[sarah]

Hello Irish,
I believe the standard treatment with any lymph node involvement would include chemo and radiation and as she is HER2+ would include Herceptin and then if she is ER+ some sort of AI (aromatase inhibitor), if she's put on one, she should try taking it at night. Good news that the margins are clean. Not sure how the grading goes but always best to be aggressive with cancer. Sounds like she's in good hands. Blood tests I believe can show a problem but are generally taken every so many months to be sure there isn't a constant uptick or that the drugs are effecting an organ but they are not a way to rule out cancer. With Herceptin, she'll need to have a heart test (a heart sonogram) every 3 months to check if it is effecting the heart. Herceptin is a miracle drug.
This is a great site with very knowledgeable people on it so you will find good advice, much better than mine.
good luck to her. Each year things get better. I am sure the diagnosis was a shock to her and all of her friends but breast cancer is one of the best treated and known. Remember if she is ever concerned, she should get a second opinion.
They say exercise is good, avoiding dairy and enjoy life and be with friends. She'll be very tired on chemo. Get a bicarbonate gargle from the pharmacy to avoid "mushrooms" in the mouth and good skin cream. There are also hardening nail polishes made for chemo patients if she finds her nails breaking too easily. Mine was called Evonail, it's expensive but it works.
health and happiness
sarah