[Becky]

I will not take sides on the aggressive treatment of Her2+ cancers. The problem on how to treat is touchy because there is still not enough information on individual tumors yet. Because of this, one has to lump themselves in with the possibility that you will be a person who would recur. For example, results on this study are not done yet but again, I emphasize that for distant recurrence free survival (5 yrs) is 85%. So, out of 100 women who have small tumors and are node negative, 85 will be fine with masectomy or lumpectomy with radiation. Of course, 15 will not - we need to find that 15 more consistently and aggressively treat them.

Secondly, the study does not separate the Her2+/hormone positive from the Her2+/hormone negative women. This is significant and may point that Her2+/hormone negative women need to be treated differently. Do more of this subclass recur than hormone positive. Bunches of other studies say so (the metastatic statistics as well as all the earlier Herceptin adjuvant trials). Anyway, I agree with both sides of this question as some Stage 1's need aggressive treatment but who are they? Unnecessary treatment is bad for the immune system and the body as well as costly (I absolutely guarentee this is where oncologists make their money - just remember the thread on the cost of a Herceptin treatment! This difference is due to the way the doctor's practice marks up the drug and is not due to Genentech). Research has to make a breakthrough on who to treat and who not to. Many women (even on this board) are treated when they don't need to be. You will just never know (with today's technology) if you survived because of treatment or you survived because you were in the 85% of women who didn't need treatment besides surgery.