Is triple positive bad?

28pregnantandscared

Me again!

Just received final diagnosis. Trying to piece together what it means...

For reference, I am 28 years old, 25 weeks pregnant, and was diagnosed with invasive ductal carcinoma. My tumour also contains dcis. They said it's about 50% of both.

It was removed with clear margins during a lumpectomy last week.

Today, biopsy results came back triple positive (er/per/her2 positive). I only spoke to my surgeon and I don't see my oncologist until next week to go over a plan and what this means. Also, I should mention my lymph nodes have not been tested yet. They couldn't use the dye while pregnant. Ultrasound and physical exam doesn't show any signs, but until we get pathology we won't know for sure.

In the meantime, can anyone help explain? Help me understand? What does this mean? Is triple positive really bad?? Will it be treated really harshly??

I'm scared.

DGHoff

I'm sorry you are having to take this crazy ride, but Triple Positive is neither good nor bad. It just means that your particular cancer is fueled by estrogren and progesterone, and that it overexpresses HER2 receptors. HER2 cancers can grow more rapidly, but there are also great targeted therapies for both HER2 and for hormone positive cancers. If you had clear margins, they may just suggest additional radiation of the affected breast and no further chemo, assuming your lymph nodes show no sign of cancer. Treatment also depends much more on the stage of your cancer vs the receptor status. They may suggest something like Tamoxifen pills for the ER/PR hormone status, but that would have to wait until after your baby is born.

Wishing you all the best as you navigate these waters.

Beesie

I would say that these days, triple positive is good. But it does mean an extensive treatment protocol.

HER2+ cancers are aggressive, and used to have a bad prognosis. But because they were so concerning, they got a lot of attention from the scientific community. As a result, there are now more effective treatments for HER2+ cancers than for any other type - and as a result, today HER2+ cancers have among the best, if not the best, prognosis.

Pretty much every HER2+ invasive cancer that is over 5mm in size (which yours is, I believe) will get chemo and Herceptin. Herceptin is for HER2+ cancers only. There are other HER2+ only treatments that may (or may not) also be thrown into the mix. It's these treatments that result in the positive prognosis for HER2+ cancers.

Additional to that, being ER+/PR+ means that you will benefit from anti-hormone therapy, which provides longer-term protection.

So all in all, with a triple positive cancer, you have an aggressive cancer but you also have more treatment options available than for any other breast cancer, which in most cases provides a very good prognosis.

LivinLife

Hi 28pregnant! I cannot add at all to what DGHoff and Beesie stated - great info and encouragement!!! Wishing you well and the best in your treatment!

ElaineTherese

Treatment for triple positive cancer is a marathon, not a sprint. I began chemo in July 2014 (finished in December 2014), had surgery in January 2015, started Herceptin alone in February 2015, did radiation in March 2015, and finished Herceptin alone in December 2015. That's two years of active treatment, never mind that I've been doing Zoladex + Aromasin (hormonal therapy) since February 2015.

You just have to take it one treatment at a time. Just know that it ends, eventually, and you won't be thinking of cancer every day. ((Hugs))

WC3

28pregnantandscared:

My cancer was triple positive and I had the standard treatment for it, which id chemotherapy, targeted therapy, surgery and then anti hormone therapy. The chemotherapy and targeted therapy is called TCHP, which stands for taxotere (or sometimes taxol instead), carboplatin, herceptin and perjeta. The taxotere/taxol and carboplatin are the chemotherapies and the herceptin and perjeta are the targeted therapies. I had 6 infusions of all of them together and then a few more months of just the herceptin and perjeta.

I had surgery after the chemotherapy. Since my cancer was aggressive and growing quickly, it was very susceptible to the chemotherapy and I had pathologic complete response to it. That means no remaining invasive cancer was found in the tissue removed during surgery.