Herceptin and care questions
 

I had a lumpectomy and sentinel node biopsy December 12th. Clear margins - my radiologist said smaller than he likes to see, but still clear, 5 nodes removed, all clear. Had DCIS and IDC - .9 cm. I am 56 years old, have gone through menopause, ER+, PR+, Stage 1, Grade 2, Her2 Positive. Did seven weeks of radiation, with the last eight, being the boost. Originally, my oncologist did not recommend chemo, which was why I started with radiation.
When I had the oncotype dx test done, it showed I had a high rate of recurrence. With that in mind, my onc recommended four doses of A/C. Just had my third yesterday.
Last Friday I went to another onc in Walla Walla, Washington. Wanted a second opinion. My original onc hadn't ordered any heart tests before A/C and also seems reluctant to prescribe Herceptin. The onc in Walla Walla thought I didn't need heart scans with only the four doses of A/C but would benefit from taxol with Herceptin after the A/C.
When I spoke to my original onc yesterday about all of this, he didn't think the taxol was warranted, but possibly a 12 week regimen of Herceptin.
Also, my original onc was proposing tamoxifen, whereas the one I consulted for a second opinion, thought Femara or Arimidex would be better.
I am so tired and confused about what to do. I feel like I really need to have the Herceptin, but is a 12 week regimen good or not? Have most of you used taxol along with the Herceptin? And is tamoxifen a good option or would Femara or Arimidex be better?
I know you are not doctors. I am just interested in what your experiences have been. Thank-you so much. I have received so much info and encouragement on this site. I pray for each and every one of you and keep you in my thoughts.

There are so many knowledgeable ladies on here who will be able to help you weed through all of this, but I know that were it me, I would definitely push for Herceptin. I don't know about it in combo as a first line, because it wasn't first line when I was originally diagnosed. I was able to get Herceptin only after recurrence, first with Taxol and Carbo, then a year later with Taxol only.

I know you will hear from some ladies here who will have some answers for you, but given the opportunity, I would definitely do the muga after A/C and jump on the Herceptin.

You can see by my signature what I have done so far! My understanding is that Arimidex (aromatase inhibitor) is prescribed after menopause. I also recommend a MUGA scan after A/C and before herceptin. My oncotype DX showed a high intermediate risk of recurrence...it seems that most Her2 cases have a high oncotype score...I decided to do the chemo as prevention, although my oncologist would have done Herceptin without chemo. I wanted to be as agressive as possible from the start!

Hi Sheryl!

You can see that my onc in San Antonio treated me and continues to treat me agressively. I am not PR/E +, but HER2 +++. I don't know what is best for you, but I love my agressive doctor. ma

It is well known that Taxol is a great drug for Her2+ breast cancer. It is also a drug that works very synergistically with Herceptin. About half the Stage 1 women on this board have had AC followed by Taxol/Herceptin and half had 4 AC followed by Herceptin. Both regimes used Herceptin for a year. Another chemo option that many Stage 1 women (and higher stages) get is Taxol (or Taxotere), Carboplatin and Herceptin (6 rounds) then continuing herceptin for a year.


Whether or not you should receive Taxol is an opinion but studies on Stage 2 women (those with 1-4 nodes positive) has shown a marked decrease in recurrence if Taxol is used when trialed as 6 AC or 4 AC followed by 4 taxol (prior to dense dose and prior to using Herceptin). So, using a taxane is a survivability boost.

Certainly you should at least use Herceptin for a year as most Stage 1 protocol is 4 AC followed by a year of Herceptin.

I hope this helps

herception and care questions
 

Sheryl;
My case sounds similiar. I am 53 years old. Lumpectomy 3/29/07 - mammosite radiation for 5 days twice a day. DCIS with microinvasion - clear margins - sentinel node biopsy negative. Tumor was 5mm. ER+, PR+, Stage 1, Grade 2, Her2 Positive 3+.
Thought I was done after radiation. Saw the medical oncologist and he wants me to take an AI and Herception. I guess it is all good - being preventive. He said I would have the heart testing a few times at the start of Herceptin treatment (once every 3 weeks for 1 year) then less often if I do well on it. I am afraid of the Herceptin side effects more than anything. My oncologist feels that Tamoxifen is more appropriate for premenopausal women - he wants me on an AI - like Femara. My hot flashes are back with a venegence after stopping my HRT - my sleep is interupted and mood swings are common with me. I am meeting with the oncologist next week - after the test for high risk or low risk is completed. If he recommends the Herceptin I will give it a go. He also recommends bone density testing and a drug like Fossamex or Boniva and maybe an antidepressant to help with the side effects of the AI. Hope this helps........will post when I know what my treatment will be.
Good luck and God bless.