My Mother has been diagnosed with Invasive Carcinoma , HER+ , 3.4 CM Lump

[Sriks]

Hi All,

I need advise on plan of treatment for my mother, she has been diagnosed with Invasive Carcinoma with Medullary features Grade 3, with Lump size of 3.4 CM in left breast, We got mastectomy and SNLB done last month. SNLB showed all 4 nodes as negative. Her immnuohistochemist report shows ER/PR- & HER2+ , Grade 3, Tubule formation 3, Nuclear ploemorphism 2, Mitotic Figures 3.

Histopology:

Nipple : Normal

Scar/ Surgical defect : Not seen

Tumor : Single

Margins of Tumor: inflitrative

Deep margin .02 CM

Muscle : absent

Axillary Tail: not seen

Her age is 52 years, Height 5.2 weight 74 KGs and her uterus was removed in 2007,

The doctor has advised 2 options

Option 1: (AC-T) 4 cycles of AC followed by 4 cycles of T

Option 2: (AC-TH) 4 cycles of AC followed by 4 cycles of TH and continue Herceptine for 12 more cycles.

With option 1 the recurring chances are less than 20% and with option 2 the recurring chances are 5 to 10%.

Wanted to check if she can go with option 1 as all lymph nodes came negative and I heard side effects on heart due to Herceptine.

Can someone pls advise? which is the best option to choose based on the above information.