A 42-year-old woman with HER2-positive, HR-negative breast cancer (T2N1M0) completes neoadjuvant chemotherapy with trastuzumab. Pathological complete response (pCR) is achieved. Which statement about her further HER2-targeted therapy is most accurate?

• A No further HER2-targeted therapy is required after achieving pCR
• B She should receive adjuvant pertuzumab + trastuzumab for 1 year regardless of pCR
• C Adjuvant T-DM1 (trastuzumab emtansine) is preferred over trastuzumab when pCR is achieved
• D Adjuvant trastuzumab should be completed for 1 year (total including neoadjuvant) ✓

Explanation

In HER2-positive breast cancer achieving pCR after neoadjuvant therapy, current guidelines recommend completing 1 year of trastuzumab in total (counting both neoadjuvant and adjuvant phases). T-DM1 (trastuzumab emtansine, per KATHERINE trial) is preferred when pCR is NOT achieved, not when pCR is achieved. Pertuzumab + trastuzumab in the adjuvant setting (APHINITY trial) applies primarily to high-risk patients.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.