Optimizing the Management of her2-Positive Early Breast Cancer: The Clinical Reality Academic Article uri icon

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  • Breast cancer positive for HER2 (human epidermal growth factor receptor 2) is associated with a poor prognosis for patients with both early-stage and metastatic breast cancer. Trastuzumab has been shown to be effective and is now considered the standard of care for early-stage patients with HER2-positive breast cancer. In that population, trastuzumab has been studied in six randomized clinical trials. Overall, use of this agent leads to a significant reduction in risk of disease recurrence and improvement in overall survival. Despite the strong evidence for the use of trastuzumab in managing HER2-positive early breast cancer (EBC), a number of clinical controversies remain. The authors of this paper undertook a review of the available scientific literature on adjuvant trastuzumab to produce practical considerations from Canadian oncologists. The panel focused their discussion on five key areas: (1) Management of node-negative disease with tumours 1 cm or smaller in size; (2) Management of HER2-positive EBC across the spectrum of the disease (that is, nodal and steroid hormone receptor status, tumour size); (3) Timing of trastuzumab therapy with chemotherapy for early-stage disease: concurrent or sequential; (4) Treatment duration of trastuzumab for EBC; (5) The role of non-anthracycline trastuzumab-based regimens.


  • Verma, Su
  • Lavasani, S
  • Mackey, J
  • Pritchard, Kathleen
  • Clemons, M
  • Dent, S
  • Latreille, J
  • Lemieux, J
  • Provencher, L
  • Verma, Sh
  • Chia, S
  • Wang, B
  • Rayson, D

publication date

  • August 2010