Taxol + Herceptin always

Confused-Bunny

Been a month since my Mom got diagnosed with breast cancer. Stage III, ER+/PR+/HER2+ (IHC). Since the HER2+ via IHC was a post-MX (mastectomy) result, the Onco now wants to wait till the HER2/FISH confirms the +ve.

In the meantime, we discover that the surgeon who did MX screwed up, and caused a heart clot to form (not as a result of the cancer, but surgery error). Not an unsolvable problem, but this is complicating things in the following way:

1. Original plan (pre-clot diagnosis) was to begin Adriamycin/Cytotoxin, followed by Taxol or Taxol/Herceptin, IF HER2/FISH were +ve. This would've given us enough time for HER2/FISH results (which apparently take 4-5 weeks?).
2. Now that the clot has been discovered, the Onco wants to start with Taxol/Herceptin, only she doesn't trust the IHC and wanted to wait till FISH came out.
3. Today, she changed her mind and said that we would not wait for HER2/FISH, since that's still 10 days away, but would start with Taxol ONLY. What she plans to do afterward I don't know - I am sitting here in the US, my Mom is abroad - so all of this information is indirect.

The Onco is, no doubt, a good one. She's trying to be very cautious given the heart clot. My question is:

Is it OK to give only Taxol if patient is HER2+ (presumably follow up with Herceptin once FISH confirms), since its known that Taxol/Herceptin together are more effective? In other words, isn't it advisable to wait the 10 days for FISH, then start Taxol/Herceptin rather than start only Taxol, add Herceptin later? The Onco's reason for not waiting - cancer in lymph nodes, so no time to waste. We were told that the surgery removed all the cancer, which is why I'm confused what she's worried about.

Sigh, thank you for reading all this. Sitting so far away, nothing I can do but ask questions.

Moderators

Taxol/Herceptin together have been shown to be more effective for certain types of cancer (see here: http://www.breastcancer.org/research-news/hercepti...). We are not medical professionals here, but are wondering if perhaps her medical team is concerned about the known side-effect of Herception on the heart muscle, and feel it best to start therefore with Taxol alone, until more is known (e.g. her Her2 status, and the condition of her heart). All worth a conversation with her doctor. Perhaps, given the technology, it would be possible to Skype in with her doctor? We understand how stressful it must be not to be there near her, and hearing all this second-hand.

We're all here for you!

Warmly, The Mods

Moderators

Thinking of you, Confused-Bunny. Have you gotten any answers from your mom's doctors yet?