I think the dialogue has been goin on for a while. My concologist put me on Herceptin my first time w/ bc because I was HER-2 positive but stopped it when my insurance company was unwilling to pay for it. (Although he didn't explain to me or I'd have raised bloody hell with them!)
Too often, doctors don't explain things to us that we want explained. I assume this is, at least in part, because many or maybe most patients, aren't really interested in knowing or understanding. But I'm sure there are any number of other reasons, too.
My point is that many doctors have been using Herceptin outside of clinical studies for early stage HER-2 positive patients. Perhaps the fact that up until now, many would not pay for it, explains why they didn't give it more often.
I hope I understood your question properly. If you had breast cancer before and are HER-2 positive but didn't get Herceptin when you got chemo, even though you've not yet had a recurrence (and hopefully, won't), I'd bug the hell out of your oncologist to give it to you now so that, hopefully, you won't get a recurrence.
I think we have to be VERY proactive in our treatment else we can far too easily fall through the cracks. Personally, I think this is why a lot of patients die--they hand over their will to survive to others. I don't think it works that way from what I've been learning (bc research and courses I'm taking). Or that's my theory at present.
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