Pregnant Newbie

[AmyJo]

Okay, lost the first post I tried to add so if this is a duplicate I'm so sorry...

Greetings all, I'm new here and not sure where to start. I was diagnosed with DCIS (in-site breast cancer) May 18th, 2006. The biopsied area was large & margins were affected so following week I had a radical mastectomy. Two small tumors of invasive were found in the removed breast but the margins & sentinal node were clear. Testing on the tumors has shown them to be HER-2 positive. Basically I'm 32 years old, stage 1 grade 3 breast cancer, er/pr +, HER-2 +. I'm also 5.5 months pregnant. My oncologist is researching Herceptin to see if it's safe during pregnancy-if so I'll start that next week, if not we'll have to wait a while. We also plan to start Tamoxifen after the baby is born, still not sure whether chemo is a good option or not. We have an appointment next week, hope to have a plan in place at that time.

Due to my age & the HER-2 + the doctors feel there is a stong genetic tendency for breast & ovarian cancers. I was adopted and have no family medical history. Has anyone had a profalactic (sp?) mastectomy or hysterectomy? I hate to remove organs for the heck of it but also hate the thought ticking time bombs just waiting to explode. I had a mammogram on the remaining breast but due to age & tissue density it may not be very accurate. I have an MRI scheduled for after the baby is born, I'm hoping to be able to nurse out of the one side for as long as possible...if the treatments are safe for breastfeeding. Has anyone read the information suggesting that breastfed babies are less likely to develope breast cancer later in life? Just an interesting thing I ran across... This is our second child, my husband only wants two children so even though another sounds like fun to me I'm probably done having children...guess a hysterectomy wouldn't be the end of the world... Anyhoo, just curious to see what your thoughts were...

Thanks,

Amy

[rinaina]

So sorry that this has happened to you. I know many women who have had a prophalactic mastectomy and that is sometimes a choice a women has to make even if the doctors aren't pushing it. I have stage 1 grade3 her2+ progestine and estrogen-, my tumor was 1.4 cm nodes were negative and margins were clean so I just had a lumpectomy and sentinel node biopsy but when my chemo is done, I will be asking about a ooferectomy,(removal of ovaries) as well as a double mastectomy because like you I don't want any timebombs ticking. I have no history of cancer in my family that I know of but I know this cancer is very aggressive. Anyone else out there who has done prophalactic removal of female organs? Good luck to you Amy and hang in there. You came to the right place for support, knowledge and help.

[Bev]

Hi Amy,

Sorry to hear about your diagnosis. Stage 1 is good but what terrible timing. I think there are quite a few ladies who were pregnant at dx. I'm not a medical practitioner, so I can only tell you my opinion. I'm sure the others will post.

Back when I had my children, 6 weeks was considered an adequate period to breastfeed to confer immunity, etc. I don't think I would defer treatment to breastfeed for the current 1 year or so reccomendation.

I don't think you'll need a hysterectomy, but you'll need to think about the ovaries. You can take shots monthly to shut down your ovaries, surgery is probably easier, but I haven't gone there yet. See what your doc has to say. I'm triple pos as well, but in chemopause. My impression is that they think I'll fare better if I stay in menopause. But I'm 47, so that's different.

Most of these things don't have to be rushed. Sounds like your'e trying to be proactive. Do the research and make a decision based on the best treatment that's available today.

Good luck, BB

[Becky]

Dear Amy


So sorry that this has happened (especially at a time that should be the happiest time of your life).

I do not know personally your situation but I do know that Herceptin can NOT be taken during pregnancy. The Her2 receptors that it blocks will prevent the growth of your baby in utero and can cause heart damage to the baby. Therefore, question, question, question if your doctor wants to do this. I believe this is on the Herceptin label (www.herceptin.com (http://www.herceptin.com)). Likewise, as you stated, tamoxifen is not allowed. However, chemo can be employed and was deemed safe during the late second and third trimesters (okayed protocol by ASCO (Amercian Society of Clinical Oncologists). Of course you cannot get radiation yet either. So your onco and gyno will have to work together to see what will work best for you and your baby.

Take care Amy and ask any questions you have at any time.

Kindest regards

Becky

[RhondaH]

so SORRY I can't provide an answer to your question as mine was not a similiar situation. I know that as my cancer journey was beginning one of the claims managers at work was finishing (she was about your age and was dx while pregnant). A good source for you to find answers is the Young Survival board as I have seen more stories there of dx while pregnant. As far as Herceptin while pregnant:

This was listed on the Herceptin website under "Precautions":
Pregnancy Category B There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, Herceptin should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.

In the postmarketing setting, oligohydramnios has been reported in women who received Herceptin during pregnancy, either in combination with chemotherapy or as a single agent. Given the limited number of reported cases, the high background rate of occurrence of oligohydramnios, the lack of clear temporal relationships between drug use and clinical findings, and the lack of supportive findings in animal studies, an association between Herceptin and oligohydramnios has not been established.

Reproduction studies have been conducted in cynomolgus monkeys at doses up to 25 times the weekly human maintenance dose of 2 mg/kg HERCEPTIN and have revealed no evidence of impaired fertility or harm to the fetus. However, HER2 protein expression is high in many embryonic tissues including cardiac and neural tissues; in mutant mice lacking HER2, embryos died in early gestation (12). Placental transfer of HERCEPTIN during the early (Days 20-50 of gestation) and late (Days 120-150 of gestation) fetal development period was observed in monkeys.

Take care and God bless.

Rhonda

http://www.youngsurvival.org/

http://www.gene.com/gene/products/information/oncology/herceptin/insert.jsp#precautions

[angelwings]

hello amy. congrats on your pregnancy. its kinda sad to read about your post. we can only hope for your betterment and that your pregnancy goes on without much trouble. my sister suffered from breast cancer while in her pregnant state too, but hers was not exactly like your case. she was following treatments at the jd healthcare clinic for her breast cancer and pregnancy. if ever you feel like having a seconn advice, you can always get in touch with them over there at the clinic http://www.jdhealthcare.com/about.html and learn more about the available treatments and let their team of professionals talk to you.

[Julie2]

Hi Amy,

I was diagnosed weh I was 32 weeks pregnant. But they they induced delivery at 34 weeks and started on neoadjuvant chemo. But my onc said AC is safe to give during pregnancy but not Taxol.

Julie

[gin-tx]

Dear Amy,

Am so sorry to hear of your situation at a time when you should be on top of the world with a new baby in a few months. I would question my doctors with everything you can think of in regards to treatment while you are pregnant. And if not satisfied get a second or third opinion. I'm a firm believer in getting more than one opoinion, this is my second time with breast cancer, first 10 yrs ago. And now that I'm older and this was more aggressive, I've been to several doctors and oncologists before I made a decision what to do about treatment. My best to you and hope you get the answers you are needing. And good luck.

ginkott1@aol.com

[tousled1]

Amy,

Congratulations on your pregnancy. So sorry that you have breast cancer. Your prognosis is good considering that you are ER/PR+ even though you are HER2+. I was diagnosed Stage III and opted to have both breasts removed. It was my decision and if I had to do it all over again I would. I wish you the best of everything. You'll be in my prayers.

[jkmellem05]

Hello Amy Jo,

I was in the same situation as you. I was diagnosed with BC and 2 weeks later when I had to go in for additional sugery, I was told I was pregnant.(I was just 4 weeks along and very shocked) I found a great DR who is a pioneer in treating pregnant with cancer patients. I had to wait approximately 9 weeks til I was 13 weeks pregnant and then was started on Adriamicain, Cytoxin and 5-FU. I also had a single mastectomy becuase they were unable to get clear margins because the cancer was multifocal. I finished those chemo and had to let the baby grow 7 more weeks til I was 32 weeks along and they delievered the baby via c section so I can have chemo that I wasnt able to receive when I was pregnant. I then received Taxotere and then I had 33 radiation treatments. Approximately a year later I had reconstruction. I was stage IIb ER/PR- but HER2 positive I had a high grade invasive ductal carcinoma.

REbbecca Faith is a beautiful 3 year old now and only had minor premie problems considering she was 2 months early. I am Happy with the decisions I made to trust God and keep my baby.

Last week I was diagnosed with a recurrence of the cancer. At the time of my treatment my DR said Herceptin wasnt being given to women with stage IIb her pos cancers. I go to back see my oncologist tomorrow to talk about the recurrence of the cancer and see what he says now. I came to this site because I hear herceptin is a great thing for Her2 pos status women. I am anxious to see what treatment plans are still available for me but scared silly about putting my husband and 7 children thru this illness again.

I pray that God had his hand on you and your baby thru all this. If you have any questions you can email me at jkmellem@aol.com.

I have tried to put as much information in here as i could and maybe something will be helpful.

Blessings
Jodie