Her2+ and No Radiation?

SpecialK

beatmon - pCR = pathological complete response. After neoadjuvent chemo the absence of detectable cancer at the site(s)of the original tumor(s).

Beatmon

oh, I should have recognized that! Thanks, Special K

SugarCakes

pathological complete response; no remaining cancer.

SugarCakes

Mardea15, thank you so much for updating us and please keep us posted. My surgery is scheduled for July 6th. I have yet to meet with a RO but if I end up having a pCr, I will definitely asking the question of Why radiation?

SugarCakes

Mardea, I hope your surgery went well this past Monday. I meant to sign on and wish you luck, but my week has been and will continue to be hectic! Thinking about you though!

Mardea15

SugarCakes, I went home from hospital on Tues with 4 drains. This is only my second day home. Still having quite a bit of of pain if I forget or try to cut back on pain meds. My breast surgeon sent me home with Lovenox injections for 10 days as he considers me at high risk for blood clots. I have a home health RN coming daily to do that, & anything else that needs to be done, like take care of drains, etc. I'm doing as well as can be expected, I think.

I had the nipple sparing surgery which is also skin sparing. I'm hoping to find out the results of the completed path report today yet, since my surgeon is leaving for vacation on 7/3, & he said he'd call me with results as soon as he gets them.

I will be sending good thoughts your way for your surgery on Mon, 7/6. Are you doing the expanders as well? In any case I'll be thinking of you. My anxiety level was much higher before surgery than after it was done. It definitely helps to have complete confidence in your surgeons, which I do.

Update: my surgeon called to tell me I have a pCR. He was very pleased & so am I, as now I will not need radiation!

I wish you all the best for your surgery on Mon. & will keep you in my thoughts all day.

SugarCakes

Congratulations on the pcr, Mardea!!! I'm so excited. I thought it would take a couple weeks to get the results; not a couple of days! That's wonderful.

Sorry you're having to have the lovebox injections, but thinking it must be nice to have a RN visit daily to handle them along with the drains, etc...

Thanks for the update. I will try to take my meds on schedule regardless of how I'm feeling. I have already filled all the prescriptions.

Yes, I will get the tissue expanders. I actually go into the plastic surgeon's office on Sunday to complete some paperwork and get markings.

mye

Hi, I am also interested to find out under what circumstances radiation is recommended (or not) for Her2+. I am still in my 4th TCHP cycle, but am trying to understand my options before surgery in Sept. I came across this website which I thought was helpful. It lists among other things the Ki-67 rate as a reason to recommend radiation if it is high. Here is the link:

http://foodforbreastcancer.com/articles/when-shoul...

mye

Sugarcakes- I feel like I'm following your footsteps. Also 43, also Her2+, Neoadj. TCHP, just 3 months behind :-)

Best of luck to you on your surgery!! Everything will go smoothly :-)

Mardea- congratulations on the pCR!

Sonjat

In looking at your diagnosis, you had a grade 3 tumor, which is what I had. This means it's poorly differentiated, meaning it reproduces willy nilly and doesn't reproduce in an orderly fashion. Much more aggressive this way. You also are Her-2 +, again, makes for a highly aggressive tumor, as it's a protein that causes cells, even cancer cells, to reproduce quickly. One good thing about her-2 positive is that this seems to respond well to the targeted treatments. I'm in a situation very similar to yours. Stage 3, Grade 3 Inflammatory breast cancer to the lymph nodes, left side. I had chemo, herceptin/perjeta, and will continue herceptin soon. Had bilateral mastectomy in January with axillary node resection. I had expanders place during surgery and then filled weekly until they were the "right" size. I had heart failure in February from the treatments and thought that we were going to ditch the radiation due to this. My doctor, who is awesome, said NO WAY! Mine is different in that it affects the chest wall and lymphatic system, however, I was disappointed to have to do radiation. I'll completed 33 daily treatments in two days My PS also would have rather done reconstructive surgery without radiation, but he and my surgeon felt that by placing the expanders and getting them filled prior to radiation they could do a very good reconstruction. This will be 4 to 6 months after radiation. Actually, having the expanders placed during surgery was great for me psychologically, as I still had something under my clothes. My daughter came into my room after surgery and said "Mom! you have boobs!" She was afraid they hadn't done the surgery Obviously I don't have nipples right now but my scars are healing well and they'll give me those at reconstruction. And I don't need to wear a bra if I don't feel like it.The flap option wasn't available to me either for the same reason you weren't a candidate. I can keep you posted after reconstruction, but so far, I'm glad that my doctor insisted that we do the trio,,chemo, surgery, radiation. Brain mets can be a larger concern with inflammatory and if I have a recurrence in the future, I want to know that I did everything that was available to me at the time. After seeing pictures of reconstructions, some done after expanders and radiation like mine, I'm thinking I'll be very happy with them. It's always your decision but, personally, I would recommend biting the bullet and doing the radiation if your doc is leaning that way. I used Calendula lotion on the area (they radiated 7 fields on my left breast, chest, and clavicle), and all I've had is some itching and what feels like small acne on one area of my chest and upper shoulder. By the way, I was, very luckily, PCR as well Radiation is to try to eradicate any little buggers that may have made it into my chest wall or lymph nodes around the collar bone.

Long-winded, sorry! Lots to say. I'd love to know how you're doing.

ElaineTherese

Beatmon -- PCR = pathological complete response, meaning that after neoadjuvant chemo, the post-surgery pathology report states that no cancer remains.

SugarCakes

I will likely have radiation. My expanders will be replaced with implants first, however. Had surgery on Monday. Hope to get the pathology results today or tomorrow. Ended up having ALND because I did not map well for the SND.

Will keep you ladies posted

Mardea15

Update: I'm 13 days out from surgery now. I've had my ups & downs with recovery thus far, but just knowing I have a pCR has definitely made it better & feel worthwhile. On my appt, last Thurs, with PS, he pulled 2 of the drains. The other 2 will be pulled on my next appt, Thurs. He will also do first post op expansion with 75 cc saline at that visit. 300 cc saline were put in each expander during surgery. Depending on how well I tolerate 75 cc will be a deciding factor on how much saline he will use each following week. The P.A. said to take valium about an hour ahead of time & I'm likely going to add pain med to that as well. I want to get the expansion completed as quickly as possible following surgery so I can get back to my home in AZ. My PS also does the final implant prior to radiation if radiation is going to be needed. He has had very good success doing it that way. Fortunately, I'm not going to require Radiation, but it will still be an option, and I will be talking to a RO once again before making my final decision on that.

SugarCakes, I've been thinking about you every day & hope your recovery is going well.

SugarCakes

My pathology results did not come before the weekend. I thought for sure they would. BS told me they would call with the results. She also said she would schedule follow-up visit to coincide with PS follow-up since they are very near each other. PS follow-up will be dictated by drain volume. Well, BS office called Friday morning to schedule a follow-up visit for Tuesday. At the time, I did not think to ask about pathology results. Later in the day, I did think about it and called the office. I was told the pathology results were not in. I hope they would not lie to me. I am wondering what prompted them to schedule the follow-up visit. I know, I know. I am over-thinking and being paranoid. Makes for a long weekend+ though.

Mardea15

SugarCakes, I don't blame you for feeling worried with having to wait over the weekend. Maybe the pathologist was on vacation so took longer. Would be nice if they'd let you know why the wait, though. The waiting is so difficult & I think sometimes the surgeons forget that! Dr Vargas told me he would call on Thurs with the path report & I'm so grateful he did because he was leaving for Peru the next day & wouldn't have been back for more than a week!. I saw his PA the following week & she gave me copies of the op reports & path reports & went over it all again, but I know he wanted to tell me the initial news himself.

When you said they did an ALND, do you know how many lymph nodes were taken? I am so hoping your report will be the best possible so at least that part will be behind you. Hope your recuperation is going well over this weekend & you are taking your pain meds as needed!

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