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Shawn;
Thinking about your triple negative tumor I remembered Dr. Carney's post (near the top of the listings) when he was talking to us about the Bayer Her2 Serum test which he developed. I am trying to get this test here to use it to monitor my serum her2 levels. Perhaps herceptin will work for ALL of your cancer cells? You might find this of interest and discuss it with your aunt. Dr. Carney said:
"There are a number of reports that patients can be HER-2/neu negative by IHC or FISH and have an elevated serum HER-2/neu. This can have a number of reasons. One reason is that the original biopsy showed too few HER-2/neu positive cells to score the specimen positive. This iisn't a mistake by the pathologist but what is seen under the microscope. With respect to IHC, a pathologist scores the patient as HER-2/neu positive if greater than 10% of the cells seen under the microscope are 3+. It is certainly possible that someone who has 5% IHC 3+ cells at the primary diagnosis is designated HER-2/neu negative according to the guidelines for scoring patients. It is also possible that these HER-2/neu positive cells are the ones that spread to other parts of the body and grow. As these HER-2/neu positive tumors grow they can shed the HER-2/neu fragment into the blood. As the tumor grows and goes to more sites, the concentration of shed HER-2/neu can build up to detectable levels in the blood. We can then detect the elevated levels in the serum of the patient with the test. I think it is becoming clear that someone with an initial HER-2/neu status of HER-2/neu negative should be re-evaluated. An elevated serum HER-2/neu can then be used to go back and test the primary tumor again or to test a metastatic lesion. If either the primary or the metastatic lesion is now HER-2/neu positive by IHC or FISH the doctor can consider Herceptin for the patient. At this time, the serum HER-2/neu test is not approved to place patients on Herceptin but it can be informative."
Cathy
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