Difference between C-erb-2 and Her-2-neu

Hi Carl,

Sorry that your family has to go through this.

C-erb-2 is a synanym for Her-2-neu.  There several tests for this.  One is an called an ICH test (the one that has probably been done already).  This test is less reliable than a FISH test (the one they are probably conducting now.)  Since the ICH test is less reliable, if it shows positive, it is often verified by the FISH test.

Grade 2 does not mean stage 2.  Grade 2 means that the tumor is only moderately aggressive in growth.  Most Her2+ breast cancers are grade 3 (very aggressive), so grade 2 is a good thing.

Node negative: A very good thing.  This is the most important predictor of your mom's prognosis - chances are she will be fine, even if the final Her2 result (by FISH test) is positive.

No sign of lymphovascular peritumoral invasion - This is also a good finding.  It means it is less likely that the cancer has had the chance to spread.

4 cm tumor - a little on the big side.  But still the fact that your mom is lymph node negative is the most important aspect to predicting her prognosis.

If you read much on the internet about Her2+ tumors it is very scary.  Most of the negative articles were written before a drug called Herceptin was approved to treat early stage breast cancer.  This drug reduces the chance of the tumor recurring by 50%.  So women with Her2+ breast cancer have a much, much better prognosis than they did before 2006.

Good luck with everything.

Jackie

I forgot to address one of your questions.

Generally for your Mom's tumor characteristics, the oncologist will give either AC TH or TCH.  AC TH is a little for aggressive, especially the AC part, but most women tolerate it okay.  The TH part is easier to handle.  Many women also get TCH.  This is easier to handle for most people.  I and many people on these boards did this regimen while working full time.  So while its not fun, its not terrible either.

The choice will depend on your mom's onc preference, and your mom's pre-existing medical conditions.  TCH has a much decreased risk of heart damage compared to ACTH.  AC TH is theoretically 1-2% more effective than TCH, so some oncs like to use that for larger tumors, and node positive.  But the difference in out come between AC TH and TCH is not significantly different.  Because of the reduced risk of heart damage with TCH, over the past year and half, many oncs are suggesting the TCH.

Good luck

Hi Karl,

According to a review I gof from medscape:  www.medscape.com/viewarticle/585224_print 

a positive result for HER2:CEP17 ratio> 2.2 is positive.  Given this, I would try to get the Herceptin.  Does your mom have insurance?  They should pay because the result is positive.  If not, is she eligable for Medicare?  If you're mom's income is pretty low, she may qualify for help from the company that makes Herceptin (Genentech).  For information on this program call Access Solutions at 888 249 4918.  They said they help with copays if you have insurance and if you don't have insurance they may fund the herceptin.

If Access Solutions is unable to help you, and if there are some funds are available and it were me, I would do Herceptin for a reduced period of time - only a few months instead of the entire year.  But I would do it WITH chemo, not after, since a couple studies have indicated that concurrent administration of Herceptin with chemo appears to be more effective than when its given afterwards.  Google "FinHer".  This is a small study that showed very good results even though Herceptin was given only for only 9 weeks. 

If none the above works, there is a vaccine in clinical trials against Her2.  In Phase 2 (mid stage trials, it was shown to be pretty effecitve.  I believe it is in Phase 3 now.  They are only giving it to people who do not receive Herceptin.  If she meets the criteria for the study, the vaccine will be provided without cost.  Let me know if you're interested and I'll find the details.  From what I have read about it, if I were eligible, I would do it (I emailed the company about it but am ineligable because I received Herceptin.)

PM me if you would like to discuss in more detail. 

Best Wishes for your family.  Jackie