I am Stage 1 but the Grade 3 continues to make me nervous

hi seyla,

i have an echocardiogram scheduled for next week but there has been no talk of getting a muga test.  will definitely inquire about that with my onc.

 i am learning so much from this forum.  thanks for the helpful suggestions!

my surgeon doesn't think an MRI is necessary due to all the false positives.  out of curiousity, did anyone else get the same advice?

Meece ...I never got an MRI during my BC journey.

Roso... They have to give you a Muga before you start Herceptin, and A/C.

good Morning everyone!

I would reccomend an MRI, my invasive component were not seen on the mammo or US it was only seen on MRI. THe mammo only picked up the DCIS. As far as ACTH it is really becoming an outdated way of chemo for early stage Her2 gals. Look at the 3rd analysis of the of the original Hera Trial that was presented at the ASCO meeting this year, I believe the risk of cardiac events or reduction in LVEF was a bit higher than 5 percent. I actually know 2 young women under 50 that had acth and both had cardiac damage irreversible both are on drugs for the rest of their lives presumably.

Roso, Yes, the echocardiograms are in place of the muga.  I don't know why some oncs prefer one over the other, though.

I would definately ask about the TCH chemo route over the Adriamycin route.  Both adriamycin and herceptin can cause heart damage,so they cannot be given together.  You have to finish the Adriamycin before beginning the herceptin.  My onc told me when I was first starting chemo that even besides the reason about the heart, why would you want to wait another 12 weeks (while getting the adriamycin) before getting that herceptin in your body--she would rather get it in as soon as possible (with the TCH regimen you get herceptin concurrently.)  Also, if you had left breast cancer, the radiation can also be another added component that has risks of heart damage.  mmm5 is right, the adriamycin regimen is becoming more and more outdated.  Recent research all shows TCH is just as effective but with lower risks. UCLA (where herceptin was developed) recommends TCH as well.  Dr. Slamon (creator of herceptin)  is speaking at a breast cancer conference in February that I'm going to with my onc, and this is one of the subjects of his talk.

My Cancer center conveniently lost my baseline echo.  My cardiologist confirms that Adriamicin is tough on the heart, but will not commit to saying that is why I have heart problems. 

Weety, do you go to UCLA for tx?

Meece, No I do not get my treatments at UCLA, but I did go there for a second opinion just recently.  I am a Kaiser patient.  My oncologist at Kaiser was the doctor overseeing the UCLA doctor I went to see back when she was doing her fellowship, so that is why she recommended me to go see her at UCLA for my 2nd opinion.

I also had an MRI following my initial diagnosis.  The MRI found 2 very small tumors (<1/2 cm each) next to my primary 1.5cm tumor.  Neither of these additional areas showed up on a mammogram.  When I had my lumpectomy my wire was inserted via MRI.  I am convinced the MRI enabled clear margins for me.  I will have both mammograms and MRIs as follow-up checks.  Yes, there are more false positives.  But that is fine with me, at least right now.

Meece, are you in the Long Beach area as well?  If so, we are neighbors!  I actually bounce back between the Kaiser in Bellflower/Downey and the Long Beach location because I'm pretty much in the middle of the two.  I followed my OB-GYN to Long Beach a few years ago, but most of my other stuff is done at Bellflower/Downey.

Weety

Met with my Onc today and He is generally regarded as tops in the field, number 1 in AZ etc etc.

He states there is data that supports zoladex being equally as effective as Tamox for premenopausal and does state that an AI does not have to accompany that for premenopausal patients.

Nicole,

I have been on Lupron every 3 months since July 2008. I will probably be on it longer than 3 yrs since I will be taking Femara and not Tamox. Im still undecided about an ooph, waiting for some SOFT trial news..

Long meeting with Onc yesterday.
He feels and I have had 2nd opinion on this from a Nationally respected ONC from MD ANDERSON, that premenopausal Her2 gals get equal benefit from Lupron or Zoladex as Tamox.

If you go on Adjuvant online they are making similar statements. I have so many issues from the NO HORMONES that My onc asked me yesterday if I can stick with it one more year as he thinks as does the other, that after 3 years our risk \is much less significant. I am doing Zoladex with no AI and that is what they both suggest\

I tried Arimidex and Femara and could NOT tolerate but Zoladex is not my best friend either.

The problem is that most premenopausal women get tamox, and if you are HER2 many ONC's don't like it so if you are under 45 and were completely premenopausal and now you are given spontaneous menopause and an AI it can be very diffucult, HOWEVER there are women that do just fine, both my ONC's feel they are in the minority.

Anyway whatever you decide it has to be right for you as an individual.

Good Luck

Nicole112; Not to butt in but I had similar questions as you. I am 38 and no where near menopause. I asked every oncologist (I saw 3 - the final one was a gynocolocigal oncologist), my radiotherapist and my breast surgeon about removing my ovaries. They all had different opinions (weak ones against removing and surgeon was all for it) and my "regular" gynecologist felt exactly as yours did. However, the final opinion was from the gyno-onc and she said that research is showing that it is very wise to remove my ovaries but ONLY if I am willing to go on a low dose of Estrogen. Odd since I am er+ and pr+, but she said that I am too young to go into menopause (other risks) and that a monitored low dose is safer than what my body is producing at the moment. I chose not to go on Tamoxifen. She also said that it is the combination of Prgesterone and estrogen together that increases chances of ovarian cancer and not the Estrogen alone. I am not Brca + either but she was discussing with me that there is a very high correlation between hereditary BC (my mom died from BC at 37, so we assume I have "a" gene not "the" gene) so I decided with this Dr to do a hysterectomy. At any momemt the patch can be removed.   

mmm5...I can relate to you about the TM test. you think after all this time would get easy right?

It doesn't I go through crisis every 4 months waiting for the result. Which only takes 2 days.

I have one coming on March 1st and i make sure the app is at the beginning of the week so no weekends fall between.

Hugs to you

Sheila