[Jean]

Hi Laurie,
Back in 2005 the standard of care for early stage was lumpectomy, radiation and if ER + a hormonal treatment, depending on status, if post menopausal an AI treatment.

It is important to know that size is now not the determination to treatment. Back a few years ago
If a woman had a small tumor often times the standard of care was once again, lumpectomy, radiation etc.
Node negative would also have the same treatment unless the tumor was 2CM in size.
While a larger tumor often had more time and cells to shed it is now understood that size should not be the decision marker for treatment. A very tiny tumor can be very aggressive. Prior to 2006 even if a patient was HER2 and early bc she would have the same treatment as a patient who was HER2 negative.

Then in 2006 the FDA approved herceptin for early stage patients with HER2 node negative. While having negative nodes is a favorable dx. it is not a 100% for certain that a cell did not pass thorugh the node sytsem or enter via the blood system. The grade of the tumor is important also, but again not the determination for treatment.

I had a tiny 6MM tumor node negative but my KI67 level were high and I had my tumor tested and it came back very high for recurrence. I went off label for treatment back in late 05 early 06, prior to FDA approval (it was appoved about 6 months) after I began treatment.
I had TCH and herceptin for one year and I was very glad that I did not accept the first dx and second.
I finally went out to see Dr. Slamon.

Your girlfriend is young and HER2 likes to travel and is a very aggressive form of bc. Today chemo/herceptin is now standard protocol. Her dr. may have decided on A/C due to other medical reasons we do not know, but she could consider the TCH - have her ask her dr. about it and why he prefers the A/C.

I wish your friend all the best.
Kindest Regards,
Jean