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My LVEF went down more than 10 percentage points between scans, so my onc took me off Herceptin. She said that's the guideline, but from what I've read on the message boards here, not every onc seems to go by that.
I'm hopeful that my LVEF will bounce back.
I took Herceptin for one year every week when I had early stage bc and never had a problem. My scans were always in the low-to-mid 60% range. But when I started taking Herceptin again after becoming stage IV, the percentage dropped from 70% to 57% after five treatments given every three weeks (or the equivalent of 15 treatments given once a week).
I'm due to have another muga scan in December, and if the percentage has increased, my onc said we'll try it again once a week. Perhaps the infusions every three weeks, which are three times stronger than once a week, are too strong for my heart.
My only concern is that I had my port removed after three years, which was just five months before my bc returned. So, I'm concerned about my arm veins, which hadn't been a problem when I was getting treatment every three weeks.
As for your reconstruction surgery, a plastic surgeon will give you a good idea whether he or she thinks you can undergo the surgery.
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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