Prognosis

[CoachPlayWin]

<TABLE class=tborder id=post144104 cellSpacing=0 cellPadding=6 width="100%" align=center border=0><TBODY><TR vAlign=top><TD class=alt1 id=td_post_144104 style="BORDER-RIGHT: #cc0033 1px solid">I've been trying to find out the prognosis for someone with my statistics. I had ER/PR-, Her2+++, 2.1 cm IDC with no pos lymph nodes. I have completed 4 rounds of AC, then 12 weekly Taxol/Herceptin with Herceptin for the remainder of the year. I had a MDM with no radiation. What kind of statistics are out there on recurrance, and what should I be looking for? It's so hard to think I am going through all of this, then it will come back because of the HER2. Does it always come back, or how often, in my circumstances?
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[Sheila]

You are asking a question no one can answer with 100% accuracy....as you can see, my original diagnosis was somewhat the same, although my tumor was smaller, and yes I recurred but Herceptin was not available then for newly diagnosed. With the treatment you are getting, you are in the best spot to prevent recurrence....you just need to be aware of any changes, as we all do. If something doesn't seem right, get it checked out. Usually, if one is going to recur, it happens in the first 2 years...but even this is not set in stone....each of us is different, just like some treatments work for some of us and fail others.....do not dwell on the what ifs, live your life.....enjoy yourself....if by chance you do recur, it isn't the end of the world, just another hurdle to climb over. You have done all you can in your treatment to prevent recurrence, don't worry about statistics, they change every day!

[PinkGirl]

Hi Coach
The problem with your question regarding prognosis is that most of the
stats were done before Herceptin came along. Before Herceptin, Her2 positive cancer was considered "poor prognosis", but Herceptin has changed that.

I think we are the ones who will make up the new stats. Herceptin was originally used for only late stage breast cancer, now it is used for early stage as well. I don't think the stats are out there yet. If you do look at prognosis information on the internet, remember that they are not taking into account that you are having a year of Herceptin treatments.

[Becky]

I just want to add a few facts. Prior to Herceptin therapy in early breast cancer, Her2 BC had a worse prognosis BUT what does that really mean. All it means is that it was more likely to recur than BC that was only ER/PR positive. And what does THAT mean. Women who are only highly ER/PR positive can get Tamoxifen therapy (within the last 2 yrs, women who were also postmenopausal might get an aromotase inhibitor instead). Those drugs reduce the chance of recurrence (in the 5 yrs they are taken) by about 42%. Secondly, in most cases, highly ER/PR positive disease tends to be of lower grade and tends to grow more slowly. This is why there is a blimp in recurrence for this kind of cancer further out from diagnosis – around 7 years or so (this kind of cancer’s highest recurrence peak is still within the first 2 years just like Her2+ or triple negative disease (not ER+, not PR+ , not Her2+).
When comparing the hormone positive bc (that is NOT also Her2+ as some Her2+ women are also hormone positive too) to Her2+ disease prognosis statistics (all PRIOR to Herceptin therapy), prognosis was better for hormone positive disease – they had a drug for it and even if they didn’t, it tends to grow slower and not be as aggressive as Her2+ (or triple negative). However, if comparing Stage 1 disease women – a hormone positive woman has about a 95% chance of disease free survival at 10 yrs whereas a Her2+ woman (who is ER/PR negative) is at about 88%. So you see, even without Herceptin, not everyone recurs. Far from it. Now add Herceptin which gives a 52% improvement on recurrence rate and now that Her2+ woman is at 94%. Now add other lifestyle modification study data. Exercising (walking one hour per day 5 days per week) can reduce the recurrence rate for hormone negative women by 44% so now that number becomes 97.36%! They also say that a low fat diet (20grams of fat per day) reduces recurrence rate by 21% (for hormone negative) so you are now near 98%. These stats make the assumption that the woman has taken chemo and had radiation if she had a lumpectomy. Also, even though there have been no definitive studies, the kinds of fats you eat make a bigger difference than if you can really adhere to such a low fat diet (you really have to be a vegan to do the 20 grams of fat – not even vegetarian will do it and the benefit is kind of small) so read the thread on the Mediterranean diet and RhondaH’s breast cancer diet and all of R.B’s posts on balancing the omega 6 to omega 3 (aka fish oil). As you can see, even without Herceptin, survival is really real for most women.
Have faith – in yourself, your treatment, and your caregivers. This is doable and survivable. So far so good for many of us. Also, this board is very valuable for cutting edge info on prevention, treatments, side effects, nutrition. Also, many who are members do not visit because they do not need to because they are survivors. Many like Juanita, Marejo, others and me still come to show our support, continue to remain informed and cheer on our new and old friends. We are here for you and I know you can do it!

[mimiflower07]

becky thank you for your explaination...i really needed perspective.
suzanne

[Grace]

Becky,

Thanks. That was excellent. I was thinking how nice it would be if every woman diagnosed with HER2+ were given a copy of your post.

[nitewind]

Once again, the voice of reason! Thanks Becky, I copied and saved your great post, so that I can read it often. So much good information and an easy read.
Hugs to you

[mts]

Becky,

Only YOU explain it better than anyone !!!

This should be posted all by itself under its own "defying statistics" heading

Maria

[Mary Anne in TX]

could we put Becky's message somewhere people could read over and over very easily? Thank you, ma

[caya]

Add my kudos here to Becky - thank you for such an informed and uplifting explanation. I will definitely print out your post and put it in my Her2neu+ file.

all the best
caya

[Susan66]

Awsome Becky...I always look for and read your posts.
Thanks!
Suysan

[Mary Jo]

Thank you Becky. I, like the others, appreciated that little synopsis of her2 disease and recurrence. http://www.her2support.org/vbulletin/images/icons/icon7.gif Also, as the others have said, your explanations, your encouragement and just your overall positive attitude to this board is so much appreciated.

You know..........God has blessed each of us with special gifts and talents. Gifts and talents that I believe were meant to be shared with others to make this "journey" a better one. You, dear Becky, use your gift of knowledge so wonderfully as you share what you know in a way that makes it easy to understand for the rest of us. Thank you for taking the time to use your "gift" with each of us.

I, for one, thank God for you.

Hugs dear "sister!"

Mary Jo

[Jade]

Thank you!
Jade

[MJo]

Also want to add my thanks. Facts help combat fear. Happy Holidays and God bless us every one.

[Faith in Him]

Becky,

Wow, thank you for that. I feel so hopeful after reading your post. I am always concerned since I am a stage 3er but I just got a huge boost from you.

I agree with you Ma, everyone who comes to this board should read Becky's post.

[murph]

Becky,

Without sounding totally repetitive !!!! Very nicely put. (I understood it all..lol) Thank you for sticking around to help us newbies out. Take care...
Pam

[Leslie's sister]

Thank you Becky. I cannot say it anymore eloquently then the other ladies. You, Lani, Marejo, and many new and old timers are the reasons that I continue to seek out this board. Your willingness to continue to educate, share, encourage and just "be there" for everyone is a wonderful gift.