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In the UK they are giving it to node negative patients on the basis that HER2+++ N0 still have a meaningful level of recurrence. Node Negs were part of the HERA adjuvant trial. My wife was N0 and had FEC then T + Herceptin.
You are younger and therefore incur a somewhat higher risk of recurrence, so I would have though you had good grounds to push for Herceptin - particularly considering it is your second time around. Also, being younger the cardiac risks may be lower.
Patients on Herceptin are monitored closely for any cardiac effects and as far as I understand it, these effect only a minority - and that proportion is smaller than in the early trials where screening for cardiac efficiency was not done before treatment.
First sign of a problem, they stop the Herceptin. Though having said that I have heard it said that a lot of Herceptin's efficacy occurs early in the treatment regime. So even if you only got Herceptin for 3 or 6 months of a 12 month course, that might confer most of the benefit considering you are N0.
If you are reasonably healthy otherwise, Herceptin is a lot more benign than most conventional chemo cocktails.
There is a good Herceptin presentation for clinicians on adjuvantonline.com. I would expect your Onc knows about this site.
Good luck.
John L
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