HER2 learning more is it a bad thing?

[chekmark]

I just want to make sure that I understand this correctly. You were diagnosed a year and a half ago and are thinking about doing herceptin now? I also had a 1.5 cm her2+ tumor with neg nodes and was told I needed both chemo and herceptin from the get go and started on femara. (Like tamoxifin but for post menapausal). Can they even do herceptin this late in the game? You got my head spinning. Like the others have said I think you should maybe consider a second opinion or have a heart to heart with your current oncologist. Yes this cancer thing is a very scary thing and unfortunately we have to deal with it forever. l hope that you qet the answers that you are looking for so that you can have some piece of mind. Good luck to you.

[KirisMum]

Chekmark, you've misunderstood. Her tumor was 1.5mm, not 1.5 cm - one-tenth the size of yours. Personally,I think your oncologist is giving you wise advice, sweetsunflwr. Treatment is not without its own side effects, even Herceptin. AND he encouraged a second opinion with Kansas, which I would certainly follow up on, just for my own peace of mind.

[chekmark]

My mistake, so sorry. Well then that changes everything. I was told that if mine was as small as yours that I would not of needed anymore treatment. You are so fortunate to have caught it so early. We all just have to pray and hope that the monster stays away forever but we have no control over it. Kirismum, I have been following your story and so glad that your daughter is doing so well. She has been so strong, god bless you both.

[MJo]

I was T1b -- 55mm or 1/2 centimeter. That was six years ago when Herceptin was just coming out of clinical trials. I had an aggressive oncologist, plus I wanted to hit the cancer hard. Now, six years later, it sounds like the medical community is moderating a bit. I know that adriamycin -- the Red Devil -- isn't routinely used any more. Maybe with your tiny tumor you can avoid chemo, but I agree with the other women here that you need to get a second opinion about Herceptin. I think er I remember a quote from Dr. Slamon, who discovered Herceptin, that every women with Her2 cancer should get Herceptin. One of the members here- Jean - got Herceptin one year after diagnosis, I think.

[AlaskaAngel]

Herceptin works about half the time. But I agree with MJo and StephN, and would give it and/or ovarian ablation strong consideration, especially if you are not yet in menopause -- even if just the briefer course of Herceptin. I don't know how old you are but your photo is beautiful and looks like you are young.

AlaskaAngel

[Hopeful]

Ok, I'll make it even more user-friendly - here are salient quotes from the article I linked above, posted in the Articles of Interest Forum:

With the absolute benefits of treatment yet to be determined, investigators also are looking closely at the risks associated with skipping adjuvant treatment.

The findings of an observational cohort study presented at the annual meeting of the American Society of Clinical Oncology (ASCO) suggest that women with early HER2 positive T1aN0M0 breast cancers can safely do so because of the low distant recurrence rate observed in this patient subgroup. A higher rate was observed in those with T1bN0M0, indicating that adjuvant systemic therapy may be more relevant in this patient population.

The study assessed outcomes among 237 women with HER2-positive T1a (116 patients) or T1b (121 patients) tumors diagnosed between 2000 and 2006, all of whom had negative nodes and no metastases. Most did not receive adjuvant chemotherapy or trastuzumab.

With a median duration of follow-up of 5.8 years, the rate of distant recurrence was 0.9% among patients with T1a tumors versus 5.8% among those with T1b, lead investigator Dr. Louis Fehrenbacher, an oncologist with Kaiser Permanente in Vallejo, Calif., reported in a poster presentation, analyzing data from the tumor registry of the Kaiser Permanente Clinical Care Program of Northern California.

Results for the actuarial distant recurrence-free interval showed a 5-year rate of 96.5% for the patients as a whole, with 99.1% and 94.0% in the T1a and T1b groups, respectively.

"The take-home message is, I think, the T1a's have too low of a risk of distant invasive recurrence to justify chemotherapy or trastuzumab," Dr. Fehrenbacher said in an interview. "We need to specifically individualize the risk of the patient based on the size of their primary [tumor], because the T1a's and T1b's are quite different in our findings."

In a recent review article looking into whether the existing data supports a definitive treatment threshold for patients with T1aN0M0 or T1bN0M0 HER2-positive breast cancer, Dr. Pusztai, along with lead author Dr. Catherine M. Kelly of Waterford Regional Hospital in Waterford, Ireland and colleagues, wrote that "a blanket recommendation to treat all small HER2 positive breast cancer with trastuzumab-based therapy will almost certainly lead to clinically significant cardiotoxicity in some without any benefit in breast cancer recurrence."

Hopeful

[alicem]

Have you considered having an Oncotype DX test?

http://www.breastcancer.org/symptoms...ncotype_dx.jsp

Just one more tool that might help you make a decision.

I agree with Steph, a second opinion would be valuable!