Five percent of breast tumors may double in month

[Hopeful]

http://www.reuters.com/article/healthNews/idUSL0777597420080507

Hopeful

[AlaskaAngel]

As a comparison, the "average" doubling of all types of bc is said to happen roughly every 100 days.

Admittedly the original "surgeon" I saw here delayed my diagnosis, so I do have personal evidence of the relative speed of doubling of my particular type of HER2 bc by imaging. Mine was 0.6 in June, 1.01 in September, and 1.6 on removal in December.

What I find particularly disturbing is that I was told by the same surgeon, (who did NOT do the surgery for removal of the tumor) that "a delay of 3 weeks won't make any difference".

Although size is only one factor to consider, it still does make a difference in terms of what treatments are generally recommended/considered/completed.

The length of delay prior to surgery I think actually may be very important in some cases. And even the posted article doesn't discuss that aspect at all and I think it should. I wonder how many patients are misled into believing that the passage of time isn't important prior to removal.

AlaskaAngel

[Becky]

I feel I was misled. Mine was 1.3 cm on mammo and ultrasound but 1.9cm on removal 4 weeks later.

However, my cousin (who I speak of here who is high ER/PR+ but not her 2+) was shown her mammos for 4 years in a row where her cancer was prominent (but deemed "nothing" by the reading radiologist). Her's was only 2.2cm on removal (with 2+ nodes). Lucky it was one of the slow growers!

[Lani]

Do you know your Ki-67? It reflects the rate of division and hence the rate of growth of the tumor at the time it was removed . I have already mentioned that the Ki-67 value may vary with the stage of the menstrual cycle during which the tumor was removed.

I think the danger here is surgeons, and others, making global statements
about breast cancer when it is several diseases and not one!

[AlaskaAngel]

No, I don't. It is not on the early 2002 path report, and so when I specifically asked my onc about it, his reply was that such things were "not really relevant anymore..." unfortunately. He is also the guy who never told me I was HER2+++ in the first place.

It may not seem like it sometimes, but being diagnosed in today's world of bc is lightyears better than being diagnosed prior to the understanding of the importance of "unimportant" things like HER2 status....

Thanks for suggesting it, though, Lani.

A.A.

P.S. I wonder if the time will ever come when oldtimers will be able to go back and have our tumors reexamined to figure out how much of our treatments were on target and how much just were "collateral damage". It might seem like just a question to satisfy curiousity but in reality it could and should help in deciding if other treatments should be started.

[Mary Anne in TX]

And I think it would help tons of other people.

[Becky]

Hi Angel

Many people have privately asked me if I was going to get my tumor TopIIA tested or PTEN tested. I said no. The rationale is I had AC followed by Taxol and then later, Heceptin. So, now that I've done the gamit, what would it do to see I am TopIIA negative (where Adriamycin was not needed) and PTEN negative (which would greatly reduce the effectiveness of Herceptin). Then I would just think about that and why? I am getting close to 4 yrs out and I have done all that is humanly possible even if (except for the taxane) it did absolutely nothing extra and its just me, my omega 3, vitamin D and aspirin!!! Right now I am cruisin' down the Survivor highway and I have no plans to exit.

Hope you had a great weekend.

[AlaskaAngel]

Hi Becky!

So far I have also chosen not to be tested because as I understand it some tests are not yet reliably standardized, and as such they can lead to false assumptions in making choices of therapies.

The farther out one gets without recurrence, the more newer "protections" there are that others will have that we will not. In my case there was no Herceptin, no standard of dose dense, no use of taxanes, and not even evaluation of Ki-67 in the recommendations for treatment. Having made it past the first 5 years I know that the choice of chemotherapy made makes little difference now -- but having missed being able to combine chemotherapy with Herceptin, I do wonder about the long-term value of that. Given the recent information about the increasing late and damaging effects of 5-FU on the brain, and knowing that the protection from chemotherapy is past, one can certainly regret having had the "cutting edge" treatment of 5-FU.

As time goes by, fewer and fewer of the conclusions reached in more recent adjuvant studies that include newer protections will apply to us because, like Herceptin, those benefits are only given and apply to those who are relatively newly diagnosed.

Very likely I will have a bit better sense of how I feel about some of this if version 9.0 of Adjuvant is released, if it provides those of us farther out from treatment the choices to enter data most specific to our circumstances. I neither believe I am home free nor about to recur, and I too believe making healthy lifestyle choices day by day can only help!

As ever,

AlaskaAngel

[Joan M]

I felt I was also misled about the urgency to remove the tumor. In mid July 2003 my tumor was 1.6 cm on mammogram. A biopsy determined it was grade III, and the breast surgeon informed me of that without blinking, meaning that it didn't seem any different to her than grade I. When the tumor was finally removed -- on Sept. 16 -- after I consulted with a plastic surgeon and everybody went on their respective vacations -- it was 2.54 cm.