Herceptin and care questions

Sheryl H · 05-04-2007, 11:39 AM

I had a lumpectomy and sentinel node biopsy December 12th. Clear margins - my radiologist said smaller than he likes to see, but still clear, 5 nodes removed, all clear. Had DCIS and IDC - .9 cm. I am 56 years old, have gone through menopause, ER+, PR+, Stage 1, Grade 2, Her2 Positive. Did seven weeks of radiation, with the last eight, being the boost. Originally, my oncologist did not recommend chemo, which was why I started with radiation.
When I had the oncotype dx test done, it showed I had a high rate of recurrence. With that in mind, my onc recommended four doses of A/C. Just had my third yesterday.
Last Friday I went to another onc in Walla Walla, Washington. Wanted a second opinion. My original onc hadn't ordered any heart tests before A/C and also seems reluctant to prescribe Herceptin. The onc in Walla Walla thought I didn't need heart scans with only the four doses of A/C but would benefit from taxol with Herceptin after the A/C.
When I spoke to my original onc yesterday about all of this, he didn't think the taxol was warranted, but possibly a 12 week regimen of Herceptin.
Also, my original onc was proposing tamoxifen, whereas the one I consulted for a second opinion, thought Femara or Arimidex would be better.
I am so tired and confused about what to do. I feel like I really need to have the Herceptin, but is a 12 week regimen good or not? Have most of you used taxol along with the Herceptin? And is tamoxifen a good option or would Femara or Arimidex be better?
I know you are not doctors. I am just interested in what your experiences have been. Thank-you so much. I have received so much info and encouragement on this site. I pray for each and every one of you and keep you in my thoughts.

hutchibk · 05-04-2007, 12:33 PM

There are so many knowledgeable ladies on here who will be able to help you weed through all of this, but I know that were it me, I would definitely push for Herceptin. I don't know about it in combo as a first line, because it wasn't first line when I was originally diagnosed. I was able to get Herceptin only after recurrence, first with Taxol and Carbo, then a year later with Taxol only.

I know you will hear from some ladies here who will have some answers for you, but given the opportunity, I would definitely do the muga after A/C and jump on the Herceptin.

suzan w · 05-04-2007, 02:07 PM

You can see by my signature what I have done so far! My understanding is that Arimidex (aromatase inhibitor) is prescribed after menopause. I also recommend a MUGA scan after A/C and before herceptin. My oncotype DX showed a high intermediate risk of recurrence...it seems that most Her2 cases have a high oncotype score...I decided to do the chemo as prevention, although my oncologist would have done Herceptin without chemo. I wanted to be as agressive as possible from the start!

Mary Anne in TX · 05-04-2007, 04:02 PM

Hi Sheryl!

You can see that my onc in San Antonio treated me and continues to treat me agressively. I am not PR/E +, but HER2 +++. I don't know what is best for you, but I love my agressive doctor. ma

Becky · 05-04-2007, 06:52 PM

It is well known that Taxol is a great drug for Her2+ breast cancer. It is also a drug that works very synergistically with Herceptin. About half the Stage 1 women on this board have had AC followed by Taxol/Herceptin and half had 4 AC followed by Herceptin. Both regimes used Herceptin for a year. Another chemo option that many Stage 1 women (and higher stages) get is Taxol (or Taxotere), Carboplatin and Herceptin (6 rounds) then continuing herceptin for a year.

Whether or not you should receive Taxol is an opinion but studies on Stage 2 women (those with 1-4 nodes positive) has shown a marked decrease in recurrence if Taxol is used when trialed as 6 AC or 4 AC followed by 4 taxol (prior to dense dose and prior to using Herceptin). So, using a taxane is a survivability boost.

Certainly you should at least use Herceptin for a year as most Stage 1 protocol is 4 AC followed by a year of Herceptin.

I hope this helps

mabrooks · 05-07-2007, 01:48 PM

Sheryl;
My case sounds similiar. I am 53 years old. Lumpectomy 3/29/07 - mammosite radiation for 5 days twice a day. DCIS with microinvasion - clear margins - sentinel node biopsy negative. Tumor was 5mm. ER+, PR+, Stage 1, Grade 2, Her2 Positive 3+.
Thought I was done after radiation. Saw the medical oncologist and he wants me to take an AI and Herception. I guess it is all good - being preventive. He said I would have the heart testing a few times at the start of Herceptin treatment (once every 3 weeks for 1 year) then less often if I do well on it. I am afraid of the Herceptin side effects more than anything. My oncologist feels that Tamoxifen is more appropriate for premenopausal women - he wants me on an AI - like Femara. My hot flashes are back with a venegence after stopping my HRT - my sleep is interupted and mood swings are common with me. I am meeting with the oncologist next week - after the test for high risk or low risk is completed. If he recommends the Herceptin I will give it a go. He also recommends bone density testing and a drug like Fossamex or Boniva and maybe an antidepressant to help with the side effects of the AI. Hope this helps........will post when I know what my treatment will be.
Good luck and God bless.