HER2 Stage 1 IDC Help!

[CLTann]

Comparing to most of you, I am probably a lucky one. Early discovery of about 1.0 cm IDC near nipple, I opted for mastec. Path report: ER/PR +, no node problem. Then I opted for no radiation and no chemo. I started Tamox three weeks ago, right after surgery. Since I am HER2 +++, should I stop Tamox and go for Herpectin/Arimidex instead? All papers on Herpectin are on patients with worse stages; in fact, I would not be qualified for the study. My question is whether I made a mistake and should now stop Tamox and go for Herptin/arimidex regimen? I could not find any paper reporting results on non-metastatic BC with Herpectin as the monomedical adjuvant for cases like mine. Please help me to make the decision. My onc says its up to me.

[saleboat]

It really isn't an easy decision to make, is it? Has your Onc told you what s/he believes your risk of recurance to be? It is reasonable to think that Herceptin could halve that risk? No one can make the decision for you, but unless someone can tell you you're cured given the treatment you've had so far, it seems reasonable to consider Herceptin. But since you've already opted out of chemo, then perhaps your risk of recurrance is minimal to start?

Good luck with your decision.

[Sheila]

CL
You are on the Tamoxifen because you are ER+...& premenopausal I would guess....I would opt for the Herceptin also, my tumor was half your size with no nodes involved & I had a recurrence! It is just added insurance to prevent it, & easy to take.
Hugs
Sheila

[BonnieT]

Hi
I agree with Sheila, my first tumor was very small, I opted for bilateral mastectomy since my mom died from BC. they felt I didn't need anything else, I thought great, but 2 years later chest wall recurrance- surgery-chemo-radiation. Now I am on tomaxifen and taking herceptin. I would definitely consider herceptin , the studies are amazing.
God Bless
BonnieT

[CLTann]

Dear Sheila and Bonnie,

Thanks for your help, re my regimen of Tamoxifen after mastec. I am postmenopause, with bad Her2 +++. You suggested to add Herceptin to my Tamox. Are these two treatments mutually exlusive? I read somewhere that one would reduce the effectiveness of the other. If I can add Herceptin, I would jump on it.

How did you discover recurrence on the chest wall? there is no mammo you can do now. What would be the symptom?

Did you have any other metastatic problem? I assume both of you have been on Tamoxifen too.

Thanks for answering my questions.

Ann

[Merridith]

Hi Sheila:

IDC means that "Guest" had NO tumour at all. She is in an earlier stage than you.
I just point this out so that Guest isn't confused when she reads your response.

[Merridith]

Hi Ann:

I have been reading your conversation string.

Are you ER positive? The purpose of Tamoxifen is to mop up the naturally produced ER in your body. Many (majority) of HER2+++ people are ER negative. Tamoxifen has a limited statistical benefit for people who are ER-. But the standard treatment protocall is to recommend it. After reading the literature and statistical benefits of Tamoxifen, I declined to use it because the life-extending benefits were so minimal compared to the side effects.

I would however in your case consider using Herceptin. The drug is so new that there is no statistical evidence available to consider for your very early stage of cancer. However, based what I've read, I have made some extrapolations. The main extrapolation that I've made is that the earlier you take Herceptin, the more effective it is at preventing and/or prolonging the appearance of a reccurance. Herceptin is also most effective when taken with a taxane (which is a type of chemo). The Herceptin/Taxane combo is where you get your highest statistical bang of 52% increase in probable life expectancy. Herceptin alone, which is very easy to take in terms of side effects has a lower benefit in terms of life expectancy incease, but is still the most effective drug available for HER2. Far more effective than Tamoxifen.

You should do a bit of statistical research based on your very early (lucky you!) stage. You can do this research right on this site. Check out the "Submitted Articles" Forum. It's like a personal library for HER2. Some of the articles have links that will take you to sites that allow you to plug in your personal data and come up with survival data as well as potential treatment plans to compare to what you are actually doing. (You can check under my name as I have actually posted one of them)

You have already made your biggest decision which was to have a mastecomy. Doing that alone gave you your biggest survival bang - even if you should choose to do absolutely nothing else. You have to consider that you are more likely NOT to have a reccurance than to have a recurrance. So that if you choose to medicate yourself further whether with Tamoxifen or Herceptin or anything else, chances are that you didn't need the medication anyhow. Extra medication only helps if you are one of the unlucky ones. But you can never tell if you are the one who will get hit or not. You can also look at it as extra "insurance" to boost your personal probable survival stats.

Bottom line, I would suggest that you go for Herceptin, and keep your eye open for any advanced stage vaccine trials that come available. And if you are ER- (and you are experiencing high levels of discomfort such as vaginal dryness and/or hot flashes) I would consider dropping the Tamoxifen.

Regards,
Merridith

[Sheila]

Merridith

On my path report IDC was Invasive Ductal Carcinoma,,,& I did have a small tumor, not to be confused with DCIS which they consider pre cancerous changes that will turn cancerous.
My mets were to the supraclavicular area, not to the chest wall. Tumor or no tumor, I believe herceptin would be beneficial.
Hugs
Sheila