were noted in both sides of the neck and the left supraclavicular region, some enlarged.

International experts, including Jonathan B Strauss and Thomas Buchholz in this case, contributed further opinions. On the basis of the MDT discussion, Liao drew up a plan for PET-CT and lymph node biopsy to clarify staging. The reported decision was to obtain that diagnostic information, rather than a completed restaging result or a treatment outcome.

The same notice announced a further consultation for November 4, 2026, from 19:30 to 21:30, with discussion of difficult cases admitted to the department and a specialist lecture.