[Jean]

All we can do is share our own information which may help you to ask more questions and get as much informaiton as possible. Treat or not treat? It would be so much easier if when dx. there was a cut and dry answer to this. When I was dx. in 05 herceptin was not offered as a treatment to early stagers. Like you I had a small tumor which when discovered early was 6MM and after the biopsey there was a 3MM tumor left for the surgeon to perform the lumpectomy. I was told like you how lucky I was to catch my breast cancer early. I will share with you my thoughts and reactions.
Lucky? Lucky would be to never have breast cancer! While I am grateful and was always thankful for an early dx. having mammos on a regular basis etc. I did not feel lucky. What made matters worse there was no definite answers to my questions especially at that time in 05. I was seeing 3 top onc. in NY one at Sloane, NY Preb. Mt. Sinai hospital. All said the same thing...small tumor, no treatment just AI. Yet my gut was reacting and my thoughts were, okay we caught it early, neg. node, (that is not a guarantee only means it is favorable) aggressive her2 +++ er+ positive. This tiny tumor which all onc. at that time poo pooed as too small to treat turned out to be rated high as a recurrence when tested on Oncoytpe DX. So, I have always said, it is like being a little bit pregnant.
Do not discount Her2 disease due to the size of tumor. I have often stated on the board that size is not the answer when making treatment decisions. All the top onc. in NY were wrong. They were following the current protocol at the time, not treating the disease as the path report showed a high KI 67 level. I finally flew out to see Dr. Slamon who is the researcher and dr. who is the father of herceptin. After reading all my reports and a complete exam he said that without a doubt herceptin treatment was a must. In fact it is his theory that all Her2 patients should have herceptin. As far as I know your insurance may not permit herceptin without chemo because all the trials have been performed with chemo. You may be able to get a dr. who will just treat with herceptin off label. You will have to find a dr.
(private practice) to treat you this way. I had TCH as Dr. Slamon advised. WE have had many discussions on this board about treatment for early stage women.
I am one and I strongly advocate that do not permit size to be the only factor when making trt decsions. We know that a small tumor like mine had millions of cancer cells ....so do not believe that motto that a small tumor holds less danger. The advantage to dx. a small tumor is early treatment and containing and controlling. We still do not know why some women have recurrence while others who have had larger tumors never recur. Remember we each have different bio chemical make ups. The oncotype requires a very small sample from the tumor. I was first told by my surgeon that the tumor was too small to offer a slide.
He was wrong - I called the lab out in Calif. and they assured me a small tiny sample on the parafin slide was all that was needed. Ask questions, get lots of information so you know what quesitons to ask.
If I can be of any help just reach out. We each have to make choices that work best for us. Now when I look back at that time I still think how silly for a dr. to say
the tumor was small enough not to be concerned. I will attach some reports for your reading on small tumors and treatment.

I understand your torture of making the best treatment decisions - I did not fear the treatment - I feared the Her2 coming back more.

I hated having to subject my body that I took great care of all these years to chemo and chemicals. But after careful study and Dr. Slamon there was only one choice for me.

I wish you all the best in your journey and please know you are never alone and this site offers wonderful support.
As I said you can reach out to me by PM

Best Wishes,
Jean