Please help - Kadcyla vs Herceptin for residual disease

SJH15

Hello breast cancer community

I recently had surgery after receiving neoadjuvant treatment (chemo/Herceptin/Perjeta) for my T3N1 diagnosis of estrogen and HER2 positive ductal carcinoma. My path report came in showing less than 1mm of residual disease in the breast, with lymph nodes coming in clear.

After discussing with my oncologist, he is recommending I stick with Herceptin and not go on Kadcyla. His rationale is that <1mm of residual is very close to a PCR, so they will treat it as such. He mentioned there is no research that shows Kadcyla is effective on less than 1mm of residual plus the risks of the drug outweigh the potential benefits for my specific case.

My oncologist is very good, definitely a leader in the breast cancerspace in Canada. However, to me residual disease means there was still active cancer after treatment and I am questioning if I should push him on this. Curious to know if anyone in this group had a similar amount of residual disease and was put on kadcyla.

many thanks 🙏

Docy

Hi SJH

I hade complete resolution of breast tumor, however had 0.3 mm micrometastasis in one lymph node.

My case some what complicated because I had positive lymph node on PET scan that was never biopsied and tagged and had lumpectomy and sentinel node removal.

Sine I decided not go for Axillary node dissection and not knowing if I have any other lymph nodes positive, I got a second opinion.

Both MOs recommenced Kadcyla and Iwill be also getting radiation to whole breast and axilla.

SJH15

Thank you Warrior73. Reading your story makes me want a second opinion. All the best to you on your journey

Imani

0.4mm residual in one node and I am doing kadcyla