Baseline → treatment → follow-up
Tests and milestones through treatment
Columns show sequence, not equal durations or appointments. A test is only complete when performed and reviewed. Echo timing and cancer-imaging timing are different. Symptoms can bring any check forward.
| Check | Before starting | Cycles 1–4 | Around cycle 5 / week 12 | Surgery / next phase | Ongoing / follow-up |
|---|---|---|---|---|---|
| Blood tests | Baseline FBC, renal and liver profile | Before each cycle; additional dose checks as prescribed | Continue the required pre-dose checks | Use the selected active regimen’s blood-test schedule | Investigate symptoms / persistent abnormalities |
| Echo / cardiac assessment | Baseline cardiac assessment | Earlier for symptoms / concern | Echo during neoadjuvant treatment, around cycle 5 | Surgery does not restart the echo clock | Agree follow-up for the active medicine and cardiac risk |
| Cancer imaging / markers | Baseline disease assessment | Clinical response; imaging if concern | Response review as planned; not tied to echo | Before surgery / pathology | Breast surveillance after early treatment |
| Surgery / radiotherapy | Agree indication and sequence | No automatic concurrent radiation | Coordinate with both teams | Local treatment as indicated | Review recovery and late effects |
| Endocrine / bone health | Check hormone receptors / fracture risk | Plan endocrine therapy if indicated | DEXA when relevant to bone-risk plan | Endocrine timing by the treating team | Individual DEXA / bone follow-up |
The whole treatment journey
TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab: the whole pathway
HER2-positive early breast cancer · before surgery
All four medicines are given by infusion on Day 1 of a 21-day cycle, for six cycles before surgery. Surgery findings guide the postoperative treatment. There is no routine take-home chemotherapy pump.
Read from left to right. Columns show stages, not equal lengths of time. This is a general plan: no dates or personal information are needed. Your team confirms which steps apply and arranges appointments.
On a small screen, swipe the map sideways. The checks below give the same timing in words.
| Care / check | Before starting | Cycles 1–4 | Around cycle 5 / week 12 | Surgery / next phase | Ongoing / follow-up |
|---|---|---|---|---|---|
| Cancer medicinesNCCP | Confirm diagnosis and exact regimen | See the dose-day map: use the current regimen and active phase | Echo due; treatment review | Surgery/pathology select postoperative medicine | Review benefit / tolerance and next plan |
| Surgery / radiotherapyEARLY | Agree indication and sequence | No automatic concurrent radiation | Coordinate with both teams | Local treatment as indicated | Review recovery and late effects |
| Blood testsNCCP | Baseline FBC, renal and liver profile | Before each cycle; additional dose checks as prescribed | Continue the required pre-dose checks | Use the selected active regimen’s blood-test schedule | Investigate symptoms / persistent abnormalities |
| Echo / cardiac checksNCCP · ESC | Baseline cardiac assessment | Earlier for symptoms / concern | Echo during neoadjuvant treatment, around cycle 5 | Surgery does not restart the echo clock | Agree follow-up for the active medicine and cardiac risk |
| Scans / tumour markersEARLY | Baseline disease assessment | Clinical response; imaging if concern | Response review as planned; not tied to echo | Before surgery / pathology | Breast surveillance after early treatment |
| Endocrine / DEXABONE | Check hormone receptors / fracture risk | Plan endocrine therapy if indicated | DEXA when relevant to bone-risk plan | Endocrine timing by the treating team | Individual DEXA / bone follow-up |
What each check is for
1Blood testsFBC, kidney and liver profile at baseline and before every 21-day cycle. The team reviews the necessary results before a planned dose.
Check safety before the next dose.
Ask / act: Agree the booking owner, result reviewer and action if overdue.
Sources: NCCP
2Heart testsCheck heart pumping function before starting HER2 treatment. Repeat echo or MUGA every 12 weeks: around cycle 5, then cycle 9 if 21-day cycles stay on time. Earlier checks are needed for symptoms or abnormal findings. Count elapsed time from the first HER2 dose; changing phase or route does not restart the clock.
3Cancer imagingBaseline breast and nodal imaging, with staging tests appropriate to the diagnosis. Review response during preoperative treatment and before surgery. After local treatment, arrange breast surveillance; routine CT, PET or tumour-marker testing is not the usual screening plan for someone without symptoms.
Assess response or follow-up needs.
Ask / act: Agree the booking owner, result reviewer and action if overdue.
Sources: EARLY
4Bone healthIf the cancer is also hormone-receptor positive, endocrine treatment may form part of the wider plan. Bone-density testing is linked to aromatase inhibitors, ovarian suppression and fracture risk; it is not automatically required because a HER2 medicine is prescribed. Agree baseline DEXA where indicated and individual follow-up.
Assess fracture risk where relevant.
Ask / act: Agree the booking owner, result reviewer and action if overdue.
Sources: BONE
At the next review, ask
- Which treatment phase am I in, and what happens next?
- Which test is expected next, who arranges it, and who explains the result?
- Who should I contact if an expected appointment has not arrived?
This map does not show whether a test has been ordered, booked or completed. Do not wait for a scheduled test if you develop new symptoms.