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margiermc
10-28-2009, 02:29 PM
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HER2 Overexpression Predicts Invasive Breast Cancer in Women with DCISAccording to the results of a study published in Cancer Epidemiology, Biomarkers & Prevention, women with ductal carcinoma in situ (DCIS) that has high levels of the HER2 protein are several times more likely than other women with DCIS to have invasive breast cancer.
DCIS refers to a noninvasive, early stage of breast cancer. Abnormal cells are found in the lining of a breast duct but do not penetrate through the wall of the duct into surrounding breast tissue. In some cases, DCIS occurs in conjunction with invasive breast cancer. DCIS may also progress to invasive breast cancer if not treated, but it’s not currently possible to predict which cases will progress and which will not.
HER2 is a protein involved in cell growth. Cancers that overexpress (make too much of) this protein may grow and spread faster than other cancers, and many women with invasive HER2-positive breast cancer are treated with drugs such as Herceptin® (trastuzumab) that target HER2.


HER2 status is not routinely assessed in women with DCIS because it does not affect DCIS treatment decisions. It’s possible, however, that HER2 overexpression could help identify women with DCIS who are more likely to have invasive breast cancer. To explore this question, researchers at the University of Pennsylvania examined DCIS samples from 106 women.

37% of patients had DCIS that overexpressed HER2.
Based on final pathology, 21% of patients were found to have invasive breast cancer.
Patients with DCIS that overexpressed HER2 were more than six times more likely than other DCIS patients to have invasive cancer.
In a prepared statement, one of the researchers notes: “From a practical standpoint, if you know that a patient has a greater chance of invasive cancer when you’re doing a lumpectomy or mastectomy, then you might want to do a sentinel node biopsy, because there is a greater chance the cancer has spread to the lymph nodes.” He goes on to say, “If HER2 is associated with invasion or plays a role in the development of invasive disease, then maybe targeting it early can keep people from moving from DCIS to invasive cancer.”
Additional research on this question will improve our understanding of the biology and behavior of DCIS, and could eventually influence treatment decisions.
References:
Roses RE, Paulson EC, Sharma A et al. HER-2/neu overexpression as a predictor for the transition from in situ to invasive breast cancer. Cancer Epidemiology, Biomarkers & Prevention. 2009 18: 1386-1389.
Penn Medicine News Release. Protein predicts development of invasive breast cancer in women with DCIS, Penn study shows. Available at: http://www.uphs.upenn.edu/news/News_Releases/2009/05/dcis-her2-breast-cancer-risk.html (http://www.uphs.upenn.edu/news/News_Releases/2009/05/dcis-her2-breast-cancer-risk.html) Accessed May 29, 2009.
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Sandra in GA
10-28-2009, 03:17 PM
Thank you for posting this information. I knew that I had read of an association between DCIS and HER2. This explains it very well. Obviously, this is what happened to you.
Sandra

margiermc
10-28-2009, 04:44 PM
I found it today, the link the missing puzzle -

The lab company that test the specimen of my lumpectomy -
never tested Her2, they tested er and pr, but, I felt from
the beginning - that's strange. i went 4 months, not knowing
I was Her2 and no wonder it landed in the liver - invasive.

I'm really upset - just found this info. today - the lab. did not do its job. Any opinions????

alicem
10-28-2009, 06:48 PM
I was originally diagnosed with DCIS and they only tested for ER and PR. I had a lumpectomy with no clear margins which led to a mastectomy. In the mastectomy they found a 2 cm. invasive tumor that was a surprise that tested positive for Her2. I asked the oncologist why the DCIS wasn't tested for Her2 and he said that they only test invasive tumors for Her2. There was almost a 2 month wait from the lumpectomy to the mastectomy. I have often wondered - could the lumpectomy have caused the cancer cells to "leak out", causing the tumor??? The sentinel nodes were checked during the lumpectomy and were negative - but none were checked during the mastectomy . . . should they have been? Now I'm concerned.

Sandra in GA
10-28-2009, 08:12 PM
Margie,
Where did you have the original surgery? One of the reasons I decided to drive almost three hours for care at the Mayo Clinic in Jacksonville was because I was afraid that the care I would get in my local medical community would not be through and competent. I knew that it would take them weeks to get answers and then they would refer me somewhere and that would take even more time. Although I had never heard of HER2 before they started talking about treatments for different kinds of breast surgery, I had a feeling of urgency about the whole situation. I truly feel that that decision was life-saving for me. I know that you have sought excellent care and gone to great expense and inconvenience to travel for the vaccine. After all, once we know what we are up against, we have to be prepared to fight for our lives.

Remember, we can't change yesterday, we can only live in the present and plan for the furure. It seems to me that you are certainly making the most of the information you are learning now.

Take care and know that you have this tiger by the tail!

Sandra

margiermc
10-29-2009, 08:18 PM
my dcis was grade 3, er, pr neg. her2 never tested, asked onc. today, why this was never tested, he of course was not the surgeon - but, said, DCIS they do not test status of Her2. Calc. on mammo. He did say, that invasive her2 cells were missed,
and somewhere in the DCIS to leak out and go to bloodstream.
I can't change yesterday's problems, but, I can only take care of today - being proactive and informing others of my information that I find along the way - Dr. said today, I'm doing great, tumor markers are still normal - cea 0, c15 - 15, c27/29 - 14, all liver enzymes are 15, normal - so he said, today, enjoy life.
To answer question about where did I get surgery - Mease Clearwater - Cancer Center - I would have gone to a bigger center like Moffit, but biopsy and all opinions leaned to DCIS, never spreads - had lumpectomy, then liver met 3 wk later.
margie

Sandra in GA
10-29-2009, 09:45 PM
Margie,
I just think you are a walking miracle. I know you thank God every day.
Sandra

margiermc
10-30-2009, 06:35 AM
I have faith - I believe that God sent me the right dr, at the right time. I never gave up! But, I did take care of myself during treatment, I never got sick, walk, good nutrition - sleep, all that helps. American Cancer Society sent me a book on nutrition, before, during and after treatment - I read it, and did everything it said, also, I shaved my hair off 16", matched hair with nice wig,
rec'd makeup, road to recovery - you name it - I read it and followed through - of course prayed along the way.

My dr. is from Moffit Cancer Society - fellowshiped there and I feel he had the best treatment, for my particular disease.

But, God is the great physician of all - I believed in this with all my heart and gambled my life on it - I had nothing else to lose.

Im healed - By his Stripes I am Healed.