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RobinP · 05-15-2006, 07:22 AM

It would be nice to know your history more completely. What are the following:
1. grade tumor
2.any lymphovascular invasion
3. any positive nodes
4. what was your risk after chemo for relapse on adjuvant online?

You know if your risk of relapse is very low and your odds of cardiac risk(s) with Herceptin are greater than relapse and you feel compelled to do Herceptin, perhaps you could consider the option of abbreviated therapy, such as 9 weeks which had no evidence of cardiac risk with comparable disease survival benefits as longer therapy. Nobody really knows yet if prolonged therapy of a year or more really is beneficial or not over the shorter 9 week therapy. But we do know the 9week FinHer trial, had no cardiac risk in three year follow-up. Beyond 3 years, we do not have data. The only thing we can look to for cardiac long term risk are some of the long term survivors on herceptin...

PS. Hormonal positives relapse for her2+bc is much less than Negative for the first few years. We don't know if that will hold true for longer followup in the Hera trial or if that will just relapse later than her2 hormonal negatives. See my post from Dec 2005 to see the break down of relapse...

Excerpts from my Dec 2005 post:

I found it particularly interesting that in the HERA discussion, node negative her2+ er,pr+ subtypes only had a 9% risk of recurrence of bc in two year follow up. This risk was so low that the investigators will be watching this group in follow-up to determine if Herceptin is indicated in this subtype. On the other hand, node negative er, pr negative, her2+ subtype relapse risk was at an alarming 18%! The break down of risk for relaspe in 2 yr. f/u is as follows:

ER,PR Negative, her2+
Node Negative 18%
1-3 nodes 25%
greater 4 nodes 33%

ER,PR positive, her2+
Node Negative 10%
1-3 Nodes 12%
greater 4 nodes 33%

05-15-2006, 07:22 AM	#10
RobinP Senior Member Join Date: Nov 2005 Posts: 943	It would be nice to know your history more completely. What are the following: 1. grade tumor 2.any lymphovascular invasion 3. any positive nodes 4. what was your risk after chemo for relapse on adjuvant online? You know if your risk of relapse is very low and your odds of cardiac risk(s) with Herceptin are greater than relapse and you feel compelled to do Herceptin, perhaps you could consider the option of abbreviated therapy, such as 9 weeks which had no evidence of cardiac risk with comparable disease survival benefits as longer therapy. Nobody really knows yet if prolonged therapy of a year or more really is beneficial or not over the shorter 9 week therapy. But we do know the 9week FinHer trial, had no cardiac risk in three year follow-up. Beyond 3 years, we do not have data. The only thing we can look to for cardiac long term risk are some of the long term survivors on herceptin... PS. Hormonal positives relapse for her2+bc is much less than Negative for the first few years. We don't know if that will hold true for longer followup in the Hera trial or if that will just relapse later than her2 hormonal negatives. See my post from Dec 2005 to see the break down of relapse... Excerpts from my Dec 2005 post: I found it particularly interesting that in the HERA discussion, node negative her2+ er,pr+ subtypes only had a 9% risk of recurrence of bc in two year follow up. This risk was so low that the investigators will be watching this group in follow-up to determine if Herceptin is indicated in this subtype. On the other hand, node negative er, pr negative, her2+ subtype relapse risk was at an alarming 18%! The break down of risk for relaspe in 2 yr. f/u is as follows: ER,PR Negative, her2+ Node Negative 18% 1-3 nodes 25% greater 4 nodes 33% ER,PR positive, her2+ Node Negative 10% 1-3 Nodes 12% greater 4 nodes 33% __________________ Robin 2002- dx her2 positive DCIS/bc TX Mast, herceptin chemo Last edited by RobinP; 05-15-2006 at 08:02 AM..