CHEMO FOR HER2

amybirnbaum1

I posted this on chemo site but then was suggested i move here so hope im not duplicating too much. Some women have said they were just a little HER2 positive . I thought it was like pregnancy you are or youre not. My ratio was 2.2 does that mean anything? Thanks, glad I found you all. Starting neoadjuvant this week.

Anonymous

With a 2.2 or a 2+ on the IHC test (often done first when your biopsy goes to the lab), they would go ahead and do another test called FISH to confirm whether or not you're HER2 positive.

Do you know if that was done?

3 or more on IHC is a definite positive, 2+ should get a FISH as far as I know.

I am HER2+ and my cancer did respond to the anti HER2 drugs - here's how it went with my biopsy results:

My needle biopsy was done at a free standing imaging center. My initial IHC test was 2.4 HER2 and the report said borderline. No FISH test was done. When I got to see the medical oncologist, she requested further testing from the hospital lab...they looked at my sample and said it was close enough to a 3 to be HER2+ and they turned out to be correct.

So - if they still aren't sure OR if they're saying you are negative, you need to ask for either a FISH test or a retesting of your sample to be sure.

edit - I think I see in your other post they are treating you as positive? So, that’s usually a good thing! Good luck with your treatment.

amybirnbaum1

Hi ! THank you for this response. I really appreciate it.

The IHC just said score 2+ sent for FISH

FISH came back 2.2.

Glad you cancer responded, hoping same for mine. Again, thank you so much!

DogMomRunner

I also had to have the FISH done which came back as HER2+ amplified. I'm glad that I ended up HER2+ otherwise I would have been triple negative which would have meant a much harsher chemo treatment.

I don't know what stage you are but my cancer also responded well to treatment and one year out from the end of Herceptin, I'm NED. I hope the same for you

SpecialK

Her2 is a naturally occurring protein in the body that assists in cell growth, it only becomes a problem when it is over expressed in breast and some gastric cancers. Too much Her2 causes cells to grow aggressively and uncontrollably, but it can exist at varying levels.

There are several testing platforms available but most labs use IHC testing, at least initially, because of cost. Here is a summary of IHC test results:

IHC test (ImmunoHistoChemistry): The IHC test uses a chemical dye to stain the HER2 proteins. The IHC gives a score of 0 to 3+ that measures the amount of HER2 proteins on the surface of cells in a breast cancer tissue sample. If the score is 0 to 1+, it’s considered HER2-negative. If the score is 2+, it's considered borderline. A score of 3+ is considered HER2-positive. If the IHC test results are borderline, it’s likely that a FISH test will be done on a sample of the cancer tissue to determine if the cancer is HER2-positive.

If you receive an equivocal borderline result on IHC testing your sample would be retested using a different platform, usually FISH. Here is what that testing result looks like:

Positive HER2 amplification: FISH ratio is greater than 2.2 or HER2 gene copy is greater than 6.0. Equivocal HER2 amplification: FISH ratio of 1.8-2.2 or HER2 gene copy of 4.0-6.0. Negative HER2 amplification: FISH ratio is less than 1.8 or HER2 gene copy of less than 4.0.

amy - since your IHC result was 2+ It looks like you had reflex testing with FISH with a score of 2.2, which is right at the cutoff between equivocal and positive.Do you know what your gene copy number was?

amybirnbaum1

Hi Special K,

Thank you for your very informative answer! I do not know the gene number but I start my chemo Thursday for positive HER2 so, even if borderline, I know it is being attacked. I am in St. Pete! Found great docs.

SpecialK

amy - I did the above post on my phone and for some reason the linked info didn't carry, so I just edited my post to show it. I am glad you have found docs you are happy with - that is very important! I am just across the bridge from you so if I can help you with anything local don't hesitate to ask! Come over to the triple positive thread - lots of good folks and good info there. Many of us have had the same regimen you will receive and can help with info and suggestions.

https://community.breastcancer.org/forum/80/topics/764183?page=1316#idx_39464

exbrnxgrl

You’ve been given great explanations by everyone. For all the hormone, HER2, ER, and PR, it is not at all like being pregnant (you either are or you’re not). Your status can be expressed as a percentage. For instance, I am 95% ER +. I have forgotten my percentage of HER2 expression, but I am considered HER2 low. It is definitely not all or nothing. Take care.

amybirnbaum1

I am 2 weeks past my last TCHP and am still having weakness and trouble walking from room to room. Appetite is non-existent still. Nothing tastes good. This one really did me in. Any one out still feeling the effects?

AlwaysMeC

Amy, I started getting heavy legs at 5 of 6 TCHP. After the sixth one, it was like my legs were made with lead. I was also very pale and fatigued. My platelets were at 102 before the sixth session, so they probably dropped quite a bit after, and RBC was a point and a half below the lowest threshold. I could barely lift my lower legs to walk upstairs, and the smallest inclines of the sidewalk would make me stop to catch my breath. I think it took me about a month to feel not so fatigued, and maybe a couple of more weeks to not feel off. Aside from some neuropathy now, 11 weeks after chemo, a couple weeks past surgery, and three HP in, I feel like I am almost myself again.

amybirnbaum1

Thank you always. I was like omg is there another medical problem lurking under here? 3 months before my dx Ihad my annual checkup and felt so healthy-bloods were all good, exercising, and then bam hit with this. So now I dont trust anything!

AlwaysMeC

I get what you mean. I rarely if ever got sick before diagnosis, so every side effect is like oh no what now?!! I hope you feel better sooner than I did!