Chemo for 2 different tumor types

April8

Hi all: I have bilateral BC, 2 unrelated tumors/one is IDC with 5mm HER2+, ER-,PR-and one is 1.8 IDC with ER+, PR+, HER2-, both lymph node negative with Nottingham scores of 7/9 on both, and both Grade 2. Know that have to have chemo with Herceptin but MO sent out for Oncotype score for hormone positive tumor as he is debating Taxol Herceptin versus Taxotere, Carboplatin and Herceptin. I don't see utility for any of these if I have intermediate to high Oncotype score but don't understand the best chemo regime for my mixed bag? Any thoughts or experience would be so appreciated!

ruthbru

I am not a doctor, nor was that my diagnosis; but my thought is that you would go with the standard of care treatment for the tumor with the 'worse case scenario'.....which would be the HER2+, hormone negative tumor. That usually calls for the regimen with more chemo. Then I imagine you would follow up with an anti-hormonal (Tamoxifin, Arimidex etc.) for the hormonal positive tumor. This may be a case where a second opinion would be very valuable.

(The Boards are usually slower on weekends, hopefully someone who has been in your situation will chime in also).

April8

thanks Ruthbro! I thought exactly what you indicated, but the MO said he would have gone with the lesser of Taxol plus Herceptin but that the other tumor was spooking him thus the Oncotype test. I just don't see his reasoning on this - but I'm not a doctor. Really nervous about making a bad decision either way. Thanks again for chiming in!