Statement: Adult Patients with Histologically proven HER2- infiltrating breast cancer that have had a Previous lumpectomy or same side mammary reduction are excluded from both the secondary trial and the primary trial.
Primary_evidence: Inclusion Criteria:   Histologically proved infiltrating breast cancer (ductal, lobular carcinoma…) or a carcinoma in-situ with an elevated risk of micro-invasion. (High grade with necrosis, radiologically evaluated size more than 40mm, or immediate mastectomy…)   Unifocal or multifocal but in same quarter   Size < 5cm clinically palpable or not   Clinically or ultrasound axillary N0   Isotopic sentinel node detection   Adult patient   Signed informed consent by patient or legally responsable authority   Patient registered to a social security system   No surgical contra-indication Exclusion Criteria:   Mammary carcinoma recurrence   Previous same side mammary reduction   Previous lumpectomy   Contra-indication to surgery   Pregnant or breast feeding patient   Denial of participation
Secondary_evidence: Inclusion Criteria:   Histologically documented, locally advanced, or metastatic breast cancer; measurable and/or non-measureable but evaluable disease is permitted   HER2-positive disease   History of prior trastuzumab therapy   Life expectancy  90 days as assessed by the investigator   Negative urine pregnancy test  72 hours prior to Cycle 1 Day 1 for all women of childbearing potential   For patients of childbearing potential, agreement to use one highly effective form of contraception or two effective forms of contraception for the duration of the study treatment(s) and for 4 months after the last dose of T-DM1 or 6 months after the last dose of pertuzumab, if applicable Exclusion Criteria:   Any chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or biologic therapy for the treatment of breast cancer within 2 weeks of the first study treatment   Prior T-DM1 or pertuzumab therapy   History of intolerance (such as Grade 3-4 infusion reaction) and/or adverse events related to trastuzumab   Grade  2 (based on National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] v3) peripheral neuropathy at the time of or within 3 weeks prior to the first study treatment   Brain metastases that are untreated or progressive or have required any type of therapy, including radiation, surgery, and/or steroids, to control symptoms from brain metastases within 60 days prior to the first study treatment   History of cardiac disease, unstable angina, symptomatic congestive heart failure (CHF) (Class  II per the New York Heart Associate [NYHA] guidelines), myocardial infarction, or ventricular arrhythmia  6 months prior to Cycle 1, Day 1   Implantable pacemaker or automatic implantable cardioverter defibrillator   Congenital long QT syndrome or family history of long QT syndrome   Current uncontrolled hypertension   Current treatment with medications that alter cardiac conduction (e.g., digitalis, beta-blockers, or calcium channel blockers) or medications that are generally accepted to have a risk of causing torsades de pointes (TdP)   Current known active infection with human immunodeficiency virus (HIV), hepatitis B virus, or hepatitis C virus   Major surgical procedure or significant traumatic injury within 28 days prior to first study treatment, or anticipation of the need for major surgery during the course of study treatment