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Do you consider multifocal disease an indication for chemotherapy with trastuzumab in patients with microinvasive Her2+/HR- breast cancer?

1 Answer
Mednet MemberInvited Expert
Medical Oncology · The Warren Alpert Medical School of Brown University
Answered on

Not necessarily those with just 2 or 3 foci of microinvasive disease, but I am concerned when a patient has multiple (though I'm not sure if the number is 4 or 7 or 10) foci of microinvasion within a sizable area of high-grade, ER- DCIS, especially when the pathologist says that there are too many foci to count. In this setting, especially with a HR-/HER2+ cancer, I believe that the risk of distant recurrence, though hard to quantify, is high enough to justify administering weekly paclitaxel + trastuzumab x 12 weeks, followed by another 3-9 months of single agent trastuzumab (probably preferring the shorter overall duration of treatment).

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