Triple positive with no nodes, mastectomy what treatment ?

I am triple positive, had bi-lateral mastectomy for DCIS in left breast.  When pathology came back I had a small (.4cm) tumor of IDC but nodes clear.  I am now taking Taxol/Herceptin for 12 weeks and then Herceptin for remaining part of year.  I am 37 years old.  I am guessing because of her age and triple positive chemo and herceptin will be in order.

I'm 45, 44 at diagnosis.  IDC and DCIS in right breast 1.9 cm tumor.  Grade 3, ER/PR+ and HER2 + by FISH test, no node involvement. I did not do the Oncotype DX test as my Dr.'s both felt that chemo was not negotiable.

I had Taxol and Carboplatin (six treatments at 3wk. intervals) and Herceptin concurrently.  I am getting the Herceptin weekly.  I also began Tamoxifen after I finished chemo.

I hope all goes well for your friend. 

I am also triple positive.  My tumor was small (.7 mm) and my nodes were clear.  I was diagnosed at age 42.  My oncologist is from the University of Pennsylvania and is very well known in the breast cancer world.  My treatment plan was 4 TC (taxotere, cytoxin) plus herceptin, and then herceptin only every three weeks for a total of one year.  According to my Doc....if you're HER2 positive, you're getting herceptin -- no matter how small your tumor is.  Keep in mind that the "personality" of the tumor is even more important than the size.  There are some people have huge tumors that are slow growers and pose no real threat.  There are other people like me with very small but very aggressive tumors (get this...Oncotype score 65!). Tumors like that need to be treated accordingly.  My guess is that your friend should be receiving 6 treaments ( of taxotere/carboplatin or taxotere/cytoxin) because the tumor sizes, and definitely herceptin for a year.

Kim

Wow - this diagnosis is almost identical to mine

Triple positive, right Mast., no nodes,, 2 tumors - 1.7 cm. and 1.0 cm.,Clear margins, age 48 at dx. (Oct. 2006) I also had FISH to confirm the Her2+, as IHC was inconclusive. I had FEC x 3, then Taxotere x 3, followed by Herceptin every 3 weeks for a year.  I had my last Herceptin May 2008..  The FEC-T chemo regime is commonly used in Canada and other commonwealth countries.  I am now on Tamox. I told my onc. to hit me with the hardest treatment possible, and he agreed.  My onc. gave me a "well over 90% cure rate".

No family history at all for me, but I did the genetic testing and am negative for BRCA1 & 2.

Triple + are a small subset of BC.

I wish your friend all the best.

Hi Trigeek

Your friend is lucky to have you helping her along on this unwanted journey.  Best to both of you.

I'm triple positive too (Er+90%, PR+80%, Her2+++).  I was Her2+ with both IHC and FISH (6.5 highly amplified).  I had lumpectomy, reexcision, 4AC (A = Andriamyacin or Doxyrubicin + C = Cytoxin or Cyclophosphomide), then Herceptin, which I will be on for a year.  I just had a bilat mastectomy due to my margins being clear of IDC, but not DCIS.  Decided to have prophylactic on other side due the fact mammograms failed to find the cancer likely due to breast density.  Left mastectomy had clear margins and right was completely clear, so no rads for me (Yay!).  I will be starting Tamoxifen in December.  

I wanted to be as agressive as possible too, but wonder if I got the right chemo.  It seems the use of anthracyclines (Andriamyacin) is on the way out, due to the fact that other drugs now seem proven to give as good or better outcomes with less harmful side effects. At the time of diagnosis, I just accepted my oncs plan without doing the research (this was before I had really begun to come to this site) and only became more proactive once chemo was underway.  Thankfully my mugascans have been excellent so far.  I also wonder why I didn't get a taxene; I had assumed these were given more for stage 2 but I see that several of you had taxotare or a taxol. I am trying just to let this concern go, for it is water under the bridge now.My onc is head of the tumor board here, so I have to trust that it is a good plan and remind myself that I am doing everything I can to kick bc in the butt.

Has anyone come across any research specific to triple+?  I would love the links to any info you have found.

Postive vibes to you all.

jennifer,

did you have chemo??

I had high grade DCIS with a tiny (3 cells!) of IDC found post mastectomy. I then went back for a lymph node dissection, and all 18 were clear.   I was 40, and considered cured- no nee cfor chemo.  Herceptin wasn't an option at the time.  One year ago at 50 I suddenly had a lump near my mastectomy site.  It turned out to be the same darn cancer, and worse still, a CT showed lung and bone mets "too numerous to count".  I am fortunate that a winter of chem brought me to a point of stable disease.  I have been on Herceptin only and an AI since May.  My advise is treat it agressively as soon as you know you have a HER2+ tumor, regardless of how "early" the detection.

Hi,

 I am also HER2+++, ER/PR Neg, grade 3, 1.6cm tumor on right side, no nodes and had a lumpectomy.  My course of treatment was 4 AC (every 3 weeks) followed by 6 Taxol, 36 rounds of radation  and 1 year of Herceptin (every 3 weeks).  I was 48 when I started treatment, and they gave me full guns because they said that my cancer was very aggressive.

Hi... I havent had surgery yet. My surgery date is April 23, 2010. I opted for the mastectomy on my right side to minimize chances of it returning. I am triple positive as well. 2.1-2.3 CM mass right in the front of my right side. I had the MRI and it showed clean left and clean lymph nodes. I was told 8 rounds of chemo ( 4 months) and 1 year of herceptin and 5 years of tamoxifin after surgery. I opted for the mastectomy to also cut out the radiation. They told me its early and I just didnt get why I had to have chemo... thats the only part of all this that I am really struggling with. I have hair thats almost to my butt!