HER2-Positive Early Breast Cancer: Adjuvant Treatment Strategies for Residual Disease

Dr. Neil Iyengar presents a second clinical scenario focused on a patient with residual invasive disease following neoadjuvant therapy for HER2-positive early breast cancer, prompting Dr. Alison Conlin and Dr. Kelly McCann to discuss adjuvant treatment decision-making. The faculty emphasize the importance of identifying patients at particularly high risk for recurrence, including those with persistent nodal disease after preoperative therapy, and review how recent clinical evidence may inform treatment selection in this setting. Dr. Conlin discusses balancing efficacy with potential toxicities when considering escalation of adjuvant therapy, while Dr. McCann highlights additional considerations for hormone receptor-positive disease, including endocrine therapy and extended adjuvant strategies for appropriate patients. The discussion underscores the need to individualize treatment based on residual disease burden and overall recurrence risk, while integrating emerging evidence to optimize outcomes for patients with HER2-positive early breast cancer.