[AlaskaAngel]

Reassurance is a comfort at time of diagnosis. Sometimes we would rather be reassured than pursue a higher degree of truth upon which to base our trust.

What is cruel about that is the professional endorsement of practices based in part upon of the failure to demonstrate proof of efficacy of therapies recommended, which plays upon our hopes, and results in the diversion of much of the limited resources.

It may sound hard-hearted because we do care about each other's feelings and like to reassure each other, but do we want to focus our limited resources on reassurance regardless of efficacy and cost, or do we want to focus them upon efficacy?

Should we continue to encourage the professional practice of shotgun application of combined therapies through the failure to demonstrate proof of efficacy by clinical trial? Have we seen clinical trial proof offered by professional direction, demonstrating whether or not there are early stage patients who maintain remission through the application of trastuzumab when used as a single agent? Or are we continuing to see earlier and earlier stage patients still being "professionally" offered the shotgun combined therapies?

As mentioned, there is a trial of the use of trastuzumab without chemotherapy. Will it provide proof of efficacy for most early stage patients, or will it provide proof only for elderly patients (who do not require chemo in addition as one method to bring about the hormonal changes of menopause)?