Recurrance

[norwegian]

Dear friends,-

I think that someone on this board once posted that everyone with HER2 bc will have recurrence. It is not a question about if but a question of when.
Do I remember correctly?

And is it true?

How scaring....

[Ruth]

Naaa...don't believe it ! Asked my lovely Onc. if that was true and he said nope.
Hugs ~ Ruth

[chrisy]

No, that's NOT true!

It's not even true (anymore) that people diagnosed with early stage Her2+ bc have a higher risk of recurrence if they are getting Herceptin...

It is scary, but as you put more cancer-free years behind you, it will get easier! There will even be days you don't think about cancer at all!

[LoriE]

What?? I've never heard either of those things!

[Joe]

Here is a study released at the 2008 ASCO Meeting by MD Anderson:


Prognosis of women with stage IV breast cancer by HER2 status and trastuzumab treatment: An institutional based review.

Breast Cancer--Metastatic Breast Cancer

Meeting:
2008 ASCO Annual Meeting

Abstract No:
1018

Citation:
J Clin Oncol 26: 2008 (May 20 suppl; abstr 1018)

Author(s):
S. S. Dawood, B. Kristine, G. N. Hortobagyi, S. H. Giordano
Abstract:
Background: HER2 +ve status is traditionally known to be associated with poor prognosis. Recent studies have shown that the addition of trastuzumab to the treatment of women with HER2 +ve disease significantly improves survival in early and advanced stage breast cancer. The purpose of this retrospective study was to determine if the addition trastuzumab in a cohort of women with stage IV HER2 +ve breast cancer improves prognosis beyond that of women with HER2 -ve disease. Methods: Women with de novo stage IV or recurrent breast cancer diagnosed between 1991-2007, with known HER2 status, who had not received trastuzumab in the adjuvant setting, were identified from the M. D. Anderson database. Disease was classified into three groups: a) HER2 -ve disease, b) HER2 +ve disease without first-line trastuzumab treatment, c) HER2 +ve disease with first-line trastuzumab treatment. Overall survival (OS) was defined as the time from the date of first distant metastasis to the date of death or last follow-up and was estimated using the Kaplan-Meir product method and compared between groups with the log-rank test. Cox proportional hazards were used to determine associations between OS and HER2 status after controlling for patient (pt) characteristics including year and age of diagnosis and site of first metastases. Results: The final analyses included 2,091 pts. One hundred and eighteen (5.6%) pts had HER2 +ve disease without trastuzumab treatment, 191 (9.1%) had HER2 +ve disease and trastuzumab treatment and 1,782 (85.3%) pts had HER-2 -ve disease. Median follow-up was 16.9 months. One year survival in pts with HER2 -ve disease, HER +ve disease who received trastuzumab and those with HER2 +ve disease who did not receive trastuzumab was 75.1% (95% CI 72.9%, 77.2%), 86.6% (95% CI 80.8%, 90.8%) and 70.2% (95% CI 60.3%, 78.1%) respectively. In a multivariable model women with HER2 +ve disease who received trastuzumab had a 44% reduction in the risk of death compared to women with HER2 -ve disease (HR 0.56, 95% CI 0.45-0.69, p<0.0001). Conclusions: The introduction of trastuzumab has altered the natural history of HER2 +ve breast cancer. Our results show that the addition of trastuzumab improves the prognosis of women with HER2 +ve disease above and beyond that of women with HER2 -ve disease.

[Mary Jo]

I just went to see my onc. for my 6 month visit. His exact words to me were .... "you hear of all the women who have recurrences but what you don't hear about are all those who do not. That would be most women."

Stay hopeful.

Mary Jo

[suzan w]

my onc agrees, not all Her2 cancers recur!

[harrie]

MaryJo, what you just said was interesting. My friend, 43 yrs old, recently dx with stage 2, joined a church and a prayer group. The leader, with all good intentions said something like "we will be with you now until the end". WHAT A THING TO SAY!! But like for many people with minimal experience or knowledge about breast cancer, the assumption is that it is a death sentence.
Because...similar to what you said....people hear about those who died of cancer, but you rarely hear of the multitude that survived it and ended up living a long healthy life.

[Jackie07]

The discussion reminds me of my In-laws' late pastor, Dr. Joe Weldon Bailey. When told by his oncologist about his situation (skin cancer which had started on his nose) being 'terminal', the 80-year-old preacher just laughed and replied: "Everyone's 'terminal'."

For whatever reason - probably because of all the sufferings (nightmares, weight loss, headaches, being called 'lazy' and 'crazy'...) I had had from the huge brain tumor since I was little - I have always felt like whatever time I have in this world is a gift from God (or 'Pure Luck' - love that movie and I am ready to go any time if it is destined to be so.

But I would hate to leave the world in a 'stupid' way such as from misdiagnosis or undergoig inadequate treatment.

I believe we owe it to ourselves and all our significant others to try our best to get rid of as much cancer cells as possible. Our worth is not determined by what we have owned or how long we have lived, but by what (obstacles) we have overcome in our life and how we have lived.

I think it's wise to stay vigilant and guard against 'recurrence' even if the possibility is minute. My doctors had missed my recurrence for four whole years because we all trusted the surgeon (that she had had a 'clean margin') and the radiologist who had read my mammagram (that those were just 'scar tissues'.)

The recurrent rate for Her-2 was especially high in the pre-Herceptin era. It may also has something to do with the trend of 'conservation' surgery in the past 10 + years. Because of its high mitotic rate (fast growing), breast conservation surgeries tend to miss cancer cells that have 'infiltrated' outside of the original cancer site. I happened to be sitting next to a lady in the waiting room of the Ob/Gyn department today and she turned out to be a breast cancer patient -found her recurrence (in the opposite breast)within two years of her first diagnosis. Sure enough, hers is also Her-2 positive.

Caught early, a local [-regional] recurrence is treated as a newly diagnosed breast cancer.

[Brenda S]

At my first post herceptin follow up I asked my onc about recurrance and he told me that for cases like mine the odds were that cancer will recur in approx 10% of cases. That means that I have a 90% chance of it never recurring.
Brenda

[tricia keegan]

Phew, I hope not as I've been feeling more and more confident about getting to four years out!!
When will there be any actual real findings of her2+ early stage that had herceptin and their risk of recurrance??? Does anyone know or is it too soon to tell??

[norwegian]

I am so grateful for all your kind and comforting answers! It seems to me that in a period (after finishing all treatment and when back in 100% job) I have only been looking at the more pessimistic sides of this journey... Like my thoughts have been tuned into the dark road...

Nevertheless I feel more and more optimistic each time I read your posts.
And I want to thank you all for that!!

[Adriana Mangus]

Dear friends;

I do not pay attention to statistics. Neither should you.

Live your life to the fullest, some women will experience a recurrence whether they are Her2+ or Negative.

My oncologist did mention to me,-- and after I read the study done by M.D. Anderson I tend to believe him, is that women with the Her2+ gene, would live longer; thanks to Herceptin. Now, that's a fact.

I thank God every day for Dr. Slamon and his team, without them we wouldn't be here.

With Love,

Adriana

[tricia keegan]

I agree Adriana on both counts!