Do you ever utilize an anthracycline based regimen rather than a non-anthracycline based regimen for patients with locally advanced HER2 positive breast cancer?

I do not use a lot of AC-THP except in a few cases where we had multicentric or multifocal locally advanced breast cancer that had both HER2+ and HER2- disease concurrently so we had to "cover our bases" for both disease types so to speak. For straightforward HER2+ disease, the 3-year EFS data from ...

That is a very interesting question!

Yes, I sometimes use the AC-THP as opposed to TCHP, though my use has decreased over time. I have used it most often in those with life threatening visceral disease where I feel a need to obtain as rapid a response as possible. I have used it less and less as neo...

There is very little reason to use an anthracycline for HER2 positive breast cancer and is best to avoid the unnecessary added risk from cardiac toxicity. I have also seen dose dense AC being used for HER2 positive disease, a practice that should be unequivocally discouraged.

The one specific situat...

For inflammatory Her 2+ breast cancer, I have used Dose Dense AC - THP.

I agree that in 2023, there are very few reasons to use anthracyclines in HER2-positive breast cancer, given the increasing body of literature (as cited by colleagues above) showing equivalent outcomes and lesser risk for cardiotoxicity and secondary leukemias. However, I like to remind myself that ...

I agree with others that in most circumstances, anthracycline use should be abandoned. I also agree with Dr. @Dr. First Last that in the setting of Her2 heterogeneity, it should be considered. I would only add one more circumstance that I would at least discuss with colleagues and your pathologist. ...