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Old 12-26-2006, 05:21 PM   #1
Catherine
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Want to talk with ER/PR neg and HER2 pos

Hi, I am new to this site. I am trying to figure out what the difference is between being ER/PR negative vs Er/PR postive along with my Her2 postive diagnois. I am 58, diagnoised April 06, Adricmyicen/Cytoxin and then Taxol. Bilateral mast. Sept 06, 33x rads. Started herceptin Dec 20, 06...with a year to go. DX Stage 2 BC. 3 of 14 nodes positive.

What is the difference between er/pr negative vs positive?
If my lymph nodes were involved does that mean metastic BC?
What do you think about the accuracy of HER2 diagnois. I read Angel from Alaska's post.

I actually am doing well. Just anxious to feel like I can truly beat this DX.
This is my first post here. Have been on the Komen site alot.

All the best, Catherine Davis in Oregon
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Old 12-26-2006, 09:50 PM   #2
tousled1
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Talking

Catherine,

I took the liberty of moving your post from "Profiles in Courage" to the "HER2 Group Forum" so that you would receive replies.

Having lymph node involvement means that you have advanced breast cancer, not metastic breast cancer. Metastic is when the cancer has invaded distant organs of the body - liver, lungs, bones, etc. Being hormone negative means that you will not have to take anything to suppress your ovaries from producing estrogen. Being HER2 means that you have Herceptin available to you and also in February 2007 Tykerb is to be approved by the FDA.
There are two tests for HER-2

IHC test (IHC stands for ImmunoHistoChemestry) The IHC test shows if there is too much HER2 receptor protein in the cancer cells. The results of of the IHC test can be 0 (negative), 1+ (negatiave), 2+ (borderline), or 3+ (positive).

FISH test (FISH stands for Fluorescence In Situ Hybridization). The FISH test shows if there are too many copies of the HER2 gene in the cancer cells. The results of the FISH test can be "positive" (extra copies) or "negative" (normal number of copies).

Only cancers that test IHC "3+" or FISH "positive" will respond well to therapy that works against HER-2. An IHC 2+ test result is called borderline. If you have a 2+ result, you can and should ask to have the tissue tested with the FISH test.

Hope this answers some of your questions.
__________________
Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 12-27-2006, 05:45 AM   #3
KellyA
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Hi Catherine,

You've come to a wonderful place. There are many terrific women here that are very knowledgable, but most of all very supportive and caring. You will have a lot of help navigating through this. We have a very similar dx- there are many informative threads on er/pr + and - . You should be able to do a search and they will be accessible.
Things have come a long way for Her2+ people- with Herceptin and many other new treatments, there is alot to be positive about. Many women here will inspire you and lift you up.

Love, Kelly
__________________
dx'd 05/06, 37 years old
er/pr-, Her2+, grade 3
double mastectomy, immediate reconstruction- implants
Stage 2b, 2 tumors- 2.2 cm and 0.6 cm, 3/5 + nodes
all scans clear
genetic testing- negative
06/06 began dd A/C x 4, 12 weekly Taxols w/ Herceptin
30 rads
Herceptin weekly x 1 year
Herceptin completed 08/07
Port removed 12/26/07 MERRY CHRISTMAS!!!!!!
05/17/08 Two year anniversary NED

"We gain strength, courage, and confidence by each experience in which we really stop to look fear in the face... you must do the thing that you think you cannot do."

-Eleanor Roosevelt

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Old 12-27-2006, 08:34 AM   #4
tricia keegan
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Hi Catherine

As you probably know I spend a lot of time on Komen too!!
It's worth coming here often as the people here are so knowledgable on
our type of cancer and also so couragous,it gives me confidence just reading
their posts.
Unlike you I'm highly triple positive so had my ovaries removed earlier in the year and now take Arimidex.
The side effects are not to bad and well worth it if it keeps the cancer away!!
I also had 3 positive nodes so we have that in common.
Hope to see you hear more often.
Tricia
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Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 12-27-2006, 06:17 PM   #5
Heart Sutra
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Hi,

There is a lot of info on the web regarding your questions.

You asked the difference between er/pr neg, and er/pr pos.

Whether or not there are estrogen and progesterone receptors with the cancer cells. This determines whether the treatment you'll receive is hormone based or not.

Lymph node involvement does not mean metestatic bc. It means that there are cancer cells detected within those lymph nodes, it does not mean that there is cancer elsewhere in your body.

The accuracy of HER2 diagnosis was well answered by Tousled1 (Kate).

Welcome here, We have found some of the best people... very warm and caring souls who are full of information and compassion. Some answered you already! We are new to this too, and we thank you for being here.

and yes... this dx of HER2 is not what it once was. There is reason to think it is the most treatable of cancers now.
__________________
---Kevin and Sue---

Dx'd 10/06 IDC grade III/III
Er- pr- HER2 3+
MRM right breast 12/5/06
nodes negative
same day reconstruction started
(implants)
Stage II (2.2 cm tumor)
fairly extensive DCIS
Ct and Bone scans clean
Port placement 12/26/06
AC (4 cycles DD)to begin 1/2/07
Taxol/Taxotere (4 cycles DD)
Herceptin for one year

"There is no distinction between the one who gives, the one who receives, and the gift itself."- Hahn
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Old 12-27-2006, 10:44 PM   #6
Catherine
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Talking Thank you for helping me with my first post.

Thanks to everyone who answered me and welcomed me to this site. Your answers were very helpful. I am not exactly sure how to navigate on this site, but I will get better. I might even figure out how to get my picture on here. I will have to decide whether the picture will be before BC, or currently with a half inch of hair, or currently with my cute wig.

Thanks so much for the good wishes...same to all of you.
Catherine in Oregon
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Old 12-27-2006, 10:59 PM   #7
Lolly
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Hi Catherine, and a late welcome to the group I'm er/pr-, her2+++, and also from Oregon!

If a cancer is er/pr positive, it means estrogen and progesterone help the cancer cells to grow. Therapys for these cancers involve blocking the effects of the hormones.

Her2-neu is a protein, and being Her2+ means our cancer cells use the her2-neu protein to grow, and that's where Herceptin and Tykerb come in, helping to block the growth effects of Her2.

Sounds so simple, wish it were as simple to treat!

<3 Lolly
__________________
Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.

Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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Old 12-28-2006, 02:09 AM   #8
Margi MacMaster
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Catherine- I too am ER/PR neg and Her2 pos and new at this- would love to hear

Hi Catherine
I am new to this completely and on a different continent so hope this works!!!..and would love to hear from others in similar circumstances.
I am also 58 years- diagnosed with Grad 111-Breast cancer in August 2006.... which had spread to lymph glands- 10 positive out of 28 (3.5-4.5 cms) removed...They were unable to identify any cancer in breast even on MRI but surgeon expects its either small and undetected or my ?good immune system eradicated it so no breast removal.. ....My understanding is that you do not have advanced breast cancer...it may still be considered early breast cancer.....the stage and grades are important to note...however.....Metastatic refers to any cancer that has spread...in the true sense of the word,,,,the risk for me is there is a chance of recurrence.. hopefully not so!! .in view of the Grade and size of cancer in my case it is considered stage 11B (early)...so need to look at size of nodes.
I have completed four cycles (three weekly) of AC treatment (adriamycin + Cyclophosphamide) and started Taxotere and Herceptin two weeks ago (and have three more cycles ) and then 25 radiotherapy sessions to superior clavicular area and right breast and then ongoing Herceptin, all being well for a total of 12 months.....So far have been able to work ...probably 75% of normal- but normal for me was 12 hour days running a medico-legal business and so cut back hours especially one week post chemo.... as was hard to see injured/disabled clients then. Interestingly the last treatment was tougher than the A/C regime for me as I had painful joints and felt like spikes in all orifaces....unsure if it is cortisone effect or Taxotere.....fortunately painful joints dissipated after about eight days post chemo but still feel very tired...and am hoping I can manage the remaining chemo better than this last one...it seems to become more managable when you know which medication you can take to assist the side effects..and pace yourself and keep positive.....the chemo is healing hopefully.....I would love to hear if others have had the same experience as me. I also have had the metallic taste only since last chemo and that is unpleasant....any remedies...I brush my teeth with moisterising toothpaste/gels use mouthwashes, biacarb mouth rinses and tried Nexium--the latter probably the best to date.
Keep smiling and enjoy every day!!
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Old 12-29-2006, 12:21 AM   #9
Catherine
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Hi Margi,

Yes we can all get on the same site and communicate and compare notes even Australia to Oregon. I completed all of my chemo in August before my surgery. Chemo was not fun, but I made it. Taxol was tough on me.

Are you having Herceptin along with the chemo? I am only on Herceptin now.
See my profile. I am still trying to navigate this site.

More later, all the best, Catherine

PS I barely work 50% of my former schedule. I love taking time off and being good to myself. I excercise and sleep as much as I can.
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Old 12-29-2006, 01:30 AM   #10
Margi MacMaster
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Hi Catherine- it's good to hear from you....and yes I am still trying to understand how to navigate around this site also...and understand some of the different words used.
Taxol is different to Taxotere...but similar class of drugs...and I am on Taxotere and yes, started it with Herceptin as an infusion two weeks ago.... I finish Taxotere on 16 February and will continue the Herceptin for the twelve months apparently.
I am just hoping I do not have the same side effects for so long next Friday when have second Taxotere.

Did you find it became worse with Taxol each time?- Accumulative fatigue I guess after all this chemo too.
My neutrophils dropped significantly (0.6) after my surgery to remove lymph glands when I started A/C chemo so I now have neutropenia and have injections of Neulastin to boost the white blood cells in bone marrow twenty four hours after each chemo session.
I see the oncologist just before I have chemo- this week two days before so will discuss my side effects in case my dose needs to be adjusted as had aching joints for 5-7 days, flu type symptoms (I know Herceptin can cause this) for which I take an antihistamine and epigastric discomfort for which I take Nexium as well as the awful metallic taste which has dissipated a bit thankfully.

Did you get any similar symptoms on Taxol? and have they dissipated now that you have finished it?

Fatigue is amazing and you just have to rest and sleep as needed don't you? Thankfully it does not usually hit me until late afternoon or early evening but like you sleep/rest is essential and pacing oneself....you cannot do otherwise and you really get to know your body I think...

And I also know that exercise is the key- the oncologist had advised me to walk to eradicate fatigue and I know when I do something such as walking or heavier gardening feel great and need to do it more......I was weeding bent over for ages recently in very hot summer weather and although it worked up a sweat felt so good afterwards...the key to know this and do it more often. Is Herceptin alone causing you ongoing fatigue? Did you find radiotherapy caused fatigue?

All the best Margi
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Old 12-29-2006, 05:49 AM   #11
tousled1
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Margi,

When I was getting my chemo my blood counts dropped - both red and white cells. I was getting Procrit shots the day of chemo for the red blood cells and Neulasta the day after chemo for the white blood cells. I also had bone/joint pain with the Taxatere. When I was on the Taxatere I received Decadron (steroid) as a pre-med so I attribute a lot of my side effects to that. Chemo does have a cumulative effect but you will get through this.
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Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 12-29-2006, 01:26 PM   #12
Margi MacMaster
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Hi Kate

Thanks for your reply.....yes I think the cortico-steroids that you take pre and post Taxotere for the three days can cause a lot of the problems..as I had this spiking feeling in all orifaces and with joint pain felt Id go crazy if it lasted...but the spiking feeling disappeared after three days..the GP (local doctor) felt it may have been the steroids....I am hopeful it will become less...the consolation is that you hope you are being healed...dont you?..and you have obviously come along way and have similar treatment.
How have you found the Herceptin?...most people say its very tolerable after the chemo.
all the very best Margi
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Old 12-29-2006, 07:18 PM   #13
tousled1
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Margi,

In comparison to the other chemos that I had, I must say that Herceptin is a walk in the park. My counts (red) still drop and I still get Procrit shots about every other treatment. There is a thread here about sides effects of Herceptin that you might find interesting. It's entitled "Herceptin side effects real or perceived."
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Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 12-30-2006, 03:17 PM   #14
Carol Carlson
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er/pr neg her2pos

they call it micromets, if it has gone from breast tissue to lymph node involvement.... at least that is my understanding.
Carol
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Old 12-30-2006, 03:29 PM   #15
Carol Carlson
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P.s.

P.S. my understanding in terms of er/pr neg, that er/pr-postive is probably preferred since the use of Tamoxifen and other drugs are available since the tumor or tumors were estrogen fed... and those drugs block the hormones..Though now with the availability of herceptin for those of us who are er/pr neg and her2 pos. it may change the playing field and outcomes..
Carol
P.S. correct me if I'm wrong....
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Old 12-30-2006, 05:04 PM   #16
Margi MacMaster
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Hi Kate- can you please help me find the thread to the article on Herceptin side effects..real or perceived?...have gone though a few pages to find it..with no luck..is there a page number it is on? Thanks!! Margi
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Old 12-30-2006, 05:08 PM   #17
Becky
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http://www.her2support.org/vbulletin...ad.php?t=23696

Here is the thread on Herceptin side effects - real or perceived.
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 01-01-2007, 08:31 PM   #18
Margi MacMaster
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thanks Becky

thanks for the info on the site....great idea to gain this insight for all parties

I think I had better wait until I have completed my four cycles of Taxotere before I talk about any symptoms of Herceptin as think most of my symptoms relate to Taxotere and as have only had one infusion of each of them I will not know until am only on Herceptin.....

I am told by all the nurses and oncologist that Herceptin is very tolerable and many symptoms may relate to the lasting symtoms of chemo..for the first few weeks/months anyway...Is everyone else told the same??
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Old 01-01-2007, 10:55 PM   #19
Adriana Mangus
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Wink Welcome Aboard!

Me too am Her2+, ER/PR -. According to studies and clinical trial women who received Herceptin and tested neg. but are Her2+ did as well as those who tested ER/PR + . It's my understanding that it just means that if you are negative you do not benefit by taking HRT . Finally, women who received Herceptin regardless of hormone receptor benefited from it. And that's all it matters to me! Is just too dificult to sort out through all these medical issues.
Now, some of the ladies on this site are genius, am sure you will receive tons of useful information from them.

Hugs and best of luck to you.
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 01-01-2007, 11:20 PM   #20
Margi MacMaster
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Thanks for the welcome Adriana

yes hopefully we can all beat it....thanks for the welcome and all the very best with your journey to conquer it completely
Margi
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