HER2 Support Group Forums - View Single Post - To treat or not to treat VERY early stage HER2 IDC

Joan M · 02-21-2011, 06:45 PM

Rebecca,

It seems that since the tumor is under 1 cm, Herceptin may not be recommended, according to the National Cancer Comprehensive Network guidelines. Be aware that many oncologists follow the NCCN guidelines for the treatment of breast cancer. Yet, sometimes a stage 0 tumor can result in a stage 4 cancer even if the probability is low.

Here's a link to the NCCN's breast cancer guidelines (see page 16, especially under tumor size):

http://www.nccn.com/patient-guidelines.html#breast

A second or even sometimes a third opinion is necessary in order to make a decision. Also, survivors differ in their level of anxiety. Some worry more and some worry less about a recurrence or they completely trust their doctor's opinion.

I would agree that the surgeon is not an expert in the area of chemotherapy, but since your biopsy showed Grade 3, she probably feels from experience with path reports that an oncotype DX test could have resulted in a high number.

Joan

02-21-2011, 06:45 PM	#20
Joan M Senior Member Join Date: Oct 2007 Posts: 1,851	Re: To treat or not to treat VERY early stage HER2 IDC Rebecca, It seems that since the tumor is under 1 cm, Herceptin may not be recommended, according to the National Cancer Comprehensive Network guidelines. Be aware that many oncologists follow the NCCN guidelines for the treatment of breast cancer. Yet, sometimes a stage 0 tumor can result in a stage 4 cancer even if the probability is low. Here's a link to the NCCN's breast cancer guidelines (see page 16, especially under tumor size): http://www.nccn.com/patient-guidelines.html#breast A second or even sometimes a third opinion is necessary in order to make a decision. Also, survivors differ in their level of anxiety. Some worry more and some worry less about a recurrence or they completely trust their doctor's opinion. I would agree that the surgeon is not an expert in the area of chemotherapy, but since your biopsy showed Grade 3, she probably feels from experience with path reports that an oncotype DX test could have resulted in a high number. Joan __________________ Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2023 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!