Early-stage HER2+ breast cancer

Authored by Paolo Tarantino, published on 2026-03-27 18:38:09.0

Treatment algorithm for early-stage (IIA, IIB, III) HER2+ breast cancer.  Reference diagram.

  1. Stage IIA* HER2+ eBC
    • THP x4
      • Surgery
        • RD**
          • T-DXd (N+ RD) vs T-DM1 (N- RD)***
        • pCR**
          • HP
  2. Stage III HER2+ eBC
    • THP x4
      • T-DXd x4
        • Surgery
          • RD**
            • T-DXd (N+ RD) vs T-DM1 (N- RD)***
          • pCR**
            • HP
    • TCHP x4
      • Surgery
        • RD**
          • T-DXd (N+ RD) vs T-DM1 (N- RD)***
        • pCR**
          • HP
  3. Stage IIB HER2+ eBC
    • THP x4
      • Clear rRD
        • T-DXd x4
          • Surgery
            • RD**
              • T-DXd (N+ RD) vs T-DM1 (N- RD)***
            • pCR**
              • HP
      • Near rCR
        • + THP x2
          • Surgery
            • RD**
              • T-DXd (N+ RD) vs T-DM1 (N- RD)***
            • pCR**
              • HP
      • rCR and HR-
        • Surgery
          • RD**
            • T-DXd (N+ RD) vs T-DM1 (N- RD)***
          • pCR**
            • HP
  4. Stage I
    • Surgery
      • Confirmed Stage I
        • TH Regimen
      • N0 Stage II
        • TCH Regimen
      • N+ Stage II or Stage III
        • TCHP Regimen
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