HER2+ Treatment Timeline...

mtspacekace

I looked through the threads, but couldn’t find my answer. I am wondering if some ladies could chime in.

What was your timeline with HER2+ bc treatment?

I am 38, I was diagnosed in June, started 6 rounds TCHP chemo in July. The plan is dmx, radiation, Herceptin for a year...

If everything goes as planned, when would I be looking at reconstruction?

What have others done????? I know plans are always changing...but I would like to dream of when I can plan my next Belize vacation 😉.

dvhmouse

I had reconstruction immediately at time of surgery after neoadjuvant treatment, but I didn’t need to have radiation because I was determined as PCR during my surgery. I had a single mastectomy with DIEP flap after finishing HP+T. Two months after surgery I started Herceptin again with no Perjeta and just had my last dose yesterday. I had a month after finishing Taxol before my surgery during which I went to Hawaii for a wedding. That was doable. So here’s my timeline... June diagnosis, July started neoadjuvant, finished in October, November went on vacation, had surgery and reconstruction three weeks later, restarted Herceptin in January and finished yesterday. Hope that is of some use to you.

December11

Diagnosed December 11, 2019

Started 6 rounds TCHP January 3, 2020, finished April 17, 2020

Left mastectomy May 19, 2020 - had pathological complete response to chemo

Radiation started July 13, 2020, finished August 24, 2020 (6 weeks & 1 day)

Still getting Herceptin every 3 weeks until December (1 year)

I'm not planning on reconstruction currently

SpecialK

I was treated long enough ago that I did not have neoadjuvent chemo (was not the norm until Perjeta was introduced for early stagers in late 2013) but my timeline was late Sept diagnosis, early Nov skin/nipple sparing BMX, early Dec ALND, three additional skin repair and TE removal surgeries Dec/Jan, started TCH mid Feb, surgery to replace TE July, fills over remainder of Herceptin, finished Herceptin and did exchange following Feb. If I had not had the TE removed prior to the start of chemo my exchange would have happened shortly after chemo was finished. Because I had ALND I did not require rads. Surgery can definitely be done while on Herceptin/Perjeta as long as your blood counts remain in the normal range. I assume your mastectomy plan includes placement of expanders at the time of surgery? Do you have positive nodes or difficult potential margin issues that require rads?

mtspacekace

SpecialK: As of now, I don’t really have a mastectomy plan...I have met with my surgeon, but that was right at diagnosis and did not really have a grasp on the situation. Since meeting with him, and talking with my MO, the double mastectomy was decided to be a good decision because of my age and VUS in a BRCA gene. At this time, there is no sign of nodule involvement, but I have not had surgery so they don’t know for sure. My MO did say there is a chance I will have a compete response to chemo and will not need radiation.

SpecialK

One of the reasons I asked about expander placement was because I have seen some advised to have less surgery (i.e., lumpectomy or mastectomy without expander placement) due to COVID precautions. Placing expanders prior to receiving radiation gives you a better edge at having a successful reconstruction if you are interested in implant recon, as radiated skin does not stretch well. It would be good to chat with your BS/PS team to ask what is currently happening with their surgeries in light of current events. If your nodes were/are negative, was the rads possibility based on having a multifocal diagnosis, or because you are not eligible for anti-hormonals and so wanting to use all available treatment options?

KV99

Hi, here is my timeline-

Diagnosed end of August 2019, HER-2+ and stage IIa

Started neoadjuvant TCHP chemo Sept 2019 thru January 2020 18 weekly sessions

Bilateral mastectomy March 3 (6 weeks after finishing chemo) and luckily right before Covid hit. Tissue expanders placed. No radiation, had pathologic complete response to chemo.

Herceptin and Perjeta continued every three weeks with no breaks from Sept 2019 thru Sept 2020 (last couple sessions coming up)

Reconstruction with silicone implants and fat grafting mid August 2020. This technically could have been done a few months after bmx (June) but with elective surgery shut down for some time in my state my PS had a backlog of reconstructions.

Basically a full year of treatment. Good luck and hope you get to Belize when it’s all done

mtspacekace

I do have multiple tumors, so I would guess that is why the radiation. Although my MO just said at my last appointment that there is a chance I may not need radiation.

WC3

Hi mtspacecase:

I was also diagnosed with HER2 positive breast cancer at 38.

I had 6 infusions of TCHP over the course of 4 months and was on the herceptin and perjeta for a total of a year.

I had surgery a little less than 2 months after my final chemo infusion and started on Tamoxifen about a month after my surgery.

I did not require radiation.

fightingmama

Hi guys. How do you determine if you had pathological complete response to chemo? My mom is about to have her last infusion of TCH next week before undergoing surgery. I just hope she will also have PCR to chemo *fingers crossed*

KV99

She should know a week or so after surgery. The breast tissue taken from surgery will be examined by a pathologist. If they don’t see any cancer cells left then PCR to the chemo was achieved. Best wishes and fingers crossed for your mom!

MinusTwo

My MO ordered an MRI and a PET/ CT after chemo. I think some scanning is in order first. My BS also required the scans before surgery to pin-point the exact area & what might still be there. So I knew going into surgery that I didn't have pCR (complete response).

ilana_lisa

Diagnosed in July, 2020 at age 49. Currently undergoing 6 rounds of chemo / targeted therapy every three weeks, so into November. (Targeted therapy will continue for a total of 1 year.) Sooo, looking at surgery and reconstruction December / January timeframe... and I am already being told told that radiation is for sure. But what if the surgery reveals PCR? Would radiation be imminent because at least one lymph node is affected?

MinusTwo

ilana - you are doing your chemo before surgery because you are HER2+. After you finish chemo you should have lots of scans before surgery. Yes there might be some surprises, but basically you will know before surgery whether or not you had pCR. The surgeon will mop up whatever is left. But it's my guess that yes, you will still have rads.

Jettie

for me ... see timeline for main higlights, waiting on date to start Radiation, had my first kadcyla today.