Her 2 But Not Doing Chemo

Christianne -

Hi.  I was in a similar situation, but I had one doc that recommened chemo and one that did not.   The key difference was that my ER positivity is weak (only 22%) and I am PR negative.  This, and my relatively "young" age (43)  caused the one doc to recommend chemo.    It was a very difficult decision at the time, but there was something in my gut that told me to go with the doc that wanted to do chemo.   However, I talked her into a relatively "light" regimen such that I could receive the herceptin.   She was originally going to throw the book at me. 

Interestingly, this past December, there was a big retroactive study presented at the San Antonio conference which studied tumors less than 1 cm.   It was conducted by MD Anderson.  The conclusion of this study was that any Her2 positive tumor regardless of size be "considered" for systemic treatment given higher recurrence risk stats.  I have included the link to the abstract below.

 http://www.abstracts2view.com/sabcs/view.php?nu=SABCS08L_444&terms=

That said, there are some other mitigating factors in your case such as ER/PR positivity and the oncotype score that would indicate you are on the more "favorable" side if the stats.    Your age and menopausal status will also play a lot into this as well.

In case you were wondering, in my case, we did not run the oncotype.  The reason why was because all the prognostics indicated that we pretty much knew the outcome  -  and that was it would be intermediate to high.   This is something that even Genomic Health (the makers of the test) confirmed for me. 

I hope this was helpful.  But, as Kim says, if it continues to nag at you, get a second opinion and show the above study to that oncologist.   In my case, my oncologist thumped her chest about this study for weeks and told me it was a huge hit at her office among the other physicians.  It basically took small Her2 positive tumors out of "mushy middle" status.

Jill   

I was told that her2 + means chemo for sure, no questions asked. 

Earlier you wrote that you wanted to go natural but being her+, you should have chemo and herceptin, please get a second opinion, it could safe your life. I didn't want herceptin I was really afraid of the cardio problems but deciided to do it. I hate it but I'm doing it.  Chemo was a given with me, they didn't even discuss not having it.  I really hope you find and onc that will recommend it, even just herceptin.  Good luck  Christianne, by the way your name is really pretty. I'm having a grandchilld and going to mention that name to my Son and future DIL

Have a great day and please don't wait to get this taken care of.  Hugs,

My oncologist did not recommend chemo. My bc was mostly DCIS with a small amount of IDC.  The tumor was so small it all was removed in the stereotactic biopsy.  When they did the lumpectomy there was no cancer cells found.  I am highly ER+ (96%) and postmenopause so I am taking Femara.  I was concerned being Her2+ but my doctor said this is found much more in DCIS.  He said the benefit in doing chemo would be miniscule compared to the risks. Hopefully he is right. I also had 7 weeks of radiation therapy.

Sandee

I am Her2 positive, but did not receive chemo or Herceptin because three years ago, it wasn't given for tumors < 1cm. I am nearly 3 years out, and am still cancer free, and I take Femara only. I didn't have chemo or rads either......just masteceomy.

Jennifer

Hi Christianne



I an Her2/neu positive, no lymph node involvement and my oncologist was on the 'fence' as to whether or not I should have chemo as my lump was 4mm and I had a unilateral mastectomy. He presented my case to the local tumor board and two breast specialists at two NCI treatment centers and all recommended chemo, but no herceptin which really surprised me. I did four rounds of taxotere and cytoxan last summer and finished in August. Now that I'm pretty much recovered from the chemo, I'm glad that I did it. As my dr said it was 'just in case' some rogue cells had gotten out.



Good luck!

Kathy

I'm also surprised that the onc didn't test for receptor status.

I haven't found anything indicating that BRCA1 status or any of the other BRCA mutations are associated with whether the cancer is hormone or HER2 postivie or negative. I looked a bit because I wondered whether my cancer might be gene related (I don't have complete faith in my family history) and figured that if I found for example that BRCA related cancers were usually HER2- then I could stop thinking about it. But I haven't seen suggestion of a relationship.

Usually the heart Damage caused by herceptin can be reversed.  Not always though.

I researched this because I already have a bad heart.

It is still a wonderful drug.  But one should know that heart damaged caused by it is not always reversible.

Pam