HER2 equivical

scaredycatwoman

Can anyone help me out with the HER2 test coming back equivical --what does it mean or predict for cancer staging prognosis etc???Thanks

Outfield

Scaredycat, there are multiple ways of evaluating HER2 status.  These are described pretty well here:

http://www.breastcancer.org/symptoms/diagnosis/her2.jsp

Frequently if the first test is 2+ (borderline), the FISH is done.  Right now, Herceptin is only indicated for 3+ or FISH +, but there are clinical trials enrolling right now looking at its use in women with intermediate results on testing.  Hope this helps.  I personally found this a difficult spot to be in too. 

  

JNS

Scaredycatwoman, my IHC also came back equivocal, so they ran the FISH test afterwards (ask your doc to run it if s/he isn't already).  I was just barely over the threshold to be considered HER-2+ with the FISH test.  So my MO stated up front that he would put me on Herceptin, but that studies show that the stronger you overexpress HER-2, the greater the effect of Herceptin (kind of a similar analogy to women with fast growing cancers getting a more dramatic response from chemo--the drugs target cells with certain characteristics, and the more of that characteristic the cells have, the more the drugs can do their job).

Anyway, in terms of prognosis, I'm not sure being HER-2 positive or negative means as much anymore as it used to.  If you're HER-2 positive, you can get Herceptin, so it's great to have another therapy to fight the cancer (and it can be very effective at preventing recurrence in some women).  If you're HER-2 negative, your cancer may be less aggressive, which is also good.

In terms of staging, what matters is the size of your tumor and the number of nodes involved.  This might help you:  http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

GottaloveNED

Mine was also equivocal and they ran it 2x along with the FISH. My onc is all about patient information and choice, so he explained the med and how it worked, the risks and in my case the possible benefits. I went from a undectectable tumor to 5 cm in a calendar year, so I decided the possible risks were worth it. I didn't suffer any side effects, although I did have MUGA heart scans before during and after treatment. After the first 3 months, I was able to switch to an infusion every 3 weeks instead of weekly, so it wasn't such a stress in terms of time commitment. I agree with JNS, I don't know that it matters so much for staging, but it might come into play as you make treatment decisions.

scaredycatwoman

Thank  you  so much for your reply

--Firstly, I wanted to say I hope you are doing well--

So by treatment I assume you mean Herceptin?  I am assuming you were being given it intravenously how many times a week?   Did they have to put a port in?  and you felt no side effects?  that is amazing. 

What are the risks? you spoke about I guess tot he heart?  What is a MUGA scan?

What are the benefits you spoke of--i am assuming to kill cancer cells

Anyway, any more details you could give me would help--I can read online but hearing from an actual person means more to me...Thanks  Carol

scaredycatwoman

Hi Thanks for your reply

I hope you are well  

My tumor was 1.3 cm PR+ ER+ and then HER was equivicol on both test and FISH.

I had 3 lumpectomys on the right breast of not only the tumor but 2 other suspicious micro-calcifications and a sentinol node biopsy--which I am not sure means they removed nodes or just biopsied the closest nodes to the tumor to see if cancer had spread.

I find out on Thursday from surgeon the pathology reports and I guess what treatment comes next

Before surgery I was listed as stage 1 grade 2 IDC.  It sounded like very early stage but as I am learning that doesn't rule out anything--It has been so very confusing.

I am petrified to hear what the surgeon will say on Thursday--does the surgeon recommend treatment or the medical oncologist.  Does the surgeon give you the staging or the MO.

Thanks Carol

JNS

Carol, I had neo-adjuvant chemo (chemo before surgery) and they don't generally give you your stage for that type of treatment (and I was never given one).  It should be the surgeon who gives you your stage, so try not to stress yourself too much before Thursday.  If you need chemo, the MO will decide what you need.  I'm crossing my fingers for you!