Hey Doug,
Ok. um... please, don't skip the brain MRi. Am glad they have taken MS off the table! But, another scan to brain is more baseline good info for your 'history'. And since you've already proven to be so sweetly 'UNIQUE'! I think it's a good idea to keep an eye on it, just as with your lung spot. OK?
Well...... you and Lyle would be a pair at the chemo center

The nurses were pretty good to him, too! His humor and high flirting ways were winners for them. Plus, being a guy with bc... well you are, as Lyle sez: "minorities".
His hardest parts were his feeling so sick, low grade fever, no appetite, weight loss, loss of energy and stamina. He was in four times for IV's to replace fluids and electrolites.
After the first four rounds of the triple chemo, we dropped the A/C. And, reduced the dosage of the Taxotere, going then to one week on, one week off til he'd finished another four rounds.
(losing all his hair... well if you could hear him talk about the smooth hairless butt, oh my!)
I share this chemo info because there are ways to tweek your chemo protocol. Sometimes, even a slower infusion rate.
Oh, speaking of that: After an hour trying to find a vein to use the first time, he went in for a port.
He is now feeling quite well. This from Lyle to you: "
It took three months to loose the 'chemo taste' in my mouth and that long before I felt like I'd regained a good amount of my strength." That was mostly accomplished by walking/hiking with our two 'fur-kids'.
He's had no obvious side effects of the Tamoxifen, thankfully.
He insisted on a sentinal node biopsy at surgery if all else seemed good to go. And it was. He's had no probs from that surgery. He did retain lots of fluid at mastectomy site for two months. Had that drained four times. Then the rest of the accumulation finally was reabsorbed.
Hope that was not overdose of information......
Honestly, I can't see why the addition of Herceptin wouldn't be indicated for you at some point. It is, afterall a
targeted therapy. And you have the right gene bullseye for it to work. I had great success with Navelbine/Herceptin for my systemic mets back in 2002. The stuff works so much better in combination with a few chemo agents, rather than just by itself.
Keeping good thoughts and best wishes,
patty & Lyle