her2 resistance Lani's Post two cents worth

[Jean]

Lani,
you posted on 3/15/06 "my two cents worth--give your oncologoist the following abstract"

You mention that at the San Antonio Breast Cancer Conference, the feeling was that all her2 positive invasive breast cancer should be treated with herceptin.
Dr. Slamon suggested that to decrease cardiotoxicity the tumor's level of topo 11 should be tested.

As mentioned size used to be considered one of the most important prognosticators. I have been having an on going battle with this.
My onc. have advised me that the size of my tumor (mine was 6MM prior to biopsy) was 3MM when lumpectomy was performed. Was small and my grade
which was 1 - was favorable and my cancer could almost be considered
a microinvasion. This did not seem to matter much to me. Micro or otherwise. I have fought with this since day one that my her2neu status
was most important. I am also er positive and I am now taking Arimidex.

My oncs advised against having the Oncotype DX test done - their point
being even if it came back high they would not advise chemo/or/herceptin.
I hope I am understanding your post correctly in that Dr. Slamon's suggestion
is not exclusive for women who have developed metastases. For instance
early stage bc patients - stage 1 - node negative - would the feeling
still apply to have treatment with herceptin?

Were there any discussions regarding treatment of Her2 positive women
to be treated with herceptin without chemo?

The statistics you obtained by Dr. Slamon regarding her2 positive tumors
which receive no systemic treatment are more than twice as likely to recur.
When you mention systemic treatment would Arimidex be considered a
systemic treatment? or is that just chemo/with hercpetin? You mention that no one knows the best way to treat hormone receptor positive her2nue + early breast cancer, (that is me) and I have been rather frantic trying to get the best treatment.
I live just outside New York City and have seen four top onc.
All of which say the same thing. No chemo/No herceptin/ Tumor size
was an important factor in their decision even though I kept insisting
that the her2 positive status was the greater concern. They all agreed
that Arimidex should be taken due to the er positive status,
had lumpectomy followed by radiation. Do you think I could contact Dr. Slamon for an opinon regarding my profile? I would be interested in a specialized institution who will review my case. Can you give me any advise?

Many thanks,
Jean