Contradicting Her2 results??

I agree with lexis--and if you are 36 and have no heart problems I wouldn't give up on the AC; it is a highly effective weapon for triple positive bc. 

I had a mixed tumor that made it hard for me to understand parts of the path report.   It meant that parts of my tumor had different characteristics than other parts (mine showed a little IDC and a little ILC all in there together).  The net of that might affect the apparent degree of Her2?  My Her2 amount is not large either--from what I can tell, right over the border. (although the pa says whatever, you are +, that's what matters.)  I asked my onc why I didn't get Herceptin first, if it was the most important.  I had one node but it was huge--1.6 cm--and loaded with malignant cells.  He said that you can't give A and H together and that AC was the powerhouse for stopping the spread, for me.  I had 4 dose dense AC and 12 TH, then 9 more months of herceptin.

I have a congenital cardiac arrythmia and have taken propanolol for WPW for 27 years; I also have extensive allergies to things like hair dye, latex, nickel, mold. . . and green beans. . . My bp dropped like a rock in the first few minutes of mx surgery; allergy to muscle relaxant.  None the less, they said I would have no problems with either the AC or the TH, and I didn't.

I think you want the big guns whenever and however you can get them.  It sounds like you are getting a lot of attention and that is extremely important.

Good luck to you; it gets easier once all the decisions are made and the info is on the table.  The ramp up is a brute though; hang in there, you are doing all the righ things.

C

I think either AC TH or TCH will be fine for you (assming no underlying medical condition that would point to avoiding the adriamycin).  The most important thing is for you to have Herceptin with your chemo.  You already have 2 positive results - there must be something her2 + going on in your tumor - maybe portions of it are positive and portions are negative.  ICH 3+ is enough to qualify you for herceptin.  IMO, its time to quit testing (you don't want to be arguing with an insurance company if the next one comes back negative).  Generally, the Herceptin is the easiest to deal with physically, so there is no downside for you to do herceptin, only upside.  The only downside is for your insurance company. 

I don't understand the logic of redoing the FISH if ICH is 3+.  ICH 3+ alone is enough to qualify you for herceptin and, as your U of M onc said, even if not Her2 amplified - only excess protein, Herceptin will help you.  With positive nodes and LVI you don't want to mess around with this.

If one onc is reluctant to give Herceptin, I'd go to the other. 

Best if luck to you and let us know how it turns out. 

Jackie

Michelle,

 My tumor was also multi-focal.  One of my tumors was HER+, the other one was not. I suspect that is what is happening to you.  I know how it feels to get mixed results.  My first test came back HER-, so when I saw HER+, I thought there was a mistake.  Turns out the tumors were different.  If any of your cancer cells are HER+, and it seems like they are, you should have Herceptin.  By the way, I was originally on the dose dense AC followed by taxol.  After AC, my onc said my tumor had shrunk enough for my surgery.  The path after the surgery showed some cells HER+, so that meant I changed from Taxol to Taxol/Herceptin.  If you want to talk more, feel free to PM me.