Dr. Borgen Discusses HER2 Blockade in Breast Cancer

Patrick Borgen, MD, chair, Department of Surgery, director, Breast Center, Maimonides Medical Center, discusses HER2 blockade in the treatment of patients with HER2-positive breast cancer.

One of the questions that comes up with HER2-positive breast cancers, is at what tumor size in the node-negative setting should HER2 blockade be considered? Borgen says that for small tumors that are otherwise favorable, patients should receive a taxane and trastuzumab (Herceptin), based on the survival rate from the APT trial in patients with early-stage breast cancers that were HER2-positive. These are patients who are not going to need multimodal cytotoxic therapy or targeting of HER2, as this adjuvant regimen induced a 97% 5-year disease-free survival in the APT trial.

For patients with tumors that are 5 mm, HER2 blockade might be considered. For patients with tumors that exceed 6 mm, HER2 blockade should absolutely be used, Borgen says.