HER2-Positive Early Breast Cancer: Applying Emerging Evidence to High-Risk Clinical Scenarios

Dr. Neil Iyengar presents a clinical scenario involving a patient with high-risk HER2-positive early breast cancer, prompting Dr. Kelly McCann and Dr. Alison Conlin to discuss practical treatment selection in the neoadjuvant setting. The faculty consider patient-specific factors, including tumor burden, hormone receptor status, comorbidities, and concerns about treatment-related toxicity, while emphasizing the importance of shared decision-making and individualized care. They review how emerging evidence from recent clinical trials may inform treatment selection for patients with node-positive, high-risk disease and discuss the potential role of trastuzumab deruxtecan-based strategies in appropriate candidates. The discussion also explores how management may differ for patients with lower-risk presentations, including smaller node-negative tumors, highlighting the continued role of established HER2-directed regimens and response-adapted approaches. The segment illustrates how evolving evidence can be incorporated into personalized treatment planning for HER2-positive early breast cancer.