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OpenOnco · Diagnostic · Breast post-biopsy staging · ER+/HER2-low + axillary node + family hx
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OpenOnco · Workup Brief · DIAGNOSTIC PHASE
Pre-tumor-board workup brief
DPLAN-PZ-DIAG-BREAST-DX-001-V1 · v1 · 2026-05-12
Patient
PZ-DIAG-BREAST-DX-001 · suspicion lineage: breast_cancer_suspect
Tissues: breast, axillary_lymph_nodes · Hypotheses: DIS-BREAST
47F with biopsy-confirmed solid_tumor_breast — invasive ductal carcinoma G2 on left upper-outer quadrant core biopsy (BIRADS-5 mammography 2.6 cm spiculated mass + targeted core biopsy). IHC: ER 95%+, PR 70%+, HER2 IHC 2+ → reflex FISH HER2/CEP17 1.6 (NEGATIVE per ASCO/CAP 2023). Ki-67 18%. Strong family history (mother breast Ca age 51, maternal aunt ovarian Ca age 47) — likely BRCA candidate. axillary_lymphadenopathy on US (one 1.4 cm node — needs core biopsy / FNA). Pre-staging mammographic_abnormality reviewed; bilateral mammo with 3D tomosynthesis + MRI breast both done. No contralateral lesions, no multifocal disease. BMI 28, no DM, no cardiac comorbidity. eGFR 92 (preserved). Needs staging CT chest/abdomen/pelvis + germline panel + Oncotype-DX (luminal-A vs luminal-B distinction matters for chemo-omission decision) + sentinel-LN biopsy planning. Receptor confirmation on surgical specimen (definitive ER/PR/HER2) before final Tx. Workup at the post-histology / pre-staging stage.

Workup steps (3)

MDT brief

MDT talk tree (2 steps)

#OwnerTopicAction
1pathologistSpecialist review Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
2radiologistSpecialist review Stage / restaging imaging + biopsy guidance — radiologist.

Skills (required) — mandatory virtual specialists (2)

  • Pathologist (general) required
    Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
  • Radiologist required
    Stage / restaging imaging + biopsy guidance — radiologist.
Technical MDT skill metadata (2/16 activated in this plan)
All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).
Specialistskill_idVersionLast reviewedSign-offsDomain
Cellular therapy specialist (CAR-T)cellular_therapy_specialistv0.1.02026-04-250cellular_therapy
Clinical pharmacistclinical_pharmacistv0.1.02026-04-250clinical_pharmacy
Hematologist / oncohematologisthematologistv0.1.02026-04-250hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)hematopathologistv0.1.02026-04-250hematopathology
Infectious disease / hepatologyinfectious_disease_hepatologyv0.1.02026-04-250infectious_diseases
Medical oncologist (solid-tumor chemotherapist)medical_oncologistv0.1.02026-04-250solid_oncology
Molecular geneticist / molecular oncologistmolecular_geneticistv0.1.02026-04-250molecular_oncology
Palliative carepalliative_carev0.1.02026-04-250palliative_care
Pathologist (general)pathologistv0.1.02026-04-250pathology
Primary care / family physicianprimary_carev0.1.02026-04-250primary_care
Psycho-oncologistpsychologistv0.1.02026-04-250psychosocial
Radiation oncologistradiation_oncologistv0.1.02026-04-250radiation_oncology
Radiologistradiologistv0.1.02026-04-250diagnostic_imaging
Social worker / case managersocial_worker_case_managerv0.1.02026-04-250psychosocial
Surgical oncologistsurgical_oncologistv0.1.02026-04-250surgical_oncology
Transplant specialist (BMT)transplant_specialistv0.1.02026-04-250cellular_therapy
plan_id: DPLAN-PZ-DIAG-BREAST-DX-001-V1 | version: 1 | generated: 2026-05-12T18:41:26.960116+00:00
Per FDA non-device CDS positioning (CHARTER §15): Diagnostic-phase MDT support: structure the workup, identify the team, surface unresolved questions. Not a medical device; not a treatment plan.
Per FDA non-device CDS positioning (CHARTER §15): DIAGNOSTIC PHASE — this output describes diagnostic workup only. Treatment plan generation is blocked until histology is confirmed (CHARTER §15.2 C7). Do not treat on suspicion.
This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.