[AlaskaAngel]

Sweetsunflwr,

To me, your question has resulted in a discussion that is really valuable here, and I'm glad for every response so that all of us are able to give it some personal time and thought.

As Hopeful has thoughtfully provided, very current study indicates that T1a's have, by scientific study, very minimal risk. So what would be the rationale for doing additional treatment?

I can only speak for my personal basis for my opinion, not that of the others. I am concerned about 2 parts to your picture in particular, rather than the less specific conclusions of the study as it applies to the general population of T1a's.

You and I share a number of characteristics. We both are BRCA 1 and 2 negative, ER+, PR+, and HER2 positive, and have done about the same time with tamoxifen.

You are presumably younger at the time of diagnosis than I was. The majority of breast cancer patients in general (and thus likely also true even in the study) are older at time of diagnosis. I may not be correct but I do see age and menopausal status as being strong risk factors that increase my concern about your situation.

Because the particular chemotherapy chosen doesn't match the patient's cancer the vast majority of the time it is given, I don't put much reliance on my having done chemo as a protective factor.

However, I did quit taking tamoxifen based on a question that had been raised about the possibility that tamoxifen increased the risk of recurrence for some HER2 patients. I think it DID initially help me, in that it immediately reduced the density of my breast tissue and made it less difficult to read mammograms. Again, I only can speak for myself, but given your youth plus your reliance on continuing tamoxifen as your shield, I would add back in a short course of trastuzumab for additional insurance, even knowing that it only works for about half of the patients who are HER2 positive.

One really rotten thing about treatment is that no one seems to have found a way to protect us without seriously affecting our sensuality. Becoming menopausal through therapy ages us tremendously in many ways that medical providers completely fail to address or even recognize in their blind continued heroic overboard approach to treatment.

AlaskaAngel