[swimangel72]

Steph - in answer to your question:

Not sure WHO orders which tests - if it is the surgeon because until a diagnosis of cancer is reached we are not yet on board with an oncologist. Anyway, that is how I usually understand the process.

my breast cancer surgeon ordered the Fish test for me. Originally, the radiologist who performed the ultra-sound needle aspiration biopsy sent all the samples to a lab and the pathology came back quickly ER+ PR+ and Her2 equivical. Then someone dropped the ball. The surgeon blamed the lab - I blamed the surgeon's office staff - they seemed very overworked and were also in the process of moving. I had my mastectomy and it was nearly a month later (due to all the time I spent in the hospital after the staph infection) when I finally got to see the oncologist. He was shocked that the Fish report never came through. I was very impressed to hear one of the secretaries yelling on the phone at whoever was holding up the results - and within minutes, my Fish report was faxed to her machine, and my onc had a much more serious expression on his face when he told me I was Her2+++. Actually he was so shocked since my Oncotype Dx was just 22 - that he sent the tissue samples to another lab for a second Fish test. This one confirmed the first test and came back with an even higher Her2+ reading.

I'm so happy that my onc changed his original recommendation from "no chemo" to "Navelbine with Herceptin" once he knew I was Her2+. My treatment was unconventional - but he didn't think I needed standard chemo which could hurt my heart or make me lose my hair. He said that Herceptin would work well with any chemo (according to some study). I was worried about that - but 3 different oncologists agreed with him, so I've stopped worrying. I'm still on the Herceptin, twice-a-week, until April. Can't wait to be finished - but I'm so grateful to Dr. Slamon and the brave women who went through the trials to make Herceptin available. And I do worry about women with early stage BC who are Her2+ when their doctors tell them they don't need "chemo".......it's not ABOUT their need for chemo - it's about their Her2+ status and their need for Herceptin! Until studies prove that Herceptin alone works well for early stage BC, many oncs will keep telling women that the risks for SEs from the chemo is greater than their risk of recurrence - which I believe is very misleading.