How do you decide between adjuvant TDM-1 and trastuzumab in breast cancer patients who have residual disease at time of surgery but were unable to complete the recommended neoadjuvant course?   

Since TDM1 is likely better tolerated than the standard neoadjuvant regimen, it would make sense  to give adjuvant TDM1 if a patient had residual tumor following neoadjuvant chemotherapy that was discontinued early due to toxicity.