title: [Small HER2-positive breast cancer: which prognosis and which adjuvant treatment?].
abstract: Incidence of centimetric or infracentimetric node negative (pT1a-b, N0) breast cancer is increasing due to screening procedures. Although considered as having an overall favorable prognosis, several retrospective studies have suggested a higher risk of relapse when HER2 is overexpressed. Since randomized studies evaluating trastuzumab in the adjuvant setting did not include T1a-bN0, there is no level I evidence supporting the administration of a trastuzumab-based post-operative chemotherapy in these cases. However, some recent retrospective data suggest a benefit for such a strategy and current guidelines recommend to consider adjuvant chemotherapy plus trastuzumab in pT1bN0. The final decision, as well as the nature of cytotoxics to be administered in combination with trastuzumab, require a careful evaluation of the benefit/risk ratio in order to minimize the risk of toxic events, notably at the cardiac level.
authors.affiliation: Institut Paoli-Calmettes, oncologie médicale, 232, boulevard Sainte-Marguerite, 13009 Marseille, France, Inserm U1068, CNRS U7258, Aix-Marseille université, centre de recherche en cancérologie de Marseille, 27, boulevard Lei-Roure, 13009 Marseille, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Gonçalves
authors.forename: Maria
authors.initials: M
authors.lastname: Vassilakopoulou
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Spano
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000379:methods; D055088:Early Detection of Cancer; D005260:Female; D005602:France; D006801:Humans; D009364:Neoplasm Recurrence, Local; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D016019:Survival Analysis; D000068878:Trastuzumab; D047368:Tumor Burden
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab
keywords: HER2-positive breast cancer; adjuvant chemotherapy; pT1N0; trastuzumab