@Cheri I didn't have Perjeta as part of my initial treatment and was not offered it. I am now metastatic and have herceptin perjeta combo as my three weekly targetted therapy for the rest of my life, at no cost. If I had Perjeta in my initial treatment I may or may not now have mets. However the govt will not pay for Perjeta unless it is for Mets and yet they have shown that Perjeta works alongside Herceptin for a better outcome. Is it necessary? I don't know. But if I had my time again I would be asking for it before I became metastatic.