What is your treatment approach in a patient with cT2 ER+HER2+ breast cancer who refuses neoadjuvant chemotherapy?

Standard neo-adjuvant chemotherapy that contains trastuzumab, pertuzumab carboplatin, and docetaxel is recommended for most cases of HER2+ breast cancer (although other, anthracycline-containing regimens also exist but are used increasingly less commonly). If this patient refuses neo-adjuvant chemot...

First, I would take the time to explain to the patient why neoadjuvant treatment is so important. Second, I would try to determine if it is cytotoxic chemotherapy she is not willing to take or both cytotoxic and intravenous/oral HER2 targeted targeted therapy. Third, I would ask if the patient is wi...