How would you approach a young patient with a prior ER+ HER2- breast CA now local recurrence that now has Her2 positive disease?

For Her-2 positive disease, I would definitely choose chemotherapy with anti Her-2 agent(s). With Her-2 positivity and a young age, the patient is at high risk for recurrence which can be significantly reduced by the addition of anti Her-2 agents to chemotherapy. Although this is a local recurrence,...