Conflicting reports-Anyone else?

3girls

Met with MO yesterday to discuss plans for chemo was told I would have ACx4 Tx4 for my er+ PR= her2- stage 2A with LNI IDC.  My MO said that further testing had been done on my lumectomy and there were 2 subsets.  One was my initial dx and the second was ER+ PR- and strongly her2+.  They are going to reanalyze the slides and discuss it with the tumor board next Tuesday.  Has anyone else had this?

reesie

My pathology after recent bmx was Her2 "maybe" and I'm waiting for the FSH results now. The way my BS explained it tumors are heterogenous and can be have different receptors depending on the area biopsied.



Since by bx was a very small section of the tumor it's possible that if another area was bx then the her2 receptor could have been picked up (or in my case the "maybe" receptor).

3girls

So would u be treated with herceptin?

RedSunshineKim

If any component of your breast cancer is HER2 positive you should be treated with Herceptin or other HER2 targeted therapy. I have seen cases like yours with heterogenous HER2 expression (I am a breast cancer pathologist) - basically cancers can evolve and have different populations of cells with different biologies. May be worth a second opinion on your pathology as it will make a big difference in your treatment with potentially different chemotherapy options as well. See what your tumor board says. 

reesie

3girls I'm still waiting the FSH test but if it's positive then yes I will get Herceptin too.

TheLadyGrey

3 girls, I'm right there with you!  

My "pattern" is ER-PR-HER2+ and ER+PR+HER2- against a backdrop of DCIS and other atypia.

The oncologist I consulted on Tuesday said the FSH test is dispositive against any other tests.  Any number greater than 2 is considered HER2+, and there isn't a meaningful top end.  In other words if it is 7 that doesn't call for a different treatment than if it is 4.  

Have a look at my last post on Blair's thread for a summary of my understanding of what the oncologist said about the mixed types and treatment for HER2+ and why Herceptin is given with chemo. 

I would want a REAL good reason for the Adriamycin, particularly in conjunction with Herceptin.  My understanding is that the "red devil" gives a rough ride.  Independent of Herceptin, it can cause heart problems.   

suzieq60

LadyGrey - Andriamycin is usually only given to node positive patients - that was one drug I was NOT going to have.

3girls

LadyGrey-  I did see ur post earlier- it's all so confusing.  I just want a definite diagnosis and plan!  Hopefully will have more of an idea on the 21st.  Good Luck to you!

reesie

Got my full path and the FSH result and I'm still HER2- .



As my BS said it's good and bad - no additional tageted drugs (bad) but not as aggressive as HER2+ (good).

1Badboob

Just wanted to add....A/C is not given to just women that have cancer that has spread to the nodes, a/c is a chemo combo that has been used for a very long time, well over 10 years. Also, I would just getting another opinion but wait and see what the tumor board comes up with. Hang in there, I know this all sucks!

3girls

Yes, I am glad I am getting another opinion and if it truly is HER2+ I am glad they found it so I can get the right treatment!

BlairK

Dear 3girls - My wife had a BMX on 10/14 and has IDC Stage 1a HER2 positive and ER positive - tumor size is 3.5 mm.  We have conflicting oncologist RECOMMENDATIONS - one treat with chemo and herceptin and the other not to treat but just use arimidex.  In all conflicting situations, you may want to consider a third opinion.  My wife (and I) will go to a third oncologist - this time in a major city hospital/breast cancer center with a national reputation and are looking for clarity and the third opinion to be the tie-breaker.