HER2+ Er/Pr negative. Not informed about Herceptin.

adamfong

Adam Fong from Malaysia. How you all doing? I'm writing on behalf of my mom. She is 67, left breast mastectomy. Histology reports shows the below:

SP Addendum Histology

AL The tumour is negative for oestrogen (ER) and progesterone receptors (PR) Her-2 status is equivocal with score of 2+ (weak to moderate complete membrane immunoreactivity in >10% of tumour cells or circumferential intense membrane statining in </=30% of cells)

SP Addendum Diagnosis

A: Left breast: Invasive carcinoma of no special type

- Grade 3 (Bloom and Richardson)

- All resected margins are tumuor free, the nearest is inferior i.e 1mm

- pT2N1a AJCC/UICC pTNM 7th edition

B: Left axillary lymph nodes: 3 out of 16 lymph nodes show tumour metastasis

C: Skin (overlying mass): No malignancy seen.

T: 04 M:85003

Marcoscopic:

2. HER2 DUAL PROBE IN SITU HYBRIDIZATION (ISH)

Probe: Ventana INFORM HER-2/Chr17 DUAL ISH

Platform: Ventana-Roche Benchmark XT.

Results:

Number of Invasive Tumour Cells Counted : 20

Number of Observers: 1

Average number of Her-2 Signals/nucleus : 16.9

Average number of of Chr 17 Signals/nucleus: 1.3

Ratio of HER-2 Signals/Chr17 Signals: 13

(control working on 12/10/2016)

Report is done 09/11/2016, just after her surgery in August of 2016. She wasn't put on any anti-her2 drug (herceptin). After 5 cycles of Epirubicin and Cyclophosphemide, she has developed brains and lung metastasis last month, January 2017. She couldn't move her left hands and feet. We were thinking she had a stroke but turns out to be secondary spread to the brains right side.

I plea to those who know, and do forgive me being a newbee at this, I could really use some help. If someone is able to decipher the histology report and to give their opinion as to her being put on herceptin as she wasn't at all told about herceptin as her treatment option.

Thanks in advance. Appreciate it. Honestly, I'm doing this for my mom.

Moderators

Hi adam,

Thanks for joining and welcome to Breastcancer.org. You're a great son for wanting to help your mom. We're sure you'll get lots of great help here soon; our Community is full of extremely helpful, supportive, and knowledgeable members.

You may also want to join the For Family & Caregivers of Loved Ones With a STAGE IV Diagnosis forum, where you can meet others who are dealing with a loved one's diagnosis.

We hope to hear more from you soon, and we're sending best wishes to your mother!

--The Mods

MinusTwo

Adam - Sorry to hear about your Mother. I don't believe Herceptin is given without chemo to start. It might be worth asking her doc, but at least in the US, Herceptin alone is only given after the prescribed number of doses in combination with chemo infusions.

adamfong

Thanks. That's right. Herceptin is normally administer together with some form of chemo. But the onset of her treatment, she wasn't put on herceptin to start off as adjuvant treatment with chemo. I've met with a private oncologist and showed him my mom's report, the first thing he said was, did they put her on herceptin? My mom had her surgery & first 5 cycle of chemo done at the government hospital. After the 5 cycle, she had brains mets. So not trusting the government hospital anymore, we went to a private oncology centre. There is when this whole issue of Herceptin arised.

In gist her HER2 status is 2+, ER/PR negative and ISH positive. Could the government hospital gave her herceptin to prevent this metstasis in the first place reading her results?

At the same time, Herceptin here is a quota based drug and it's pretty expensive. If she is eligible for herceptin, would it be prudent for the doctors to at least inform us that it's quota based and expensive, perhaps need to find it elsewhere?

A little bit frustrated because we trusted the hospital in their treatment but after understanding bit and pieces, seems like she wasn't given the right chemo treatment.