A 59-year-old postmenopausal female underwent a partial mastectomy and sentinel lymph node biopsy (SLNB) for a 1.5 cm right breast moderately-differentiated invasive ductal carcinoma, ER 100%, PR 90%, HER2 positive (3+), with 0/1 positive lymph nodes.
What would you do next?
The 21-gene signature is only indicated for HR+ / HER2 negative tumors.
For small node-negative HER2 positive tumors, paclitaxel and trastuzumab are recommended
1. Tolaney SM, Barry WT, Dang CT, Yardley DA, Moy B, Marcom PK, et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. New Engl J Med. 2015;372(2):134-141.
2. Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005;353(16):1673-1684