What is the first treatment for HER2-positive breast cancer?

HER2 is a protein found on some breast cancer cells. A laboratory test confirms whether the tumour is HER2-positive, and that result helps the oncology team choose medicines that specifically target the HER2 signal. Chemotherapy works differently, so the two approaches may be combined.

Treatment may begin before surgery to shrink the tumour and show how it responds. In other situations, surgery is discussed early and medicines follow. The decision also considers tumour size, lymph nodes, hormone receptors, overall health, heart history and pregnancy plans. A treatment plan can change when the surgical specimen provides more information.

Ask for copies of the HER2 and hormone-receptor results and ask whether treatment is planned before or after surgery. Tell the team about heart conditions, current medicines, allergies and pregnancy or breastfeeding. Some HER2-targeted medicines require heart monitoring, so ask which tests are needed and when.

Discuss hair loss, nausea, fatigue, infection precautions and appointments before the first infusion. If future pregnancy matters to you, ask promptly about fertility options because some treatments can affect reproductive health. Keep a symptom diary and report new concerns rather than waiting for the next visit.

During treatment, seek urgent advice for fever, chills, trouble breathing, chest pain, fainting, facial swelling, a severe rash, or vomiting that prevents drinking. Call emergency services for severe breathing difficulty or chest pain. The oncology team can tell you the exact fever threshold and after-hours number to use.

Ask what the HER2 test shows, why chemotherapy and HER2-targeted therapy are being combined, whether treatment comes before surgery, and how response will be checked. Ask about heart monitoring, fertility, contraception, infusion reactions and which symptoms require an urgent call.