"HR2 stongly positive" ?

[Luck2U]

Is being HR2 "stronly positive" always a bad thing in the scheme of a grade 1 tumor? My wife has a recently diagnosed large breast tumor (5+ cm) that they are considering for chemo to shrink the tumor prior to removal. The PET scan does not show any node involvement (or any other metastatic disease), but I guess that might not mean a lot until they look under the hood (so to speak). She is also ER positive, which I understand is a good thing. Have many of you gone the shrinkage route with good results? If you've had bad results, I'd just as not hear from you (relax, I'm kidding). Any way, I've read and studied until my eyes are bleeding, but talking with those who are on the front line seems might help me be the most helpful to my wife. Does everyone get deatly sick with Chemo? Please share what you are comfortable sharing.

[Barbara2]

I can not answer you question regarding being strongly Her2 and grade 1 cancer, as I don't know.

My tumor was "at least" 4.5cm, (Oct 2002) according to the information I received. The doctor never mentioned trying to shrink it first, but I think that might be because we really didn't know the size. It felt smaller than that, and the ultrasound was negative; the core of the tumor was smaller than that, but the "fingers" extended the tumor to 4.5cm. I, too, was Er+ which, yes, is a good thing.

I did get very sick with CEF chemo. I think the more current practice of 4 rounds of AC, followed by Taxol/herceptin would have been easier to tolerate. I was sickest with round 5 and 6 of chemo, which I wouldn't have had on the Taxol/herceptin plan.

I have a friend who did the AC, Taxol, then herceptin 5 years ago. She is a teacher, (mid 40's) and I don't think she ever missed any days due to illness, but she did admit there were a few times when she shouldn't have been working. It affects everyone differently. She is doing great and NED so far.

All the best to you. Barbara2

[michele u]

i think the answer is, if one is going to be positive for Her2 you want it strongly positive. I believe the higher the FISH score the better the Herceptin works. That is my opinion and i bet there is evidence somewhere out there for that. I was 3+ on my first test, then i did a FISH test and it was 10. That's pretty high. I'm 2 years out having 34 positive nodes and took one year Herceptin. The question about shrinking the tumor first has been proven to be better. MD anderson did a study and showed this was better. The theory is to shrink the tumor and you have less to take out. The only bad side to that is i don't think you get the axillary dissection surgery so you really don't know if there is any positive nodes. If she had a pet scan and no positive nodes, that is a good thing.

[PatS]

I had chemo first (neoadjuvant chemo) to shrink my tumor. I was diag. in July 2002 w/ a
tumor that was approx. 6cm. I had 4 A/C (adriamycin/cytoxin) followed by 4 taxotere, each 3 weeks apart. At the time of my mast. the tumor was only 1cm and all 7 nodes they took were negative. So, this route worked well for me. Chemo first lets you know how your tumor is responding to chemo, so if for some reason one type doesn't work, they can always try another. For me it was also good as my tumor was very close to the chest wall. If I hadn't had chemo first to shrink it away from the chest wall there would of been more risk of leaving cells behind in the chest wall. I don't know if my nodes were always negative or if the chemo did it, but my treatment would have been the same either way. I was also estrogen positive and now take arimidex. I also had radiation after my surgery. I finished treatment in June 2003 and so far am fine. As to the effects of chemo, with the A/C I was nauseaus (sp?) for 2-3 days afterwards but
it was very manageable. For me, the taxotere was easier. Everyone reacts to chemo differently but they do have a lot of good anti-nausea drugs that work well.

Hi! Just a few words about chemo.- The first chemo I was on, adriamycin was the worst. But encourage your wife to be a good listener, because here's what happened to me. The very first day they gave me chemo, I went home and I reacted so badly, I called my whole family to gather around my bed so I could be with them while I died. I had such a burning in my chest- I figured that was it for me. Well, guess what it was? Heartburn. I had never experienced it in my whole life until then. Apparently the nurses gave me pepsid to take home with me but I forgot to take it. The second I took it, the heartburn disappeared. Another thing that drug gave me was nausea, but they gave me anti-nausea medicine. The drugs I am on now, xeloda and herceptin are not preventing me from anything. I feel great and blessed that we live in such a time to have all these new medicines.Onward and Upward! God Bless You, Cathy

[tammymarie1971]

If I had to do things over I would shrink the tumor first, Mine was 5cm as well but I was pregnant at the time, so I did not want chemo until after the baby was born. I really think that the more they shrink it the better, I would hope they would do chemo before and after taking the lump out as well as radiation. Herceptin has an awesome track record for stage 1. I was still able to run my household of 3 kids plus a newborn during AC chemo it is doable, but listen to the nurses and write their instructions down it's important to follow them, the nurses often know way more than the doctors in this area!! Also let your wife know that she doesn't have anything to prove to anyone...if she feels like crap than stay in bed!!!! If she is tired than rest!!! Also don't let her eat any of her favorite foods on chemo days, I've ruined some of my favorites that way can stand the thought of most foods I ate on chemo days!!!Maybe I'm just weird.
Tammy

[Luck2U]

Thank you all for sharing your comments; nothing like an insider's view. Was told today that they are going to run a FISH test to confirm the IHC that showed my wife HER/2 +. Her onc had commented that it is very unusual to have a grade 1 tumor (not agressive) in combo with HER2/ +, which seems to go hand-in-hand with more agressive C's. The onc also said, however, that in the overall scheme of things, HER/2 + is not of sufficient concern nowadays to obsess over. We should have a plan in place by next week as to how best to proceed.

[Julie2]

I had neoadjuvant dosedense AC+Taxol which shriked my tumor from 4.5cm to just DCIS and 4 micromets to auxillary nodes . Please see my profile below.

julie

[Luck2U]

Julie, thank you. Did the regime you were on cause you to be very sick, or were you able to soldier on?