How do You know what is Your chance of recurrence??

sylwiamolik · July 2009

sylwiamolik · July 2009

Hello Ladies,

I'm curious about it. How do You know what will be Your recurrence chance with treatment or without it?

I'm writing to you from Poland, Europe. In our country we dont have such a big breast cancer internet message boards so i decided to sign up here

I was diagnosed with <1 cm IDC, negative nodes (0/15), grade 2, HER2+, ER-, PR-

My onc said that i'm going to have 4x AT chemotherapy (doxorubicin+ docetaxel) and after that, 1 year of herceptin treatment.

I see most of You know the percentage chance of reccurence, but personally i have no clue how to measure it:( Please help me!

THANKS, WISH YOU THE BEST AND SORRY FOR MY ENGLISH

lexislove · July 2009

Dobre dan!!

Going by your stats..you have a low..low chance of recurrence. The Herceptin will be key for you! I did the same chemo as you too, and that is one strong regime. Usually your onc can go on a program adjuvantonline.com or you can too and put in your info and the computer will come up with a percent.

But really...everything is a crapshoot.You either will recur or wont.

Hope this helps!

Oh ya..adjuvantonline says you have to be a doctor to sighn in ect...just make up a name we all do it...ha!

sylwiamolik · July 2009

Dzień dobry Lexislove for You too Laughing

And thank You so much for Your reply Smile You're right, most of us spent many sleepless nights searching the net for info, collecting medical data or at least thinking of what it will be in the future, so we can say that we're almost an unwritten doctors Wink So this adjuvantonline software is dedicated for us!

Wish You the best, we must fight these ugly bugs from our bodies, no other choice )

lexislove · July 2009

Yes, check out that site. I'm sure you will be just fine.

Be well!! Smile

Sassa · July 2009

Be careful with the percentages with adjunctonline. Unless the site has been updated, there is no allowance for the use of herceptin in HER2+ BC. Herceptin is a huge factor in cutting recurrence risks.

lexislove · July 2009

Thanks Sassa..

I forgot to mention that Herceptin is not included in adjuvantonline yet...hurry up!!!

bluedasher · July 2009

Sylwiamolik, I'm sorry you have to deal with this but I'm glad you found us. Don't worry about your English, it is much better than my Polish. We have some other women from Europe here and some from Asia. We are all in this together

The problem with Adjuvantonline is that it doesn't take into account HER2 status as Sassa has pointed out. Being HER2+ really increases our chance of recurrence without chemo. In December of 2008, two retrospective studies released recurrence statistics for women with tumors less than 1 cm who didn't get chemo and the recurrence is much higher when the tumor is HER2+. When the tumor was HER2+, the 5-year disease free survival was 77% so recurrence was about 23%. Distant recurrence (mets) was about 14%. I'd call that pretty high making chemo a good choice. (For HER2- tumors, those numbers were about 7% and 3% respectively.)

Link to the poster with the MD Anderson study data

On the other hand, I don't think a therapy that includes Adriamycin (doxorubicin) is good for small HER2+ tumors. Adriamycin and other anthracyclines have too much heart risk. About 2% of the women who get a therapy with it can't get Herceptin after because the anthracyline has lowered there LVEF (left ventrical ejection fraction) too much. TCH therapy (Taxotere, Carboplatin and Herceptin) has been show to be about as effective at reducing recurrence and it has lower side effects and lower long term risk - especially less risk to the heart. TCH was studied in the BCIRG 006 study along with AC-TH and AC-T therapy. You can find a slide set on this at:

http://www.bcirg.org/Internet/Studies/BCIRG+006.htm
scroll down to where it says: 2nd analysis presented at SABCS 2006

bluedasher · July 2009

lexislove, adjuvantonline doesn't even include HER2 status - it has a box to indicate ER positive or negative but not one for HER2 so it produces very misleading results.

lexislove · July 2009

I thought that it ASKS for Her2 status but it doesn't factor in herceptin tx? I haven't been on it in over a year...lol.

My Polish friend...you either will 100% recur or 100% won't. There is no crystal ball.Now how about some Pieroski recipes... Kiss

bluedasher · July 2009

I forgot to put the good news in the post above. The BCIRG 006 interim results above show disease 4-year free survival (DFS) for node negative HER2+ at 93% with TCH chemo. I think the study required tumor size over 1 cm so this was for women with larger tumors than us. While the chance of recurrence without chemo is rather high, with chemo and Herceptin bring it down quite a lot.

sylwiamolik · July 2009

Hello to Everybody

Lexislove i promise i will prepare and paste here my special recipe, just for You But, in turn, You have to give me Your strictly protected, secret formula for tasty grilled burgers Tongue out

Bluedasher Smile Thank You so much for info, i've just noticed that there's lack of her2 status on this adjuvantonline as well as herceptin factor in treatment options. But i concluded if her2 is negative factor and herceptin in fact eliminates this negativity, so we can estimate the result is zero (maybe). You're right about the results of MD Anderson study data but look at what i have found for You :

1.

Note that in this study no patient received trastuzumab, and maybe only a part of them received chemotherapy in the adjuvant setting. (Copy and paste it into your browser because the link doesn't work):

http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=31608

2. and this (look what they wrote about patients T1a,b who received chemotherapy, during the follow up period only 1/25 recurred which is 4 %, and they didnt take herceptin)

http://www.abstracts2view.com/sabcs06/view.php?nu=SABCS06L_976