Jut Diagnosed

[Guest_pmrobinson_*]

I am trying to ask a question on this web site that I found today. Obviously I am having difficulty finding the correct location to ask a question...please forgive me but I have to start somewhere.......

I am 50 years old, was diagnosed in October with breast cancer. On November 16 I had a mastectomy and the pathology report came back with the following:

the invasive cancer was .7 cc
the nodes were negative
the ER and PR were negative
HER 2 was positive

I have conflicting directions on what to do next. The oncologist wants me to have 4 sessions of chemotherapy and the surgical oncologist says not to have chemotherapy. I am so confused as I do not fully understand what Her 2 postive means and all of the informations seems to be directed towards women who have metastic breast cancer.

My pathology report on the breast cancer itself is very positive but what does a Her 2 positive marker mean if all of the cancer was removed?

Again, thank you for reading this and could you please help me in getting my question to the right place.

Regards

Patti

[Sheila]

Patti
Your diagnosis is identical to mine. I was 50, tumor size 0.7cm invasive ductal, ER PR neg, Her2 3+...I also got conflicting opinions on whether or not to have chemo. 2/3 oncologists said no, not needed...but I felt like I was in a gray area. 1 1/2 years later I had a recurrence to the lymph nodes in my neck. I was placed on Herceptin every 3 weeks, and 6 mos. later there was no evidence of disease. I remain on Herceptin, however now, after 1 year of treatment it is once again back in the lymph nodes in my neck. No one knows the magic answer, you could take the chemo and have a recurrence or have no more problems, or not take it and be fine...or have recurrences. It has been almost 3 years since I had my diagnosis and mastectomy, and I am still fighting/ The important thing to remember is the Her2 factor makes this a more agressive cancer, so you need to always be aware of your body and report any changes to your oncologist.
You have found a wonderful group on this board, and no matter what you are going through, there are several here that have been there already. Weigh all the options and listen to the Dr.s....they should guide you in the direction you need to take.
Hugs
Sheila

[Kim in DC]

If I were you I would have the Chemo. Everything Shelia said is correct. It's a crap shoot. I guess where I have a problem is that your surgeon is putting in his or her 2 cents (even though oncologists only really get paid when you get chemo). I would seek additional opinions from other oncologist. Your surgeon is looking at it from the point of view of how much the cancer physically invaded your body. The oncologist is looking at the biological make up of the tumor. Her2neu makes it more aggressive. You only need 1 microscopic cell floating around in your body to cause a recurrence. Chemo can help kill it before it causes mets. The way it was explained to me is that there is an 80% 5 year survival with node negative bc. Adding chemo would bring it to 90%.

[*_eric_*]

Patti,

I'm sorry that you're faced with this decision. As several have already said I would certainly weigh the advice of the oncologist far heavier than the surgical oncologist since he/she has more experience with treatment.

My only other advice is to get all the information to make sure that you make an informed decision for yourself and then don't look back and 2nd guess yourself. Remember, none of us have a crystal ball.

Best of luck to you with whatever you decide.

Eric

[mamacze]

Oh Patti,
A sad but warm welcome from one of your sisters. I agree, the more
aggressive you can get with treatment on the advise of your oncologist, the better. All it takes is one of these cells floating around to cause a reoccurance; so if you can get it now with treatment, go for it.
Stay with us and keep us posted on how you are doing.
Warm Hugs
Kim (from CT)

[*_AlaskaAngel_*]

You are not the only one who gets confused. The problem is that breast cancer is very complicated, mostly because there are so many variations in everyone's cancer characteristics.

The people who posted to you before me have a experience and offer good advice.

However, I have to differ with the concept that a single cancerous cell floating around could cause recurrence. It is just my opinion, but I think that is generally said as a simple way of explaining things that are complex. The more that concept is expressed, the more people believe it whether it is true or not, and it becomes a fear factor for people who are trying to make an educated decision about therapy.

Current commonly accepted chemical therapies are not relatively harmless remedies like aspirin even at the proper dose. That is why there are differences of opinion among doctors, especially with patients in your situation. There are doctors who are more reluctant to subject patients to the added risks of chemotherapy or radiation, and there are doctors who are on the other side of the fence and will recommend those therapies to you. Both have valid concerns, based on real science.

What it comes down to is that you have to search your own feelings and thoughts about it. Try to get the clearest explanation you can from docs on both sides of the question about why they recommend what they are saying to you, to help you make a decision.

[Lolly]

Patti, just wanted to add that you HAVE come to the right place to post your question, in case you still had any doubts...you've gotten some good advice, but as Alaska points out, you need to get some straight answers from your medical team regarding the basis for their recommendations; then go with what your instinct tells you is the best decision for you.

Keep us posted,
Love, Lolly

[Janet/FL]

Hi Patti
I am in a very similar situation.

I had a lumpectomy on December 7th, invasive ductile, 9mm, node negative grade 2 cancer and I am ER and PR negative and HER2 +3. Age 60.

I just found this board and am happy I did. I am faced with the decision of chemo or not also. They will do radiation.

It is a hard decision and I talk again to the Oncologist next Tuesday. I have had endometrial cancer 2.5 years ago with no follow up other than surgery. I was hoping this cancer would be the same. Apparently with HER2 + it makes a big difference. Other than not being able to be treated with an estrogen blocker, I am unsure of what it means, for further treatment, to be ER/EP negative. Reoccurance rate, etc. Any help on clarifying this?

If any of you reading this could add some thoughts or experiences, I would, and probably Pattie would, appreciate it. Any suggestions for further research?

I am worried about the heart and chronic fatigue that are possible side effects. Any comments or experiences?
Thanks
Janet/FL

[HER2+++]

I have been lurking in regard to your question hoping that someone who actually went to the San Antonio conference could address it first. But you posted on the 17th and it is the 19th now... so I will give it a shot.

1. ER-/PR- are more prone to recurrence than ER+/PR+

2. HER2+++ if it recurs is more aggressive / grows faster

Therefore, your likelihood of having a cancer develop is stronger in the first place and if you do it would be more aggressive so it could grow to a higher stage faster.

3. Being HER2+++ means there are therapies available to you that you would not otherwise benefit from as simply an ER-/PR-.

[*_Janet M_*]

Janet F/L and Patti,
My cancer was 14mm and i had two out of twelve nodes affected so chemo was really highly recommended by my oncologist. It was suggetsed that i have 4 doses of AC and 4 doses of Taxol, one dose every three weeks. Looking back it doesn't seem so bad but going through it was. I lost my beautiful long blonde hair which in the big scheme of things may seem minor but was very important to me. I also felt constantlu nauseous. The fatigue was also horrendous, some days i felt like i was just dragging myself around. However i worked full time throughout my treatment which i now realise was not the most sensible thing to do - i should really have given my body a chance to heal and recover. Some days in the office i don't think i achieved anything i was simply there. By the time i had my sixth dose of chemo 4 doses of AC and 2 of Taxol i realised that i could not do it anymore and i chose not to have the last two doses of taxol. It was at that point that i found out that i was HER2 +++ and my onc said in those circumstances not having the last two taxol doses would not make a significant difference as taxol was not particularly effective with HER2 positive tumours. I have been reading this website ans i see that a lot of woman have had taxol so i don't know if they were given any information different to me. However the bottom line is that at 39 (age of diagnosis) and my children only being 15 and seven i had to do everything i could to ensure that i survived. Two years down the track i am disease free and hoping to remain that way. Janet M

[Janet/FL]

>>Shiela writes: Patti
>>Your diagnosis is identical to mine. I was 50, tumor size 0.7cm invasive ductal, >>ER PR neg, Her2 3+...I also got conflicting opinions on whether or not to have >>chemo. 2/3 oncologists said no, not needed...but I felt like I was in a gray area. >>1 1/2 years later I had a recurrence to the lymph nodes in my neck.

Hi Shiela
I just reread the above. Your tumor was even smaller than mine and yours came back. Sure wish I knew of more who had the same and it DIDN'T come back!
I have some lypmh nodes in my neck that have gone crazy since the surgery. Makes me wonder if they could have cancer or are just upset from the surgery. I have already had to take antibiotics from celuitius in my arm. I wish this would all just go away!
Patti, are you still reading this site? What have you decided? I am hoping for a second opinion by M.D. Anderson, Orlando but I think I know what they will say. I just don't feel my body will bounce back after the onslaught of chemo. Heck, it doesn't have much bounce now!
Janet/FL