how large does your tumor need to be to have herceptin?
 

I have a 7mm tumor no vascular invasion, negative sentinnel nodes. Have done 4 rounds of AC, bilateral mastectomy. My onc told me that I should not have Taxol as the risks outweigh the benefits of only 1%. She seems reluctant to give me herceptin as well. On one hand she leads me to believe that I am a high risk of reccurance due to may age, 35, and on the other she says that I am on a lower end. I can't figure it out. Any thoughts ladies?

You're not the only one who wonders how this guessing game is supposed to be played. For starters, get a copy of your pathology report and take a look at the current national breast cancer guidelines, which were posted by Rhonda:

NCCN Practical Guidelines in Oncology= V 2.2006
http://www.nccn.org/professionals/p.../PDF/breast.pdf

Also, ask your onc to go over your risk using the online Adjuvant! website if she hasn't already done that with you as it can provide you with a rough idea.

Hopefully those with tumors under 1 cm or your age may also respond to you here. If you can add more info about your hormone receptors or your tumor grade that might help.

AlaskaAngel

Hi,

I too had a 7mm IDC, ER+ HER+++ , Grade 2(this was a recurrence) with no lymph node or vascular involvement. The first time my tumor specifics were the same as this last one except I was not HER+++. I had lumpectomy followed by rads and 5 years of Toremefine (was premenopausal). I had a mastectomy this time around and my onc said no to both chemo and Herceptin due to the risks of the treatments outweighing the benefits. He put me on Tamoxifen for a couple of months before I opted for removal of my ovaries (I am 52 and was premenopausal still) so that I could take Arimidex. This is a really tough call and for me I guess time will tell if we made the right decision. I feel comfortable with what I have chosen to do and that is basically what you have to decide with your oncologist. Keep us posted. You have certainly come to a great forum for support and info.

Blessings.

Petesmom

I'm 52, had bil. mastectomy for .7cm IDC and 1.3cm DCIS comedo, ER+(weakly)/PR-, no lymphatic invasion, Her2+++, grade 2, neg sentinel node (removed 3). My onc rec. 6 rounds Taxol, 1 year Herceptin, an AI after chemo. Am 1/2 through the chemo.

My onc feels the real sticker is my Her+++ status, hence the aggressive treatment.

oops! Sorry I left out info.
My tumor grade was 2 (scored 6 on SBR), er (weakly positive at 5%) and pr-, miotic count was 2/10 hpf for a total of 1. Thanks ladies you are a wealth of info.

My tumor was relatively larger(1.9cm), but my onc did not feel I strongly needed taxol. I did Ac, and insisted on the taxol. Regardless my onc. felt herceptin was a must I'am 34 and her2+++. If you feel uncomfortable with your onc's decision a second opinion would not hurt.
Best wishes
Michelle

small tumor
 

I had a small tumor 7mm (invasive lobular), node neg. ER+,PR+,Her2+++ did 4 rounds A/C. And am doing arimidex, and Herceptin for a year-3 week intervals. (Had oncotype dx test done-predicted a high intermediate risk for recurrence ) Onc. said she would have done herceptin without chemo but with the oncotype dx results she felt strongly that the chemo was necessary.