her2 and chemo therapy

[jane thompson]

I was diagnosed with her2 one week ago. The "score" on my path report reads [quote] 3+ over 3+ [end quote]. I have had a lumpectomy; sentinel node biopsy scheduled but not done yet. I have 2 questions:
first: what does 3+ over 3+ mean...not familiar with the "over" part. And 3 out of "how many?"
second: One nurse told me that if I was node negative I would not need chemotherapy. A radiology oncologist said she thinks I should consider chemotherapy. Does anyone have any statistics or concrete evidence one vs another?
Appreciate any info anyone has. Thanks. Jane

[Sheila]

Jane
The Her2 3+ is the highest rating of Her2 overexpression...so yours is very positive. You should request as assay by FISH standards if they didnt already do one...it is more accurate. As far as chemo, it would depend on the tumor size and the nodes. I had a very small tumor...7mm, no positive nodes, but my Her2 was also 3+...I did not have chemo, it was NOT recommended by 3 different oncologists...and now 1 1/2 years later I have mets to my lymph nodes...get more than one opinion would be my advice...chemo may or may not prevent recurrance...they look at the size of the tumor, type, node status, S phase, diploidity of the cells, Her2 status, PR ER status etc to decide.
Good Luck
Hugs
Sheila

[lauren]

I think that conventional wisdom has changed in the past few years, if not the past year, itself. The conventional wisdom used to be that if you were node negative and under a centimeter, then you could get away with mild (CMF) or not chemo. Now, I believe that it is better understood that it is the TYPE of cancer cell that determines the treatment, and if you are her2neu3+, then you SHOULD have chemo...and aggressive chemo at that, one which involves adriamycin or a similar anthracycline PLUS a taxane.

You only want to do this once, right?

[Lolly]

Jane,
Lauren and Sheila have given you some good advice, and in addition I would suggest that you click on the "Return to: Her2 Support Group" link above, then go to the "Index" page, and then the "Her2 News" page, where you'll find links to information about what it means to be Her2 Positive. No doubt this will raise more questions for you, which we can then help answer, but it will hopefully answer some also. This is a great site, with incredible amounts of info available, and lots of support.
Love, Lolly

[Bevie]

Hi Jane, I was diagnosed 3 1/2 yrs ago tumor size 1 1/2 cm HER2 + 2 FISH test, sentinel node neg. and ER+ I had lumpectomy four A/C chemo treatments plus radiation and now on Arimidex my onc. did not give me a choice about the chemo he said it was a must and so far so good no recurrence.

[Merridith from Canada]

Here is a useful tool to assist you with your choices. It also directs you to studies.

https://www.cancerfacts.com

This online resource is for cancer patients, their families, and caregivers is dedicated to delivering accurate and personalized information at a time of need. The NexProfilerâ„¢ Tools for Cancer help people with cancer make informed treatment decisions for an optimal outcome.

[jane]

Thanks for the advice. Boy, do I no longer feel alone in the wilderness...still a bit befuddled but not abandoned. Thanks to you and to all. Jane

[eleanor]

I don't know which breast cancer you have but I have lobular and was her2 3+ positive. I wasn't given any option about chemo. The dr's all said I was dealing with a monster and to start chemo immediately. A/C followed by taxol. Although it did recur 12 mos later, the new chemo combo along with herceptin stopped it from progressing.
el

[jane]

Thanks. Mine is infiltrating intraductal. And, I'm getting a strong message re chemo; as in do it. Thanks.

[Vicki]

Hi Jane,

Your situation sounds very similar to mine as do the responses. As you can see from what I wrote to the board yesterday, I, too, have to decide how to proceed and want to do as much as I can without doing what's harmful. (My FISH was 4.13). You're raising very good questions that help all of us and I wish you the very best.

Copied from posting under "Quick Response needed...":I just received a call from my medical oncologist and your quick response is appreciated. I'm due for my sixth chemo this week (May 27, '04)of FAC (have been going every 3 weeks). I've asked my doctor several times about my node negative T1N0 status and my high 8/9 Bloom-Richardson score and 3+ her2-neu status and the merits of taking Herceptin at this early stage.

She just called today and said that if I would like to switch my sixth chemo to Carbo-taxol (4 cycles) every three weeks and then have Herceptin on the fourth week for 12 weeks, I can do do this.

I am in a quandary, because I have been a "curious cat" about this and now that Herceptin is being offered to me, I'm wondering if I'm doing the right thing or rushing this a bit. I was so ready to start growing my hair back and getting back to work next week. Please let me know your thoughts, especially those of you who may have a similar status (I was diagnosed in Dec., 2003 with Paget's Disease, DCIS and infiltrating ductal carcinoma and three negative nodes from Sentinel node; had surgery Jan. 8, 2004, skin-sparing mastectomy of right breast and immediate reconstruction). Thanks for everything. I appreciate your input in helping me decide before this Thursday.

Vicki in Calif.