er/pr weak...

[Jean]

I am moving this post over to this area as you may recive additonal information.

robind
Member

Join Date: Aug 2008
Location: Central,New Jersey
Posts: 17


ER/PR weak, Her2 Positive vs. Femera
3 months into receiving Herceptin, just started Femera. Oncologist said Femera won't be as effective in my case because I am weakly er/pr positive (both 15%). If I were strongly er/pr positive I would benefit much more. She gave me the impression that my prognosis is not as good because of this or maybe I was so shocked to learn the above that's what I read into it. My question now has become then why would I take Femera to begin with? If I am considered weakly, and the benefits are not so high than what real benefit will it be? The side effects might not be worth it if I am not going to benefit from taking this drug for 5 years. My bc tumor was 1.4cm, stage1 upgraded to stage 2 with cells in 1 sentinel node. Her2 positive (3.1 amplified), clear margins, IDC.
Is anyone out here weakly er/pr positive but her2 positive that is receiving Herceptin but not taking a Aromotose Inhibitor?

[Jean]

Adjuvant therapy for postmenopausal women with hormone receptor–positive breast cancer should include an aromatase inhibitor in order to lower the risk of tumor recurrence. Aromatase inhibitors are appropriate as initial treatment for women with contraindications to tamoxifen. For all other postmenopausal women, treatment options include 5 years of aromatase inhibitors treatment or sequential therapy consisting of tamoxifen (for either 2 to 3 years or 5 years) followed by aromatase inhibitors for 2 to 3, or 5 years. (American Society of Clinical Oncology [ASCO] guidelines include narrative rankings) (ASCO)

http://www.qualitymeasures.ahrq.gov/...1&doc_id=12039

I think you have to be ER positive by 4% to be considered for AI...but I am not sure...Becky knows much on this....
I am sure she can offer some solid advice.

Jean

[Debra]

I am 17% Est. and 15% prog. I would guess that too is considered weak. Neither one of my two oncologists questioned going on an AI. I even had a hysterectomy at the age of 41 in order to be on an AI rather then tamoxifen.
I hope maybe you find some insight so I can learn as well. I have oftened wondered if I really should be on it as well.
Thanks for posting a great question.

[Becky]

I believe that for women who are weakly positive for both the estrogen and progesterone receptors, taking an antihormonal at least while still on Herceptin therapy, is highly beneficial. The Herceptin takes away the ability of the Her2 receptor's activity and the AI (or Tamoxifen) takes away the ability of the hormone receptors.

Women who are weakly positive for both E and P should understand that (in the case above) 15% of the cells are positive for the hormone receptors and 85% are not. If you shutdown Her2, then the other line could "take over" and be the predominant line and then you aren't doing anything about it. Even if you were only weakly positive for ER, I would still take an antihormonal drug. If weakly positive only for PR - there is not any data on that so alot of investigation may be needed.

Secondly, taking an antihormonal will and does prevent the formation of totally new breast cancers and even if you had a double masectomy, there is always a little breast tissue.

The best chance of beating bc is to do everything at your disposal and being at least alittle positive, especially on both E and P makes you a good candidate for an anti-hormonal treatment (and ESPECIALLY while still taking Herceptin).

Please realize this is only my opinion based on my research and talking to my doctors but I believe - shut those suckers down!