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...