newbie

Martin,

As you can see you have come to the right place for advice. You will get varying opinions which is nice to see all the different points of view - which in the end is what feels right for you. With no node involvement, I can see why your oncologist is hesitant to give Herceptin at this point in treatment - that is an opinion 99.9% of oncologists would share under these circumstances. Although it is true that recurrence generally will occur in the bones or organs and not the breast, by having radiation treatment to kill any remaining cells in the breast she will greatly reduce the odds of a recurrence in that area, and it is important she has this. Generally, the pathway to the cancer cells spreading is through the lymph nodes because it is then circulating throughout your body. This is what chemo is for to help kill off any buggers running around. So again, the oncologist is providing her with another preventative measure by giving her chemo (even though there are no positive lymph nodes). This is a very appropriate plan of treatment that I would venture to say most oncologists would prescribe. It still has not been proven out with the clinical trials that by adding Herceptin early on will prevent or delay recurrence longer than the average time period (when it does happen - there are those out there who haven't had a recurrence and were not treated with Herceptin so go figure). Answers to other unknown factors will be even further out such as how does taking Herceptin early on (in a case like you wife's) affect its use later on in the event of a recurrence. Having said all that, I was diagnosed with stage IIIa cancer, 7 cm of DCIS, 1.2 cm and 1.3 cm invasive ductal carcinoma tumors, and 15 of 19 positive nodes, er/pr- and her2+(3). Had mastectomy, 4 rounds A/C, 4 rounds of Taxol, 28 days of radiation. Recurrence to liver 18 months after diagnosis (fairly average time with lots of positive nodes). Am currently on weekly chemo and herceptin and scan shows liver mets are little lines (and assumed to be gone). Will continue my treatments with chemo until such time we are comfortable with weeky herceptin as maintenance. I am telling you this for two reasons: I entered the clinical trial to add herceptin on original diagnosis and was randomized in the group NOT to receive it (and was very disappointed at the time). Now that it has recurred I am receiving herceptin (with chemo) and doing wonderfully well. The treatments do not make me sick, I work full-time and enjoy a perfectly normal, otherwise healthy life. Herceptin has proven to work best with cases that are Her2+++, and in my case, that is fact. I expect to be living a long and healthy life. After going through all this (and keep in mind my case was much more aggressive than your wife's) I would not be at all apprehensive with undergoing what is suggested and waiting later for the Herceptin. I also want you to know I still would not have gone outside for Herceptin early on. Although I was very disappointed in not getting the Herceptin through the clinical trial, I was secure in knowing it would be here if I needed it. Just, of course, my view. Best of luck to your wife - I am confident she will do just fine.
Kitty