What should I do

[Daizy68]

I was diagnosed with DCIS 1.2cm with microinvasion of 0.4cm her2neu3+. I had bilateral mastectomy on 5/23/07. My oncologist says I don't need any more treatments and that Herceptin would do me more harm than good. What do you think?

[Mary Jo]

Good Morning Daizy,

I am not a medical expert and certainly don't claim to be. Also, I am not comfortable offering any medical advice to anyone. However, I can speak of what I know about this disease as it pertains to me and you can take it for what it's worth. Most definitely though, I would advise you to get a second or third opinion.

Your main tumor is insitu. Meaning it did not break through. That is a good thing. However, what would concern me is the microinvasion and the her2 status. I do not agree that herceptin would cause you more harm than good unless you have major medical issues I know nothing about. As for me (knowing what I know 2 years later) just hearing the word "invasion" and being her2 positive would make me search out an aggressive treatment.

As I said before, most definitely if I were you, I would seek out a 2nd or 3rd opinion.

I am sorry this has happened to you and know and understand the pain and confusion you are going through. Trust me, things will get better.

May God's Peace surround you today.

Mary Jo

[Mary Anne in TX]

Good Day Daizy!

Get another opinion! When your instincts alert you to a possible problem, get more information and get another opinion. Your doctor may be right on, but until you feel at peace with it, the choice is not ok! Best wishes, ma

[saleboat]

Hi Daizy,

I agree that a second opinion would be a good thing in your case. Did you go to a major cancer center for your pathology report-- that would be the person who evaluated the DCIS for receptors, size, and whether or not it was invasive. It is an art as well as a science and if you have any doubts, you may get some peace of mind by sending it to a major cancer center-- MD Anderson, Sloan-Kettering, etc.

I hope your pathology reports stays very much the same and you can avoid some of the treatments that many of us here on the site have had.

Best of luck,
Jen

[Grace]

Hi Daizy,

My cancer was similar to yours, although it was not considered microinvasion. The DCIS was 6mm and the invasive part was 5mm. According to national cancer guidelines (you can find on internet) chemo would not be recommended for a cancer your size. In general (note the 'general'), oncologists do not give herceptin alone, as the protocol is herceptin with chemo; however, mine had agreed to give herceptin without chemo, but then I decided for chemo because my tumor markers were elevated despite the small size of my tumor, very clean margins, and no node or vascular involvement. I only had two rounds of taxol and carboplatin because of my reaction. Unlike you, I had a lumpectomy and radiation.

I have had some problems with herceptin (and with chemo) so if you can do without, that would be great. I do agree that you should have a good pathology report, however: grade, ki67, and whatever other markers you can have taken before making that decision.

Chemo I should mention is really not for the breast; it's systemic, to insure that if any cells got loose outside the breast that they also have been taken care of.

Very good luck in your decision making. And I should note that herceptin does not work on all women with HER2 positive disease (about 40% I believe are helped), and it can cause problems, including damage to the heart.