Hi ladies
Hopeful, I didn't choose those locations for opinions, my oncologist did. He has done all of the legwork for me, so now I don't see a reason for me to go searching for answers. In fact, I have an email that he forwarded to me from the doctor who was the main investigator of the HERA trial that approved Herceptin.
Actually, I'll cut and paste it......
The names of been changed to protect the guilty
Hi, just want to farward email response from Dr Leyland, main investigator of HERA trial which approved Herceptin in adjuvant setting. Pretty much the same response i got from other experts. Dr xxxxxxx.
----- Original Message -----
From: xxxxxxx@aol.com
To: xxxxxxx@rrbiznet.com
Sent: Tuesday, February 12, 2008 5:45 PM
Subject: Re: advise on a difficult case
Very, very difficult, Noman.
Even the more aggressive are using 5mm as a cut-off.
Small, node negative lesions, as you know, are not usually treated with chemo.
I would run adjuvant-on-line and present the data and the risks to the patient. I would also suggest Oncotype. Choices range from Tam only/ chemo followed by Tam/ chemo + Herceptin (eg TCH) followed by Tam.
To me,it really depends on how agggressive the path is/ LVI, etc
Warmest, B
In a message dated 2/12/2008 3:39:16 P.M. Eastern Standard Time, XXXXXXX@rrbiznet.com writes:Hi, I need your advise in a difficult case,
39 y/o male with 2.5mm poorly diff adeno with DCIS on Rt mastectomy, 17 lymph nodes negative, ER/PR and her2 neu strongly positive, Fish 4.5 .
I confirmed with pathologist her2 neu was done on invasive tumor.
I would really appreciate your comment.
thanks, Dr Noman xxxxxxxxx
Bev, I wasn't able to have the sentinal lymph node surgery.
When I had the masectomy, they did a freeze biopsy on the tumor to see if any infiltrating cells were found. None were found so he didn't take my nodes.
A week later the full pathology report came back and said that I did have some infiltrating cells, and a month later I went back in for a node removal
Hermiracles,
That is exactly why my wife and I chose to do the chemo now. If it comes back I don't want to sit around beating myself up with the could have should have thing.