for Jean, RobinP and all of those with small tumors who had difficulty convincing onc
 

ologists their tumors (although not associated with + lymph nodes) conveyed a high risk and warranted treatment appropriate with the risk:

ABSTRACT: Human Epidermal Growth Factor Receptor 2 Overexpression As a Prognostic Factor in a Large Tissue Microarray Series of Node-Negative Breast Cancers [Journal of Clinical Oncology; Subscribe; Sample]
Purpose: Human epidermal growth factor receptor 2 gene (HER2) is associated with a poorer outcome in node-positive breast cancer, but the results are conflicting in node-negative disease. This study assessed the prognostic impact of HER2 overexpression/amplification in a large series of node-negative breast cancers.
Patients and Methods: A tissue microarray (TMA) series was constructed consisting of 4,444 invasive breast cancers diagnosed in British Columbia from 1986 to 1992. Within this series, 2,026 patients were node negative, of whom 70% did not receive adjuvant systemic therapy. The TMA series was assessed for estrogen receptor (ER) and HER2. Logistic regression modeling was used to estimate odds ratios at the 10-year follow-up.
Results: HER2 was positive in 10.2% of the node-negative cohort. In this cohort, an inferior outcome was seen in patients with HER2-positive tumors compared with HER2-negative tumors for 10-year relapse-free survival (RFS; 65.9% v 75.5%, respectively; P = .01), distant RFS (71.2% v 81.8%, respectively; P = .004), and breast cancer-specific survival (BCSS; 75.5% v 86.3%, respectively; P = .001). A trend for a worse overall survival was also seen (P = .06). HER2 was an independent poor prognostic factor for RFS and BCSS at 10 years, with odds ratios of 1.71 (P = .01) and 2.03 (P = .003), respectively. The number of HER2-positive tumors that were ≤ 1 cm was small, but there was a trend for a worse outcome in T1b tumors.
Conclusion: HER2 overexpression/amplification is correlated with a poorer outcome in node-negative breast cancer. Larger studies are needed to more clearly define the prognostic impact of HER2 in tumors ≤ 1 cm, particularly within the separate hormone receptor subgroups.

Thanks for the post, Lani. You can see my comments on the stats for very early stage her2 bc on the other recent threads concerning this on this board. You know, we all had a good idea that the relapse for node negative her2+ hormonal negatives was poor from the 2005 HERA trial and that is the reason that I ultimately sought late Herceptin. Neil Spector, head investigator for Lapatinb, actually consulted with me and convinced me to do the 9 week regimen of Herceptin like the Finnish Trial. Yep, I don't regret doing it one bit now.

PS Still we don't have a clear idea if there is a difference in prognosis for T1a and T1b, as these two variables were not isolated well, nor was hormonal status with her2.