In which patients will you consider the use of adjuvant pertuzumab for HER2 positive early stage breast cancer?  

The benefit of adding pertuzumab to a trastuzumab-based regimen is quite small (0.9% at 3 years, 1.8% in those with involved LNs). This will not change my practice for most patients. Certainly for a patient with multiple involved nodes and ER- disease, the addition of pertuzumab will become a long d...