stage1 er+ her2+ choosing to not do chemo/herceptin

Tami the big difference in your pathology and Idaho's is that your tumor was Her2 negative - but of course the feelings involved in this decision are similar and important to share.

Idaho, I'm so sorry you're worried about SEs - I was very worried and upset when I learned I needed chemo and Herceptin - but now that it's all done (remember I had "light" chemo - Navelbine - for just 4 months which didn't cause any hair loss or heart problems - and the remainder of the year on Herceptin, which caused just some tiredness and brittle nails. My heart is fine). I'm more worried about taking Arimidex for 4 more years........but I'll do whatever I can to avoid getting mets.............I'm a firm believer in fighting this beast with every weapon at my disposal now, while I'm still young enough to handle SEs. I do NOT want to revisit this nightmare in 5 years or 10 years or 15 years when I'll be much older. I think it was mentioned on another thread that even though your tumor is Her2+ you could still ask your onc to send it out for Oncotype DX which will help with this difficult decision. My tumor tissue was sent out (before the FISH report came back) and my Oncotype DX score was 22 - which meant, without treatment, I had a 14% chance of a recurrence. My original risk for getting BC was MUCH MUCH lower (m risk was so low, it was shocking when I did get bc!) I felt like I was on a "bad-luck train" so I did not want to play a game of chance with this beast at all.

Good luck with your difficult decision!

One more thing... you mentioned your mastectomy. That's an option for preventing local recurrence, but it doesn't protect against metastasis. That's what the Tamoxifen and/chemo is all about - going after those cells that might have escaped surgery.  Chemotherapy offers protection against local recurrence and distant recurrence both; whether you need more than Tamoxifen to address that risk is a discussion you should have with your oncologist.

U2fan7,

The way my biopsy read was "Invasive Ductal Carcinoma with Ductal Carcinoma in Situ.  Carcinoma occupies 20% of biopsy material".  There were 8 core samples taken w/calcifications ranging in size from 4.5cm in length x 0.3cm in diameter to 1.7cm in length x 0.6cm in diameter.  there were also 10 samples without calcifications which also IDC with DCIS but those samples were said to have carcinoma in less than 1% of the total samples.  My surgeon told me the total tumor was less than 1 cm given those dimensions.  I don't know how much was IDC and how much was DCIS. The pathology on my lumpectomy stated "no residual tumor present", nothing.  They did find "Sclerosing adenosis and stromal fibrosis which are benign conditions and that was removed in the lumpectomy.  It was sent out for a second opinion to an expert in that field at  Cornell Medical Center in NY who confirmed it.  They also got another opinion on the original biopsy to check that it was indeed cancer. That was also confirmed.  It is unusual to have all tumor removed in the biopsy but there was someone else on these boards who also had that situation.   

Everyone has to make their own decisions.  That being said, all decisions need to be made using you own individual information regarding your individual situation.  Hormomal treatment is different from the HER2+ component.  Each needs to be looked at individually.  The statistics suggest that all HER2+ benefit from the Herceptin.  The problem is that statistics are made on a group, you however are an individual. Your doctor is the best person to advise you.  If you still aren't sure, go for a second opinion at a large CC or CCC center.

I can say, Herceptin wasn't bad at all for me. Remember, it's not a chemo, it's an antigen therapy which does affect the body differently. I hope you can make a good decision with which you feel confident and comfortable. 

Best to you all.

Hi,

When I was dx'd and tx'd the results from the trastuzumab trial were not yet available so I never had it. There are some oncs out there who will do trastuzumab without chemo if you keep trying to find one. As a premenopausal middle-aged early stage IDC with some DCIS I had chemo but if I were dx'd today I would choose not to do the chemo and do the trastuzumab alone. The problem is primarily in paying for it when it is not given with chemo, which is the standard.

Hi, u2fan7,

I didn't select chemo nor herceptin. After long discussion with my doctor, I chose taking AI (Femala) with Zoladex injection. Chemo was not recommended.

Last year, I had mastectomy because of wide spread high-grade DCIS with microinvasion in right breast when I was 37. SNB was negative. I had 3 or 4 microinvasions with a few cells, of course they were all under 1mm and ER2+/PR2+ and Her2 3+.

Even my Her2 status and younger age, small size of IDC was the key not to call chemo. But hormonal therapy was recommended. I selected the strongest one.

I don't know your case and my case is similar or not. Because my decision is based on my size. But I just want to tell you my case.

Good luck,

ZOO

Hi, I was diagnosed with breast cancer in Aug. 2008 at age 49; three areas of calcifications which turned out to be cancer (had to have a full mastectomy on my left breast; which now is already full reconstructed). My sentinel node they also found to have cancer, but the remaining 13 nodes were clear. I chose NOT to have chemo.  I am on tamoxifen and so far am doing great. Sometimes you just have to follow your gut instinct.  Yes, at times you will have doubts whether or not you made the right decision, but everything I have read about breast cancer and chemo especially with my situation I believe I made the right choice and I know my faith has also helped me in that decision. Have faith in your decision and like my mom tells me all the time:

God knows what he is doing!!!