Would you give adjuvant TDM-1 to a patient with HER2-positive breast cancer s/p NAC with TCHP found to have no residual disease in the breast, but presence of ITCs ypN0(i+) in one axillary lymph node?

Adjuvant T-DM1 is not recommended for a patient with HER2-positive breast cancer who has no residual invasive disease following neoadjuvant chemotherapy (NAC) and only ypN0(i+) findings. In this setting, the patient is considered to have achieved a pathologic complete response (pCR), and adjuvant tr...

This is a tough question. If a node is pN0(i+) without prior systemic neoadjuvant therapy, then we all agree that this is considered a negative node for treatment and prognostic purpose. However, in patients who received neoadjuvant systemic therapy, I don't think a ypN0(i+) should be interpreted in...