Prescribing Herceptin
 

Can anyone tell me what the criteria is for prescribing Herceptin for patients with Her2 positive tumours less than 1 cm with no node involvement?

I don't know what the procedure is...but I just finished a year of herceptin (prescribed "off-label" (it has now been approved by the FDA for use in early stage bc))...see my signature for details of my type of cancer! I had a smaller lump...node neg.

Joan

My signature is my history. My oncolorgist stated form the beginnnig that Herceptin was not "approved" for node neg. patients. I spent many hours researching the pro's and con's and felt that I would benefit from Herceptin. It took a 3rd opinion but I finally got started in Oct., and will be getting every 3 wks. for a year. I might add that I am feeling great, except for a little chemo brain!

Mine was right at 1 cm, grade 3, er/pr-, her2+, no node involvement. My onc automatically started me on herceptin as soon as I finished chemo, which was like a week after they made it available without being in a study.

I don't know if there is a protocol yet as it was approved last month. You have IDC which means some cancer cells could be circulating looking for somewhere else to create havoc. Herceptin has few side effects but only works for about half of HER+. Your grade may tell you if you should persue more treatment. Get more opinions. The downside is they might want to combine it with a chemo agent to make it more effective. Only you can decide. If you can get Herceptin alone, I would do it. I think I would do it also if you had to do it with taxol.

Also if you are ER/PR neg, you have more limited treatment options, which would make Herceptin look like a very good choice. Good luck, BB

get additional opinions,
 

I had a small tumor (one size does not fit all) do not decide based on tumor size alone, rather decide on the character of your tumor, is it high risk, what is the grade and what is the KI67 levels, as I said, I had a small tumor 6mm prior to
biopsey and 3mm when lumpectomy was done, but it was high risk for recurrance and was node neg. It is favorable to have node neg. and small tumor catching the beast early, but Her2 likes to travel, I would consult with additional dr. - treatment has changed much this past year. I did decide to have chemo/herceptin ..

Wishing you the best.

Jean

Me too! I had a 7mm node negative tumor and had chemo and herceptin. I finish in January. Herceptin is easy to take.

I was stage 1 with a .5 CM tumor and node neg. My Oncotype DX score was 32 -- the beginning of high risk. I took Herceptin. My impression is that Her2 cancers, no matter how small, always score "high intermediate" or "high" risk of recurrence in 10 years on the Oncotype DX test. My guess is that in the future the question will not be whether or not to take Herceptin (or Tykerb) if we are Her2, but how long to take Herceptin.