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The grey zones
I don't think this discussion has to be one that separates people into just 2 sides of a sensitive issue, black and white, and I hope that it isn't offensive to raise very real questions about who benefits and who doesn't from adding chemo.
I wish that none of us had to make these awful choices.
I don't want to lose sight of the information that tells us that trastuzumab is more effective when chemotherapy is added to it. That is a weapon we didn't have before, and should be used for those who are most likely to benefit from it.
But because both the AI's and Herceptin were not commonly available even just 5 years ago I have to ask whether statistics about 5 years ago or 15 years ago showing a success rate for DFS are meaningful for women with HER2 positive HR positive bc, particularly those who are 50 or over.
In addition, as I see it there is one other huge difference for those in this group who are currently diagnosed. They stand to have the choice of using even newer drugs, newer methods of individualized analysis of their particular disease characteristics, and newer and better ways of analyzing whether they remain NED.
To me those things are a really, really big deal.
AlaskaAngel
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