Bilateral BC at time of dx, left ER+ right Her2+.. chemo advise

bcann

Both my left and right BC were dx same time, no family history, brca neg. Went in for bmx and standing at the doors of chemo now. I'm not yet 40.

Left breast : 5.6 cm, ER+ 99%, PR-, Her2-, Grade 2, Stage 3A, 1 Lymph micromet, negative margin

Right breast : 2.6 cm, ER-, PR-, Her2 +ve, Grade 3, Stage 2B, 1 Lymph, micromet, negative margin

Onco says, both my tumors are aggressive, left in terms of size, right becos of her2 nature. If left were to be treated alone, then ACT, and right TCH-Hp. So combining , its suggested as AC-TH-Hp, dose dense. AC every 2 weeks, 4 times. TH Taxol+Herceptin every week for 12 times. Later Herception + Perjeta for 1 year and then tamoxifen.... seems they are trying all drugs

Anyone with this kind of cancers and what were your chemo treatments ? Also if you could share good onco referrals near south bay, CA.... thanks for sharing your advise and help.

Grande

hi bcann,

I have bilateral breast ca too. Right: 2.2 cm, grade 1, 1/4 nodes, 40% er +; Left: 2.3 cm, grade 3, 0/1 nodes, 90% er+.

I am presently receiving Dose dense AC (every 2 weeks) x 4. Then dose dense taxol x 4.

I will also have radiation after chemo. It was strongly advised on the right bec of micromets and also thinking of having my left side radiated too because it is grade 3.

Funny how can we have BC with 2 different personalities at the same time. I know MO and RO are all recommending what is best for us. It is just the trusting issue here. It is scary. But I want to pull out the big guns and hope all bc cells will be wiped out.

I live in Toronto, Canada so I can't recommend any md

Hoping you find confidence with your MO

Grande

bevin

Goodness. Sorry you are going through this . Good luck with your . Keep us posted and I just wanted to stop in and lend support.

exercise_guru

you can read my stats they are similar but everything was stage 1. They did TCH but I would have thrown a fit and gotten perjeta if I could but the tumor was under 2cm/ I almost wonder if TCHP plus radiation would be better than AC TC HP. are they taking your case to the tumor board? there was a gal who was triple positive who did TCHP as a start and when it didn't respond did the AC after that . That is a whole lot of chemo I would definitely want a second opinion. Also since you have a high ER I would be talking to someone about the necessity of an oophrectomy or not.

I would also pitch a fit ten ways to Sunday and try to get a PET. These are the things that I didn't find out about until later.

Sorry for the diagnosis it sounds like you are working through to get a good treatment plan. It feels a lot more stable once your plan is in place.

exercise_guru

Also I hope this makes sence but for me because of the her2 ( left) side they did not do an oncotype or mamaprint on the er (right) side. That was the pits. I still am not sure if it would have benefited me to even have chemo if it had been right side only.

I would insist that they do test the Er side. If it comes back low effect from Chemo? then you could just pursue the TCHP with confidence. I would insist on them looking at it front of the tumor board and get a 2nd opinion. Both of those chemos are very hard on your heart. I would want to make sure that it was the best treatment.

April8

I was diagnosed with ER+PR+ left side in September 2014 and HER+ right side (both Stage 1) in September 2014. Had lumpectomies and chemo (Taxol) plus Herceptin plus radiation. Now taking Arimidex. They decided to do Oncotype for ER+PR+ tumor because oncologist wanted to do different chemo and I wanted the single agent chemo. My Oncotype score was low (11) so I won the day on that battle. You should ask for the Oncotype test-they keep the removed tumors in storage and at least you will know what your score is. It doesn't mean you won't have a recurrence at some point. BTW, the oncologist told me that they will run a test on my tumor in two years to see if I will benefit from continuing Arimidex-I hate taking it but if it can help, I will do what I need to do!

exercise_guru

Yes April that is a very good idea because it could help her avoid the AC part of Chemo and just do the TCHP part. Its important because of what that much chemo would do to your heart muscle especially followed by a year of Herceptin which is more important for the HER. Also the ER+ may benefit more from hormone therapy or suppression than the chemo so not worth it to risk both regiments. The oncotype is worth it. They didn't do it for mine but that is because It was small so they chose to put me on TCHP and then hormone therapy.

bcann

Thanks everyone for the advise and for sharing your experience!! I consulted about 5 onco, and only couple of them said the TCHP would be a better idea. Rest favored the AC regimen. The AC is more taxing on the heart and could also cause irreversible damage to the heart in the long run. We felt going the TCHP regimen for the Her+ is better and HP is given over a year and the heart functioning matters a lot to complete this course. I would be starting the hormone therapy along with the HP, right after chemo.

I was not aware of the Oncotype on the tumors, I will bring it up with my onco. I still don't feel very normal on the mastectomy site but I guess that will recover over few months. Just hoping the chemo that I have chosen is effective. Yet to meet my RO to see what they suggest about the radiation.

Thanks everyone, I will keep posting on how things go, atleast hoping that will be helpful for folks facing different BCs at the same time.