The human epidermal growth factor receptor-2 (HER2) is an important mediator of cell growth, differentiation, and survival.

1,2 Approximately 2025% of breast tumors overexpress HER2.37 Overexpression is nearly always the result of amplification of the HER2 gene (also known as erb B-2 or HER2/neu), and amplification or overexpression in breast carcinoma is associated with poor clinical outcome. Trastuzumab (Herceptin_, Genertech, Inc., South San Francisco, CA) is a monoclonal antibody that selectively binds to HER2. Although the exact mechanism of action of trastuzumab has not been definitively identified, several proposed mechanisms include antagonism of the growth-stimulating properties of HER2 by down-regulating receptor expression, activation of complement-mediated tumor cell lysis, and augmentation of chemotherapy-induced cytotoxicity.8 Approved for use in the U.S. in 1998, trastuzumab is indicated for the treatment of metastatic breast carcinoma in women whose tumors overexpress the HER2 protein. It is approved for use both as monotherapy in women who have previously received one or more che-