Concerned son

Alex82NY

Hello to all.

I just joined the forum in an effort to provide my mom with as much information possible and share other stories of women (and men) who have fought and continue to fight breast cancer.

For starters, let me tell you about my mom. Her name is Silvia and not because she is my mother, but she's the most caring, beautiful, and strongest person I know. Like you (or the women/men in your life fighting breast cancer) she is simply amazing. She is 56 years old and my love for her is so deep that I would do anything and everything for her. Anyway, enough with my sappiness.

My mom was diagnosed in November 2015 with Invasive Ductal Carcinoma, grade 2 tumor, ER-/PR-/HER2+. She opted to have a double mastectomy followed by an immediate reconstruction this past December. The mastectomy determined that she had Paget's Disease of the Nipple, small tumor measuring 0.3 CM, and no lymph node involvement and clean margins. She has been recovering extremely well from the reconstruction with minor side effects/discomfort. Mom is practically cured since no lymph nodes were involved, did the double mastectomy, and left breast was completely healthy (but Mom wanted it removed too for preventive purposes). However, she just had her first appointment with the oncologist and she is recommending that my mom do a treatment of Taxol for 6 sessions once every couple of weeks followed by one year of Herceptin (every three weeks).

Mom is tossed as to whether she should do chemo because tumor is small and she is Stage 1A. A couple of medica professionals we know have said that they don't think she needs chemo while others have suggested she does it to eliminate any possible cancer cells left behind. More than the physical side effects of chemo(ie. Hair loss), my mom is more concerned about how it may affect her heart, stomach, and destroy good cells as chemo usually does. I have also read that it's rare for chemo to be given for a tumor smaller than 0.5 CM. but the question is should she do it? Do they want her to do chemo because she is ER-/PR- and the fact her cancer was an invasive ductal carcinoma? I look forward to your thoughts.

Thanks,

Alex

Obxflygirl1

I don't have the answer for you but I'm sure others with a similar diagnosis will be along. The boards are sometimes quiet on the weekends. You will find lots of support and answers here. Do you know if the doctor sent off tumor for an oncotype test. That is a good indication of the recurrence risk that physicians can rely on to recommend treatment. Good luck and hang in there. You've come to the right place

ElaineTherese

Hi!

Your Mom's doctors want her to do chemo because she is HER2+. Before Herceptin, women with HER2+ cancer had some of the worst outcomes because an overexpression of the HER2+ protein causes cancer cells to divide like crazy. Some women with small HER2+ tumors have gotten Herceptin alone instead of Herceptin + Taxol. Herceptin is not chemo; it is a targeted therapy and has very mild side effects, though it does have some potential to affect the heart. Maybe your Mom can ask about receiving Herceptin alone, if her heart scans are good. By the way, I had Taxol; it's a milder cousin of Taxotere and wasn't too bad.

Best wishes!

ShetlandPony

Hello, Alex. Tumor biology trumps stage. Her2+ tumors tend to be a fast ones, so they want to make sure to get any cells that might have escaped. Ask for explanations until your mom is comfortable with the plan. Also ask if your mom has any other health conditions that must be considered. Personally, I found Taxol very do-able. Herceptin has been a real game changer for Her2+. The doctors and nurses will monitor your mom's condition regularly while she is on treatment, and help with any side effects.(The Oncotype test that Obxflygirl mentions, while helpful for determining the need for chemo in ER+Her2- tumors, is not used for tumors with ER-PR-Her2+ because chemo is typically considered necessary for this type.)

Welcome to BCO and best wishes to both of you.

Moderators

Alex, we just wanted to say WELCOME and what a great son you are to have concerns for your mom and search for answers. Our members here are extremely helpful (as you can already see!) and you'll find great support here.

We are thinking of you and your mom! Please continue to let us know what she decides and how she's doing.

--The Mods

JoniB

Alex,

So sorry to hear of your mother's diagnosis. Your concern brings tears to my eyes as I was recently diagnosed with a recurrence and I am sure my son is feeling the same emotions as you. My original cancer was Her2+ and back in 2007 doctors did not always give Herceptin and chemo to small tumors (mine was 4 mm and was completely removed at biopsy, so by the time I had a lumpectomy it was no longer there). I went before two tumor boards and both said no chemo and no Herceptin. What I really wanted was the Herceptin alone, but they would not do it. Fast forward 8 years and here I am again with a recurrence in the same spot. If I had the chemo and Herceptin, would I be going through this again? My doctor said there is no way to know. I am sure that they will want to give it to me now. I am worried about the damage chemo will do to my body, particularly my heart. i am also concerned about hair loss (already researching cold capping). 6 sessions of Taxol should be manageable - I have heard of patients getting Taxol every week for 12 weeks. Please keep us up to date. I wish all the best for your mom.

Susie123

Hi Alex, There's a lot of information to take in with a cancer diagnosis, especially early on and it can be confusing.

It's important to get your medical information from health professionals that have all the info about your mom's cancer who are looking at her complete pathology report. Stage 1A (small tumor, no node involvement) typically does not require chemo, but when you throw in a Her2+ status, It's a complete game changer as Her2+ tends to be more aggressive. But the good news is, they have meds to treat that. People who are Her2+ normally get Herceptin. Also, stage 1A people who are ER+ & PR+ take a drug like tamoxifen or Arimidex for 5 years. That would not benefit your mother since she is ER- & PR-. In each case it's all about the oncologist determining what will treat each persons individual cancer. There's a lot more to your mom's pathology than just the stage. My suggestion is to share your concerns about chemo with her oncologist. If you and your mom do not feel comfortable with the answer, then make an appointment with another oncologist for a second opinion. A treatment plan must include the entire pathology of your mom's cancer as everyone's cancer is different. As an example, I am stage 1A, like your mom. However, It's very important to understand that even though our stages are the same, and we had the same surgery, Mastectomy on both sides even though I also only had cancer in one breast, so we look the same on the surface to people who only have part of the information, but we're not. Because our pathology (I am ER+, PR+, HER2-) was so different, our treatment plan at the oncologist would also be completely different. 

StayingRetired

Hello Alex.

I understand.

My mother is 72 years old. She was misdiagnosed following years of denial. When we discovered the correct diagnosis, she was Stage 4 (metastatic) with ER+ breast cancer. She was developing 2cm diameter tumors everywhere at an alarming rate. She could have been one of those ugly creatures in a Lord of the Rings film.

My story is the only one I have. My point of view is from a dramatic series of battles for her life, with me on the front lines as her assistant. She got it fairly early. Maybe they got it all; maybe they didn't.

At least she is open to chemo.

In my mother's case, it was not so easy. Following attending to her sister (who lost a truly horrendous bout with radiation and chemo, only for it to return 10 years later and throw her into coma, from which she never recovered), she swore off radiation and chemo. It was too late for surgery, so I was able to talk her into seeing a naturopath where she was living in Ecuador.

He treated her with IV ozone and megadoses of IV Vitamin C. (In Kansas, the Riordan Clinic has published multiple studies suggesting that it becomes cytotoxic if administered following a certain protocol.) It was working.

She became anemic following the loss of 2 pints of blood due to her veins collapsing (twice) during venipuncture after 6 months of therapy. Many of her tumors DID disappear, but the blood loss was too much and she was succumbing to cachexia (appetite loss) and was down to 87 pounds. The tumors invaded her lung space and she started to drown in her lung's lubricating fluid. We got her hospitalized, drained and properly diagnosed and on hormone therapy. (Not being able to walk, she finally quit smoking. Hard to argue health with a woman who hauled a 25lb propane canister 1/4 mile uphill to the store to swap it out for a new one, but when you are too weak to get out of bed, it's not a choice any more.) It isn't perfect, but she is getting better.

The problem is that many physicians look at her age and write her off. "Quality of Life" and "she had a good run" were phrases I heard often. She's a tough lady. She has no problems aside from the cancer and related issues. NO diabetes. NO hypertension. No weight issues. The naturopath gave up. The oncologists at the city hospital were less than encouraging. So long as we were paying (and paying cash) they would keep going through the motions.

I decided not to leave it to the professionals any longer. I have now been caring for her full-time for two years. I research the drugs, ask questions, get second opinions. She's on narcotics for bone pain (yes, it is EVERYWHERE, but not her kidneys, liver or brain!) I understand what young parents go through. I have been vomited upon, urinated upon and... you get the idea.

She's lucky I took early retirement at a steep discount to what I could have gotten had I stuck it out.

What I have learned is that Western medicine does not consider FOOD to be part of the treatment protocol. I have her on dietary supplements for detoxification, immune support and general nutrition. I have read lots of FREE peer-reviewed research at the National Cancer Institute (Cancer.gov), the Life Extension Foundation website (LEF.org), the National Institutes of Health (NIH.gov) and others which I regularly print out and bounce off of the oncologists (which is usually just frustrating for them, but I am quick to remind the lead oncologist that I overheard two of the surgeons making bets on how many HOURS she would last after I got her admitted to the hospital!) Two years later, she is still fighting and I am still doing research.

Whey protein, tumeric and CoQ10 are only some of the tools I have up my sleeve. She was deficient in selenium, iodine and Vitamins D & E, among others. I feed her my pink coffee in the morning. We supplement with baking soda from time to time (Sometimes she is on up to 15 different pills - all of them acids of one sort or another.) There are modified rice bran supplements which have some interesting effects on metastases. There are some amino acids which do amazing things to the immune response in breast cancer victims. We drink lots of purified water. (I installed filtration systems, got one of those alkaline water machines which helped some.) We drink natural juices, not stuff with high fructose corn syrup. I'm big on high-quality vitamin and mineral supplements and she always gets MORE than the Recommended Daily Allowance. We have bread made without bromides. Vitamin C comes in huge containers. I'm probably going to have to write a book before this is all over.

Diet, exercise, sunlight, things to keep her mind active... Attitude is a component to survival in ANY situation.

RESEARCH! Learn so that you don't get steamrolled by a 'team' that answers to an insurance company. (I have heard some truly horrendous stories since this adventure began.) Become her champion.

Face the fact that it is a battle. And sometimes, the Dragon wins. It is up to her to fight. And the time to fight is NOW, while the Dragon is still small, because it ain't going away unless you beat it good and keep it beaten.

Fortunately, in her case, she found it early and there are drugs that often work. They work better when the rest of the body (mind, spirit, too) is in the best shape it can be in (peer-reviewed research backs this up) before she gets blasted with poisons (that's what allopathic medicine is, using a poison to kill the hopefully weaker virus/bacteria/germ/whatever) in the chemo clinic. The doctors are probably not going to make sure that she isn't fighting with a handicap. They like to focus on the easy clinical stuff, like diagnosis and treatment instead of treating the whole patient.

If you have a car, do you choose the worst possible fuel to put in the tank? She has to look at diet. Do you drive like a maniac all the time? She has to look at lifestyle & exercise. She's a complete package, not a mouse in somebody's lab.

That's her job. Not theirs.

Whether your mom gets the chemo or not, is her decision. There are lots of studies available that talk about adjuvant treatments (like IV Vitamin C) during chemotherapy which can improve her tolerance. She also has to look at how the chemo will negatively impact her immune system. She's the one to be suffering through it. Her body, her choice. Your job is to support her.

I got second, third and fourth opinions. She would be smart to do the same. Even if she opts to not get the chemo, she would be wise to join a support group to learn about the disease. Cancer is the end stage of a lifetime of exposure to bad things and if she can minimize her exposure to them (lifestyle, diet), her body has a chance to reverse what caused the cancer to manifest in the first place. She can learn best from people who are have had the diagnosis, because it eventually comes back if you don't change.

It's her fight. If she's not 'in it to win it', the Dragon wins.

Asking about chemotherapy alone is a mistake. There is not ONE THING that cures cancer, just as there is no ONE THING that causes it. Many types, many treatments, many causes. We've been through tamoxifen, anastrozole and now fulvestrant. The side effects truly suck. You need to be asking her about how she intends to change her lifestyle, her eating habits and maybe even her approach to living. Yes, cancer is that serious and the family needs to be supporting her choices 157% as well as helping her struggle through any therapies she decides to undergo.

My mother is now a proponent of Medical Marijuana after Dronabinol didn't do anything for her appetite. (Shock to the rest of her family!) I've even talked to the Cannabis College in Amsterdam, which was a wealth of information. She now weighs 101 pounds. Fifteen pounds to go.

We've done the hair-loss fight (and found a pill that kept it from falling out so bad) and are still dealing with the upset hormones, the unsteady digestive tract and pain. We are walking now and off oxygen. The other oncologist is now relying on tumor markers to determine if the treatments are working. It looks like we might be close to winning this round.

Ask your mom if she wants into this select group of hardcore suffering survivors. I would guess not. It's Decision Time.

Kudos to you for steeping up to the frontlines.

Alex82NY

Good evening
everyone:

Happy
Valentine's Day to all. I feel pleasantly overwhelmed by all your support and
words of wisdom and encouragement for my mom.

Last night, I
stayed up all night reading and re-reading my mom's pathology reports from the
day she was diagnosed -- I included everything from the initial mammograms,
sonograms, biopsies, all the way up to the mastectomy report. I'm trying to be
as pro-active as possible in finding as much information possible, researching
information, hearing other women's experiences, etc. My mom is already going
through a lot with the stress of determining as to whether or not she wants to
do the chemo. My mom lives in Miami and I live in New York. I work at a
hospital that has been wonderful in interpreting my mom's reports for me
including looking at her pathology slides which I had asked to be FedEx'd to my
hospital. We have a great cancer center with great doctors and I'm lucky I'm
able to have that resource. As much as I would have wanted to fly my mom out to
New York to be treated by our doctors, she has a health plan through the
Affordable Care Act which she obtained through the State of Florida so she's
only able to treat herself in Florida. But, I've also researched the hospital
she's being treated at, their cancer center, the doctors, accreditations, and
without naming names, they seem to be a strong and reputable
hospital. It makes me feel good that all of the procedures, pathology, etc all
coincides with what I'm being told here on my end. This oncology stuff however,
just surfaced over the last two days since Mom just saw the oncologist for the
first time since her surgery. When I return to work on Tuesday I will make sure
to speak to one of the oncologists there but of course, the uncertainty keeps
me up.

What has me a
bit unsettled is the following:

Early November,
mom went to her primary care physician because she had been experiencing right
nipple discharge, flaking, and itchiness for weeks. The doctor prescribed her
an ointment which didn't work. However, he told her he would send her
for a quick biopsy to the nipple which mom had done at a private lab (not
the hospital's). They scraped off a small piece and send it to pathology.
Two days after that appointment, mom went to Europe for a few days and when she
came back a week later, she received her results from that biopsy which read
the following:

Diagnosis:

Right breast
nipple:

Invasive Ductal Carcinoma, Moderate Nuclear Grade

Immunostain for Calponin, with Adequate Controls, Supports the Diagnosis.

Tumor measures 0.3 CM in Greatest Dimension (measured on slide).

It also appears to involve lactiferous ducts with ulceration of skin surface.

If results are positive please do ER/PR/HER2 test.

Results:
ER-/PR-/HER2+

Mom immediately
went to the hospital's breast center and she was given another sonogram and a
needle aspiration biopsy to an area near the right nipple where she had been
experiencing the itchiness and the discharge. That was 2 weeks after the first
biopsy which had first determined she had IDC. The results came back as
follows:

Right breast,
11 o'clock mass, 10 mm (size by imaging), gumby clip core biopsy

- DUCTAL CARCIONOMA IN SITU, HIGH NUCLEAR GRADE

ANCILLARY STUDIES: ER-/PR-

The carcinoma
is best demonstrated in sections from block A2 where a microscopic focus of
DCIS is present (1.3 mm in greatest dimension). The pattern is predominantly
solid with papillary pattern or DCIS involving a papilloma.

The history of
invasive ductal carcinoma is noted on report from (name of private lab,
specimen number XXXX). Detached fragments of tumor are also present in sections
from block A1 which could represent fragments of invasive carcinoma or DCIS
inadvertently displaced during sampling or processing.

Stromal
hypercellularity and atypia are noted surrounding a subset of ducts in block
B1. The stromal cells are negative for pancytokeratin. E-cadherin and p120
catenin show no evidence of lobular neoplasia. The findings support the
diagnosis.

A few weeks later, Mom went on to have
a double mastectomy and immediate reconsutruction. She has been recovering
extremely well. However, as I read her mastectomy report, this is what it says

Left Breast,
mastectomy

- Ectatic ducts with usual ductal hyperplasia and apocrine cysts

- Negative for malignancy, three acillary lymph nodes (0/3)

Right breast,
mastectomy

- DUCTAL CARCINOMA IN SITU, SOLID PATTERN, HIGH NUCLEAR GRADE

- Nipple with PAGET'S DISEASE

- Radial sclerosing lesion

- Negative for metastatic malignancy, six lymph nodes, including one sentinel
lymph node as confirmed by additional deeper levels abd pan-keratin
immunohistochemical stains (0/6)

Pan-keratin
highlights the epithelium of the DUCTAL CARCINOMA IN SITU, while p63 and myosin
confirm the presence of a myoepithelial cell layer. THERE IS NO EVIDENCE OF
ADDITIONAL INVASIVE DUCTAL CARCINOMA.

This patient
has an outside lab report from a biopsy of the right nipple from (name of
privae lab). Those slides were not reviewed at this institution. The diagnosis
is of an invasive ductal carcinoma of "moderate" nuclear grade
measuring 0.3 CM in greatest dimension and involving lactiferous ducts with
ulceration of skin surface. The reported immunohistochemical stains from that
biopsy include estrogen receptor negative, progesterone receptor negative, and
HER2/neu 3+ by IHC. Results from this biopsy will be used in the staging
summary that follows. However, it is again noted that those slides were not
reviewed at this institution.

Pathologic
staging: (PTNM)

Primary tumor (pT):

pT1a: Tumor
> 1mm but =5mm in greatest dimension (based on right breast nipple biopsy
done at (name of private lab), again, slides not reviewed at this institution).

Regional lymph nodes: (pN): pN0: No regional node metastasis

Total number of nodes examined: 6 (1 sentinel and 5 nonsentinel)

Tumor focality: Single focus of invasive carcinoma

Tumor site (invasive carcinoma): Nipple

Histologic type: Invasive ductal carcinoma per outside right breast nipple
biopsy done by (name of private lab)

My million
dollar question is: Because my mom first had symptoms involving nipple
discharge, itchiness, flaking – I think that explains why the mastectomy
determined she had Paget’s Disease of the Nipple as those are hallmark
symptoms. However, because Paget’s is so rare (2-3% of all breast cancers), I
wonder if the doctor interpreted that as an IDC? Is Paget’s considered an IDC? Is
that possible? It seems to me that the mastectomy primarily highlights the
DCIS, Paget’s Disease, and the clean nodes. Consistently, the report shows that
the hospital did not review those slides and were done by an outside lab. I’ve
also read that Paget’s Disease and DCIS go hand in hand.

As for the
oncologist, I'm wondering if she's basing her wanting to give my mom Taxol
followed by Herceptin because of this supposed IDC. The oncologist has
requested the slides from the private outside lab to be sent to the hospital
for review. At first she wanted to give my mom a stronger chemo and then called
hours later to tell her that Taxol followed by Herceptin is the best course of
action. Taxol is supposed to be easier on the patient as it's not as strong as
the one she originally wanted my mom to be on. I'm wondering why she changed
her mind? Did she receive the slides and maybe there is a possibility that
what my mom had biopsied that first time wasn't invasive after all? I
don't know. But, it seems from what oncologist is saying and from what I'm
reading here that because she is ER-/PR-/HER2+ she needs to do chemo and
Herceptin (after chemo). Lastly, is it normal to wait for Herceptin following
chemo? I don’t think they’re doing them simultaneously.

I didn't mean
to go on and on, but I thought it was important for me to share as much
clinical information as you all know how to interpret this info more than
myself. Ultimately, the oncologist (and the other medical second opinions) is
who/what is going to determine my mom's treatment, but hearing your perspective
is so helpful because it's another source of information and who knows...
something new can come up for us to consider. Learning from one another's
experiences is so helpful. Oh, and the only reason I didn't name the private
lab is because it wasn't done at the hospital, and I'm not sure if I can
"legally" mention it.

I look forward
to your thoughts. Thanks so much!

Alex

ElaineTherese

Alex,

There is a thread devoted to Paget's in the "Less Common Forms of Breast Cancer" section of this website. Typically, there is underlying cancer that accompanies Paget's. Sometimes, it is IDC; sometimes it is DCIS; and sometimes, it is a mixture of IDC and DCIS. Hope you can figure this out!

Alex82NY

Joni,

Thank you so much for sharing. I'm sorry to hear about your recurrence and it's hard a pill to swallow to think that treatments that are being offered today were not given as recent as 10 years ago. You have been such a trooper all along and you continue fighting please. You have done so great and don't let the "what if's" take over. The good news is that while you're having a recurrence, there are many options out there that will help you now -- new treatments, more advanced meds, etc. I'm very close to my mother and I love her dearly -- which is why I decided to be her advocate and educate myself as much as I can on the disease -- for her, and for other beautiful women like yourself. I, myself, am learning something new every day.

Alex

BarredOwl

Hi Alex82NY:

I also have no medical training.

As part of a second opinion, you could seek a review of the pathology slides and findings to confirm the assessment of 3 mm, ER - PR - HER2+ invasive ductal carcinoma, which is a base finding that taken alone could lead to consideration of chemotherapy plus trastuzumab.

I do not know whether the Paget's should be factored in to the ultimate treatment recommendation or not, which is another area of inquiry.

I can provide the following general information about such small tumors.

One thing I did not understand when I was first diagnosed is that some relatively small tumors may be capable of distant spread via the blood stream or lymph channels. In addition, while negative sentinel nodes are a favorable finding, sentinel node biopsy has limitations, which is why chemotherapy plus HER2-targeted therapy may be considered or may be indicated in HER2-positive patients despite having node-negative (N0) disease.

The considered or recommended treatment(s) under consensus treatment guidelines from the National Comprehensive Cancer Network (NCCN) (Professional version, Version 1.2016) for breast cancer differ depending on a variety of factors, such as histology (e.g., ductal), hormone receptor status, HER2 status, node status, and size of the tumor.

Moreover, the guidelines address the typical case, so in certain cases, it may be appropriate to depart from what they provide.

Very generally, NCCN guidelines provide in the case of invasive ductal carcinoma that is node negative (N0), hormone receptor-negative, HER2-positive, Tumor ≤0.5 cm:

Consider adjuvant chemotherapy with trastuzumab (category 2B)

Use of the word "consider" indicates that the treatment (chemotherapy plus trastuzumab) should be considered. This entails a case-specific, personalized assessment of risk / benefit as part of an individualized decision-making process.

The risk assessment is complicated by the fact that patients with T1a disease (T1a Tumor > 1 mm but ≤ 5 mm in greatest dimension) are a less studied subset of HER2-positive patients, and the available studies are small. As a result, there is quite a bit of variation between studies regarding the magnitude of the risks of recurrence (loco-regional and distant) that they face. In addition, for these smaller tumors, there is not as much clinical evidence available about the results of treatment.

Here is one recent study that influenced treatment guidelines in this area and led to revision of the NCCN guidelines in 2015:

Tolaney et al. (NEJM): http://www.nejm.org/doi/full/10.1056/NEJMoa1406281...

As you may appreciate, the decision regarding chemotherapy plus trastuzumab entails a personalized risk / benefit analysis, which patients must make in consultation with expert medical oncologists, who by the nature and focus of their clinical practice are familiar with the relevant clinical studies in the HER2-positive setting, including those that are specifically applicable to T1a disease:

T1a Tumor > 1 mm but ≤ 5 mm in greatest dimension.

As part of this process, patients should seek expert professional advice from medical oncologists regarding what is known about the risks of local and distant recurrence with or without treatment for patients with their same ER, PR, and HER2 status. They should ask if any clinico-pathologic features of their disease may present added risks.

Patients should not hesitate to investigate the risks of specific treatments, including serious side effects, and their estimated magnitude in light of their overall health, personal medical history and risk factors.

Patients should ask about the results of studies that evaluated any proposed treatment regimen in patients with T1a disease with their same histology (in your mother's case, ER- PR- HER2+ disease) to learn about the "benefit" side.

There is a thread here which may be of interest. Please note that the NCCN guidelines changed some time in 2015, thus treatment recommendations earlier in the thread may not reflect current practice. Please also note that some patients with ER and/or PR-positive, HER2-positive disease have the added option of long-term endocrine therapy, and choose to rely upon this; some patients had co-morbidities concerning for treatment; some patients posting in the thread have tumors larger than 5 mm; and some are younger or older than your mother. In addition, even in cases where risk/benefit profiles are identical in all aspects, people with different personal "risk tolerance" may decide the same question differently. Thus, each person must come to their own personal decision.

https://community.breastcancer.org/forum/80/topics...

Because this is an area where reasonable professional minds could differ, and because she may find further advice, input, explanation, and discussion to be valuable in gaining an understanding of risk / benefit, it would not be unwarranted to seek a second opinion.

BarredOwl

[P.S., I had a small 1.5 mm invasion, with insufficient tissue remaining for testing. Thus, my HER2 status is unknown.]

BarredOwl

FYI, as usual, I've edited my post a few times.

BarredOwl

Karan_bc

Hi

mom diagnosed with stage 2b IDC her2 neu positive, t3n0m0, ER/PR -ve breast cancer, tumor size in left breast 6-7 cm, doctor decided chemo first with herceptin, biopsy report says occassional lymphovascular invasion. concerned, prognosis?

ElaineTherese

Hi!

I had HER2+ cancer, and neoadjuvant chemo (chemo first) worked very well. It wiped away all of my 5+ cm. lump, and I ended up having a very minor lumpectomy (took a golf-ball sized amount of tissue from around my tumor marker). It's great that your Mom is getting Herceptin; Herceptin has really improved the outcomes of women with HER2+ cancer. Some of us also get Perjeta. Perjeta, like Herceptin, targets the HER2 protein, which when overexpressed, causes cancer cells to reproduce like crazy. You might see if she can get Perjeta added to her chemo mix; it has been shown to be very powerful.

Before Herceptin, women with HER2+ cancer often had the worst outcomes. With Herceptin, our prognosis is pretty good. Best wishes to your Mom!