kk - followup question

Thanks - actually on my list of things to ask her about. I'm actually ER- and only slightly PR+. I'm a bit of an anomoly (only about 1% of breast cancers are in that category). But I want to ask her about the shots anyway as I think it's more aggressive as well as the fact it would be a good form of birth control. By the way, do you have any articles on her2's being resistant to tamoxifin? I'd love to have a bit of research on my side when I bring it up. I've heard that from others but haven't see the research yet. Thank you!

Rozebud, I assume you have seen the review articles in regard to TAM resistance that Jeff posted yesterday under the Adriamycin question they are a very good source of information.

If you are ER- and only slightly PR+ I would discuss with my doc if hormone therapy was really worth the risks for you. I too have small children but sometime in our desire to be aggressive we can go overboard.

The thing I worry about in regard to the TAM and Herceptin is the following:
It seems pretty clear from the research at this point that the mechanism of TAM resistance is the stimulation of HER2 production, thus in the absence of Herceptin or the like to block the HER2 receptors TAM actually stimulate cancer growth in her2+ cancer cells and has even been shown to transform her- cancer cells in to Her+ cells. It is my understanding that only 40% of HER2+ cancers respond to Herceptin and there is no test to absolutely predict who is Herceptin sensitive. So 60% of the Hue2/neu+ patients would have no protection from the stimulative effects of TAM. Currently I am taking Herceptin and I am er + /pr+ but I was reluctant to take the risk with Tamoxifen given that phase II trials of Herceptin and Tamoxifen have not yet been reported and the combination of ovarian suppression and AIÃâ€*s have been shown to work well and in some case even better regardless of the her2 status. Of course when my bones start to break 10-15 years from now I may have wished I made a different choice. This is just my opinion and I am sure others on the board may feel differently.

kk

Rozebud, I assume you have seen the review articles in regard to TAM resistance that Jeff posted yesterday under the Adriamycin question they are a very good source of information.

If you are ER- and only slightly PR+ I would discuss with my doc if hormone therapy was really worth the risks for you. I too have small children but sometime in our desire to be aggressive we can go overboard.

The thing I worry about in regard to the TAM and Herceptin is the following:
It seems pretty clear from the research at this point that the mechanism of TAM resistance is the stimulation of HER2 production, thus in the absence of Herceptin or the like to block the HER2 receptors TAM actually stimulate cancer growth in her2+ cancer cells and has even been shown to transform her- cancer cells in to Her+ cells. It is my understanding that only 40% of HER2+ cancers respond to Herceptin and there is no test to absolutely predict who is Herceptin sensitive. So 60% of the Hue2/neu+ patients would have no protection from the stimulative effects of TAM. Currently I am taking Herceptin and I am er + /pr+ but I was reluctant to take the risk with Tamoxifen given that phase II trials of Herceptin and Tamoxifen have not yet been reported and the combination of ovarian suppression and AIÃâ€*s have been shown to work well and in some case even better regardless of the her2 status. Of course when my bones start to break 10-15 years from now I may have wished I made a different choice. This is just my opinion and I am sure others on the board may feel differently.

kk