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Old 12-13-2008, 11:25 AM   #1
RobinP
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SABC another abstract on her2+ early stage outcomes...

This is a slightly smaller study of about 120 her2+ bc patients, which does reach statistical significance. It is reflective of slighter higher survival stats in the first five years than the previous article that I posted by SABC, abstract 701. Again, the article eludes to the fact that probably these study patients did not receive adjuvant tx with herceptin and chemo., which probably would have positively increased survival rates, according to the HERA trial and other studies.



[6058] HER2 amplification does not alter outcome in small (1 cm) tumors.


Ananthakrishnan P, Patrick RJ, Rybicki LA, Tubbs RR, Crowe JP, Budd GT Cleveland Clinic Foundation, Cleveland, OH

INTRODUCTION: Amplification of human epidermal growth factor receptor-2 (HER2) has been associated with an aggressive clinical phenotype, however the management of patients with small tumors (<1 cm) that amplify HER2 is controversial. The goals of this study were: 1) to describe characteristics of HER2 amplified tumors based on tumor size, and 2) compare outcomes among 4 groups based on tumor size (small tumors <1 cm or large tumors >1 cm) and HER2 amplification (+ or -.)
METHODS: Data were collected prospectively in our institutional review board approved breast center patient registry for patients with infiltrating ductal or infiltrating ductal-lobular mixed breast cancer. There were 770 patients with N0 tumors who were diagnosed between January 2001 and April 2005 (prior to treatment of HER2 amplified tumors with Trastuzumab). Categorical variables were compared using the Chi-squared test; outcomes were estimated using the Kaplan-Meier method and the log-rank test.
RESULTS: At 4 years, estimated disease free interval was 97% in small HER2- tumors, 92% in large HER2- tumors, 91% in small HER2+ tumors, and 86% in large HER2+ tumors.

At 4 years, breast cancer specific survival was 97% in small HER2- tumors, 92% in large HER2- tumors, 91% in small HER2+ tumors, and 86% in large HER2+ tumors.
CONCLUSIONS: In our series, larger as opposed to smaller HER2+ tumors tended to be of higher histologic grade (SBR), and showed a trend toward more frequent lymphovascular invasion (LVI) and negative hormone receptor status. In small tumors, HER2 amplification did not predict recurrence-free survival or breast cancer disease specific survival at 4 years. The survival curves do show trends towards worsening outcomes for small tumors with HER2 amplification; these trends may show significance with additional follow-up.

Sunday, December 14, 2008 7:00 AM

Poster Session VI: Prognosis and Response Predictions: Response Predictions - Biomarkers and Other Factors (7:00 AM-9:00 AM)
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Last edited by RobinP; 12-13-2008 at 11:34 AM..
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Old 12-13-2008, 08:34 PM   #2
nannamer
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You girls in America seem to get much better treatment than here in Australia. I had 2cm her2+++ er+ lump plus dcis July 2005. 11 glands were removed and all clear.Had 4 rounds of chem and rads. No Herceptin as early stage not covered here.Have had 2 bone scans because of back pain. Both NED. Have yearly mammogram (which did not detect cancer initially- found lump). I have 6 monthly check-ups with blood tests only. I am terrified of recurrence. Does anyone survive this type of breast cancer long term? As in cured.
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Old 12-14-2008, 07:28 PM   #3
RobinP
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I did late Herceptin...

I understand your concerns over your treatment lacking Herceptin. At least you are hormonal positive, which is not as high relapse as hormonal negative her2. Note I did late Herceptin because of my concerns about not having it. That's an option and as Becky has posted and others elsewhere, green tea vitamin D3 supplements, high omega three intake and olive oil may decrease the her2 pathway as well and is avialable daily to fight her2. Keep the faith and stay well.
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