Do you give adjuvant chemotherapy/trastuzumab to a premenopausal woman with a pT1aN0 HR+, Her2+ breast cancer?

Existing data are from convenience cohorts, but generally don't support infusional therapy for T1aN0 HER2+ tumors, who seem to do well with DRFS well above the usual threshold for intervention of 8-10%. An analysis from the MDACC database included about 250 untreated T1a-bN0 HER2+ tumors with long-t...

We would certainly bring this case to our Multidisciplinary Case Conference and look at the pathology. If there is simply a <5 mm focus of invasive cancer, either alone or in a field of DCIS, and nothing else in the surgical specimen, then, I agree with Dr. @Dr. First Last's response that her progno...

A corollary question: For the above patient who declined any adjuvant therapy (chemo, trastuzumab, tamoxifen, radiation) after lumpectomy for a 6mm triple positive tumor and had a local recurrence (5mm w/ DCIS) 18 months later, would your recommendations be the same?