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11-28-2005, 12:19 AM
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#1
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Senior Member
Join Date: Jul 2005
Location: Ontario, Canada
Posts: 722
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HER2- BC may have HER+ mets
Here's a real scarey situation for women with HER- primary tumors with mets.:
HER-2 overexpression, a predictive marker of tumour aggressiveness and responsiveness to therapy, occurs in 20-30% of breast cancer. Although breast cancer is a heterogeneous disease, HER-2 measurement is carried out in primary tumour. This study aims to evaluate HER-2 overexpression in primary and metastases and its effect on treatment decisions. Biopsies from primary breast cancer and corresponding metastases from 58 patients were studied. HER-2 overexpression was evaluated immunohistochemically in all primary and metastatic sites. Positive overexpression in primary and/or metastases was confirmed by fluorescence in situ hybridisation (FISH). Discordance in HER-2 overexpression between primary and metastatic sites was 14% (eight of 58 patients). Concordance was found in 50 (86%) of patients (95% CI: 77-95). In one patient (2%), HER-2 was negative in metastasis but positive in primary. In seven (12%) patients, HER-2 was positive in metastases and negative in primary (95% CI: 3.7-20), and three of them responded to trastuzumab. Gene amplification by FISH was found in all cases with HER-2 positive (+2 and +3) by immunohistochemistry. Our data suggest that a possible discordance of HER-2 overexpression between primary and metastases should be considered when making treatment decisions in patients with primary HER-2-negative tumours.
Sounds like all mets should be biopsied and tested for HER2
May be good advice for Oncs.
Al
__________________
Primary care-giver to and advocate for Linda, who passed away April 27, 2006.
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11-28-2005, 11:16 AM
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#2
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Senior Member
Join Date: Sep 2005
Location: Alaska
Posts: 2,018
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War is WAR...
Fighting cancer is not a lot different from trying to avoid being a war casualty, keeping ears and eyes out for the best information and then using it strategically. With the Human Genome Project, the amount of scientific information has exploded and it is very hard for doctors to keep up with even just theorizing, much less any clinical trial results and then how to best use them. If your source is trustworthy, your suggestion makes very good sense even though unfortunately it takes too much time to conduct long enough clinical trials to convince medical providers to deal with information like this. Thanks, Al.
A.A.
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11-30-2005, 05:45 PM
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#3
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Guest
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I have seen other documentation making the same observation.
I will post it if I can find it.
RB
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01-28-2007, 08:16 AM
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#4
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Member
Join Date: Jan 2007
Posts: 5
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Thanks for all your responses
Please keep replying as you discover more information.
thanks
Cathy
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01-28-2007, 08:27 AM
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#5
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Senior Member
Join Date: Oct 2006
Location: Chicago
Posts: 36
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This happened to me!
Thanks for sharing, Al.
My HER2 status did a flip upon mets! My primary BC tumor did not overexpress HER2neu, but my lung mets were slightly HER2+ by FISH.
Just reemphasizes the fact that mets needs to be tested for ER/HER2.
__________________
Michelle
Stage 2 '99, triple negative, 5 nodes involved
mastectomy, AC + T, rads, '01 TRAM flap
Stage 4 '06, lung mets, ER/PR-, HER2++
07/06 - 11/06: Taxol + Herceptin to 'strong partial remission'
11/06: Herceptin every 3 weeks indefinitely
01/07: brain mets, finished WBR, NED in head!
04/07: Xeloda and Tykerb for lung met progression
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01-28-2007, 02:40 PM
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#6
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Senior Member
Join Date: Aug 2003
Location: Morris, IL
Posts: 3,507
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I am wondering how many of those that were diagnosed as Her2 - originally were done by IHC and not FISH, and possibly were not accurate....and were actually Her2 +. There was alot of discussion at the SABCS on diagnostics of tumors, and slides, grinding up the tumor versus section slides, and basically your diagnosis is reflective on the quality of pathology lab that performs it.
__________________
"Be kinder than necessary, for everyone you meet is fighting some kind of battle."
Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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