Should I be treated with Herceptin

[Janet]

I had 4mm x 2mm invasive ductal carcinoma grade 2. I had radiation and no chemo. My test results were ER/PR + and HER2 + (ratio 3.5). My oncologist said I didn't need Herceptin unless the cancer had spread. Is this correct.

[Lolly]

Hi Janet,
Herceptin is currently only approved for use by patients with metastatic disease, that is cancer that has spread to sites beyond the breast such as distant lymph nodes, organs, etc. There are trials underway that are recruiting patients with earlier stage disease but who had positive lymph nodes found in the biopsy. You don't say if you had any positive lymph nodes, which would be a factor in considering whether you should push for Herceptin. There are women who post to this site who have convinced their oncologists(or found a doctor who was receptive to their concerns) to give them Herceptin off protocol for non-metastatic disease, as they had positive nodes and consider themselves at high risk for recurrence, but there is no evidence at this point that Herceptin will prevent such a recurrence. Thus, the clinical trials, which you could consider joining.
I posted a link below to the HER2 News page, which will in turn provide links to clinical trial info, a neat site which helps answer questions about your pathology report, and more on what it means to be Her2 positive. Although it's not a club you would choose to join voluntarily, since you're here, Welcome! You've found lots of good company!
Love, Lolly

[Anonymous]

Hi Lolly,

Your response to Janet is a good one and I appreciate the Her2 News link, as well. I just started posting on the message board as I'm Her2-neu positive 3+ and Bloom-Richardson score 3+, 3+, 2+ and, I feel very fortunate that I was node negative (thre negative lymph nodes taken) with a right skin-sparing mastectomy and immediate reconstruction for Paget's disease of the nipple, DCIS and infiltrating ductal carcinoma (1.5 cm.). I'm on my fifth chemo of FAC and was really interested in taking Herceptin as a way to not have a recurrence, but you gave a reasoned and good response as to what is being done with it right now. I hear there are long-term survivors who did not take Herceptin and I also know that Herceptin is relatively new (1998).

Best to you,

Vicki

[Vicki]

Oops -- I forgot to put in my name and e-mail, Lolly on the anonymous entry. My apologies.

Vicki

[Janet]

Hi Lolly,
Thanks for your great reply. I had one sentinel node taken and it was negative. My other scores were rated on the Elston & Ellis Modification of the Scarff-Bloom-Richardson Method. They were Tubule formation 1, Nuclear Pleomorphism 2, Mitotic Count - 1 Total 4/9 Grade 1. I'm not sure how this differs from Vickie's--except I noticed that mine don't have any + signs.
Thanks for the web site--I really want to learn all I can about HER2.
Take care, Janet