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Old 06-21-2008, 10:03 AM   #1
Val Pfeiffer
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New cancer found in remaining breast

hey guys--
I know the odds were supposed to be higher that I'd end up with cancer elsewhere in my body than the odds were that I'd find cancer in my remaining breast, but I guess the odds aren't always correct! The good news is that this time it's a very early stage, so when I have the mastectomy this time, I probably won't need to follow up with chemo or radiation. I don't know yet whether it's Her2+ yet, so I'm not sure what I will decide about the quarterly herceptin I've been taking. I'll cross that bridge when I get to it.

More details are on my blog (including the pathology; see the "All About Me" column at the right of the page)...here's the address to my blog:

http://journals.aol.com/valleygirlvn...CancerUpdates/


Val
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BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 06-21-2008, 10:09 AM   #2
dhealey
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That sucks! But good it was found early. Best of luck with your up coming surgery and praying you have a speedy recovery.
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Debbie in North Carolina
Diag 10/2006-high grade invasive ductal carcinoma- mastectomy L breast
2.5 cm tumor ER/PR pos-Her2+++
4 rounds A/C, 4 rounds Taxol
Herceptin every 3 weeks until Jan. 2008
6/18/07 prophylatic mastectomy R breast
8/2007 started aromasin/stopped arimidex (side effects)
12/07 stopped aromasin due to side effects (now what?)
Finished herceptin 1/8/08
started tamoxifen for 2 years then will switch to femera
allergic to tamoxifen started femera 4/2008
June 20, 2008 portacath removed
Learnig to live life to the fullest!
Stopped Femera due to side effects
July 28, 2008 start trial for breast cancer vaccine
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Old 06-21-2008, 11:24 AM   #3
StephN
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Unhappy

Darn sneaky devil of a disease! Another example of why surveillance is mandatory. All positive thoughts that this is the only site.

Are you sure that surgery is the way to go and not some other treatment?

Will check your blog to see the rest of the story.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 06-21-2008, 11:29 AM   #4
Val Pfeiffer
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Thanks, Steph :-) Once you read the rest of the story, you'll understand why surgery is the only option. In fact, after all the hassle of having the biopsy, I was ready to do this even if the biopsy was negative. Anyway, the cells were found throughout the entire biopsy sample. And besides, a biopsy sample taken from an incredibly small breast leaves it sorta funny looking...so yes, the breast has gotta go!!

Val
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BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 06-21-2008, 12:52 PM   #5
tricia keegan
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Val

Just wanted to tell you I'm sorry you're facing this again although given the choice I suppose if it's going to return it's far preferable in the other breast than elsewhere in the body.
Just wanted to wish you well with the surgery and glad it looks like that's all you have to face this time. (as if that was'nt enough!)
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Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 06-21-2008, 06:11 PM   #6
Becky
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ahh Val. I'm so sorry. Stay strong dear girl. I'm thinking of you. I'm glad you nabbed this one early.

Love and hugs
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 06-22-2008, 06:20 PM   #7
Liz J.
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Hi Val,

I am sorry that you had to go through this. I am sending all good wishes your way.

Sincerely,

Liz J.
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Old 06-22-2008, 08:08 PM   #8
TSund
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Val,

Tis a drag that you need to hassle with this but I"m glad that the prognosis looks good and you seem to have a great attitude.

Sometime when you have time I'm curious about your quarterly Herceptin; perhpas could you share some info on that when your current stuff is dealt with.

Best to you,

Terri
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Terri, spouse of Ruth, Dallas/Ft. Worth area
Ruth dx 05/01/07 (age 50) Filipino
multifocal, several tumors .5 -2.5 cm, large area
Breast MRI showed 2 enlarged nodes, not palpable
100%ER+, 95%PR+, HER2+++
6x pre-surgery TCH chemo finished 9/15/7 Dramatic tumor shrinkage
1 year Herceptin till 6/08
MRM 10/11/07, SNB: 0/4 nodes + Path: tumors reduced to only a few "scattered cells"
now 50% ER+, PR- ???
Rads finished 1/16/08
Added Tamoxifen,
Finished Herceptin 05/08
NOW is the time to appreciate life to the fullest.

Last edited by TSund; 06-22-2008 at 08:19 PM..
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Old 06-22-2008, 08:22 PM   #9
Val Pfeiffer
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No magic in the quarterly Herceptin...I just wanted to have something to keep the battle going. It seemed too scary to completely quit :-)

Val
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BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 06-22-2008, 09:15 PM   #10
lexigirl
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Dear Val,

I am sorry that you are facing bc once again. However, I am happy that it was discovered early and that your prognosis will be good.

Hugs and Prayers,
Lexi
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Old 06-22-2008, 09:28 PM   #11
jones7676
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Hi Val,

I'm sorry you have to go through this again...but I'm glad it was caught early.

My wish for you is that you have the strength and the knowledge to face, endure and be rid of those pesky cancer cells.

I hope whatever treatments you choose that they are very successful.

Barb
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Barb

10/03 Radical Mastectomy 3 cm tumor - 1/17 Nodes Stage II B, Her 2 +++ ER-/PR- 11/03 4 AC 4 Taxol 12/05 Stage IV - Lung met , Bone mets - Carbo, Taxotere, Herceptin 9/06 - 2 cm brain tumor 10/06 - Tumor removal surgery - Herceptin Halted 12/06 gamma knife tumor base.1/07 Navelbine/Herceptin 4/07 Rads to R femur 5/07 Stereotactic - new 2 cm brain tumor 4/07 Start Xeloda 5/07 Tykerb added 7/07 Brain MRI clean 10/07 .055 cm brain met found. 12/07 Stereotactic -1 cm brain tumor Start Tykerb 11/07 Abraxane/Herceptin 5/08 Cisplatin, Gemcitabine/Herceptin 6/08 Stereotactic to 1cm 9/08 Stereotactic repeat (growth). 11/08 Pet Scan Good but new tiny met on L lung/dead Brain surgery (no cancer cells found/scar tissue) 1/09 Chemo restarted 2/09 Pet Scan Bad - R larger very active/active L active lymph nodes both sides of chest MRI- mets slight increase 2/09 Start Doxil/Tykerb Treatment
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Old 06-23-2008, 06:15 AM   #12
notamrnpsn
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Smile Cancer in other breast.

Hey Val, I know exactly how you feel. I just had my second mastectomy on the 19th, came home the 20th. I had ductal cancer in the left breast, but this one was Lobular.
It was very small also ,no node involvement. I see my surgeon tomorrow and my onc. in a couple of weeks to see it I do need any treatment. Keeping my fingers crossed on that one.
It is like getting a punch in the gut when you hear the news, but like true Warrior Women we will get thru it. Hugs and Blessings, Jeanette
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Old 06-23-2008, 07:08 AM   #13
MJo
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I'm sorry you are going through this, too. It could happen to any of us and we all must be vigilant. I think you have made the right decision about the mastectomy. May you have many years of health ahead of you.
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IDC, Stage I, Grade 2
Oncotype DX Score 32
Her2++ E+P+, Node Neg.
Lumpectomy 11/04/05 Clear Margins
3 Dose dense AC (Couldn't tolerate 4)
4 Dose dense Taxol & Herc. (Tolerated well)
36 weeks Herceptin (Could not complete one year due to decrease in MUGA score)
2 years of Arimidex, then three years of Femara
Finished Femara May 2011
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Old 06-23-2008, 07:54 AM   #14
Colleens_Husband
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Val:

I am sorry you have to do this a second time. I can't imagine how tough you will need to be to repeat all the grief of a second go-around.

Val, please know that you are not alone. We are on your side. Our prayers will go out to you and your family.

Lee
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This happened to Colleen:

Diagnosed in September 2007
ER-/PR-/HER2 Neu+++ 2.1 cm x .9 cm spicluted tumor with three fingers, Stage 2B
Sentinal node biopsy and lymph node removal with 3/18 positive in October 2007
4 TAC infusions
lumpectomy March 2008, bad margins
Re-excision on June 3rd, 2008 with clean margins
Fitted for compression sleeve July 16, 2008
Started the first of two TCH infusions August 14, 2008
Done with chemo and now a member of the blue dot club 9/17/08
Starting radiation October 1, 2008
life is still on hold
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Old 06-23-2008, 09:50 AM   #15
michka
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Post

Val, it gets me upset each time I see that one of us gets hit by this horrible disease. But after going through the heavy treatment once, finding another cancer in the second breast must be so difficult. I read your blog. I understand what you felt about the biopsy. I hope you can give us more news when you will have the final results.
Michka
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08.2006 3 cm IDC Stage 2-3, HER2 3+ ER+90% PR 20%
FEC, Taxol+ Herceptin, Mastectomy, Radiation, Herceptin 1 year followed by Tykerb 1 year,Aromasin /Faslodex

12.2010 Mets to liver,Herceptin+Tykerb
03.2011 Liver resection ER+70% PR-
04.2011 Herceptin+Navelbine+750mg Tykerb
06.2011 Liver ned, Met to sternum. Added Zometa 09.2011 Cyberknife for sternum
11.2011 Pet clear. Stop Navelbine, continuing on Hercpetin+Tykerb+Aromasin
02.2012 Mets to lungs, nodes, liver
04.2012 TDM1, Ned in 07.2012
04.2015 Stop TDM1/Kadcyla, still Ned, liver problems
04.2016 Liver mets. Back on Kadcyla
08.2016 Kadcyla stopped working. mets to liver lungs bones
09.2016 Biopsy to liver. no more HER2, still ER+
09.2016 CMF Afinitor/Aromasin/ Xgeva.Met to eye muscle Cyberknife
01.2017 Gemzar/Carboplatin/ Ibrance/Faslodex then Taxotere
02.2017 30 micro mets to brain breathing getting worse and worse
04.2017 Liquid biopsy/CTC indicates HER2 again. Start Herceptin with Halaven
06.2017 all tumors shrunk 60% . more micro mets to brain (1mm mets) no symptoms
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Old 06-23-2008, 11:04 AM   #16
Jean
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Dear Val,
I am glad that you maintain good check ups and caught this early. I am very sorry that you have to have surgery. I wish you a speedy recovery - keep that beautiful smile going....

Prayers and best wishes,
Jean
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Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
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Old 06-23-2008, 03:45 PM   #17
Joan M
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Val,

Sorry to hear that the cancer has returned in your other breast. I would agree with your decision to have another mastectomy. Glad that you don't have any sign of disease anywhere else.

Joan
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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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Old 07-02-2008, 09:22 PM   #18
ElaineM
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New cancer found in remaining breast

Cancer is sneaky. I am glad you caught it early. I don't blame you for wanting to continue some kind of therapy especially after the sneaky cancer snuck up on you. Hopefully the surgery will take care of it. Take care and hang in there.
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ElaineM
12 years and counting
http://her2support.org/vbulletin/showthread.php?t=48247
Lucky 13 !! I hope so !!!!!!
http://her2support.org/vbulletin/showthread.php?t=52807
14 Year Survivor
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Old 07-03-2008, 10:32 AM   #19
Val Pfeiffer
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Lexi, you asked what I have decided about the quarterly Herceptin. I'm pretty sure that I will continue with it quarterly. I called my oncologist yesterday and told him what has been going on (I hadn't talked to him since the new cancer was discvered, so I thought it was time to bring him into the loop). We chatted for awhle; he mentioned that at ASCO this year a study was presented that combined the post-tx Herceptin (triple dose every three weeks) with a lower dose of Tykerb. He knows that I have been following and thinking about Tykerb for long time, but previously I had decided to save Tykerb for a "rainy day."

I have an appointment with him on th 17th. By then I will have the pathology report on my new cancer cells. For some reason they never ran the Her2 or the ER/PR path tests on the biopsy sample, so I have to wait for the path results on the tissue they removed during the mastectomy (that really ticked me off...what a bone-headed thing to do). So when I know for sure that the new cells were also Her2 then I can make a better decision.

If the new cells are Her2+, then I will most certainly stay with at least the quarterly Herceptin. Unless someone tells me differently, I don't believe that mets travel to the other breast, so this is a new primary site. There wasn't evidence of cancer in the nodes, so theoretically my situation hasn't really changed. So I guess I could decide to go back to triple doses every three weeks and add the low dose Tykerb, but since things aren't really that different, I may stick with what I'm doing.

If any of you have any other thoughts, please let me know :-)

Val
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BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 07-03-2008, 11:56 AM   #20
StephN
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Dear Val -
You answered the question I was going to post.
What is the pathology of the new tumor?
Guess you will post that when you know.
In your signature you did not give the GRADE of you first tumor. Mine was high/3 and moved fast.

If it is still HER2, I would tend toward stepping up the frequency of Herceptin. Since you were only getting it quarterly, that leaves you some time between treatments that you are unprotected, giving the cancer time to do its sneaky thing.

And you don't KNOW that there are no micromets in the nodes or remaining tissue. Even though it is considered a new primary, the cancer remained active and did not develop in a vacuum.

Hope you have a great weekend and get in a little fun!
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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