her possitive and neg

If You're pos then Your tumor is fueled, stimulated to grow by a substance called 'human epidermal growth factor'.  There's a lot of HER2 receptors (receptors of this 'human epidermal growth factor,) on the surface of Your cancer cells. 'Human epidermal growth factor' is a normal, physiological tissue hormone present in human body and plays there many many important roles, but the fact that cancer cells have to much of it's receptors is wrong.

This day its hard to say if its good or not. Herceptin has proven to benefit women with her2, many other targeted therapies have also been tested. Besides, modern chemotherapy (with taxanes) works far better for her2 positive women (than for negative). I think her2 in the present day has much lower prognostic significance

Koryn

Actually Her 2 is now thought of as a prognosis with less chance of recurrance (if targeted by Herceptin) Both my Onc's (one is nationally recognized from MD Anderson) state is is a more favorable prognosis. In addition there are many drugs that target Her2 now, including Neratanib, and Tykerb etc.

I agree Trip Neg needs much attention.

But, for those dxed with Her2 there is great hope and many feel blessed that they were able to have such wonderul molecular targeted treatment.

My onc was also encouraged by the ER/PR receptors because of the drugs to target it. Being triple positive was better than triple negative in his opinion.

Thanks, Sassa! Love your comments and those of mmm5 and jamieh on this topic. I still remember the horror of my path report - "ER- = prognosis unfavorable." Ditto PR-, Her2+, 50% ki67, and some other factor I've managed to erase from my memory. Uh...so I guess my prognosis is unfavorable, huh doc???? (Oh, grade 3 = p.u. also!) Thank God for the sanity I've found on bc.org!

In addition to the Her2 treatments mentioned, there are many more drugs in early stage development.

Re: Long term risk of recurrence Her2+ ER- vs Her 2+ ER+ breast cancer that has been treated with Herceptin in the adjuvant setting (non-metastatic).   No one knows the long term outcome of herceptin treated Her2+ ER- or hercptin treated Her2+ ER+ because the studies only go out about 5 years.  The information Sassa is referring to applies to breast cancer that has not been treated with Herceptin.   

mmm5, how is life? Have your skeletal pains resolved? Hope you are fine and feeling better about the whole thing.

Best,

Helena.

Hi, Karen; somewhere in the vast Internet world there is a table of recurrence rates reflecting some general statistics around the + and -; I remember seeing it and I'll try to find and post the link.  But I think it's important to avoid good, bad and better when it comes to things like this.  For one thing, the + and the - have degrees of this and that, nothing is purely one thing or another. Not all TN is the same.  There are degrees of ER+ and ER-.  Grade? Nodes? Vascularity? Stage? Categorizing disease has taken a new turn with Luminal A and Luminal B categories, still controversial.  Nothing is straightforward in medical oncology; you play the hand you are dealt as best you can.

New treatments and combinations of treatments, your overall health and compliance with your protocol, the choices you make and your own priorities all affect your own outcomes, too.  Your ability to handle the intervention plays a role. Stats are just that: chances.  

I mean this all very gently.  The Her2- women breathe a sigh of relief for not having that added dimension, but so do the Her2+ women, for having Herceptin and Tykerb to treat it.  It's just a different sigh.  Different path, different cohort, but we all have the same fear and all of us have something to celebrate and something to curse.

I'll look for the link and post if I find it; just don't put too much emphasis on these broad comparisons.  

Warmest wishes for a peaceful weekend,

Cathy 

Hi Helena

Always good to hear from you, skeletal pains somewhat better as now I know that they are estrogen deprivation related. Its something in the knowing that makes them not as prominent in the mind. However I continue physical therapy weekly.

Hope you are well!!

You bring up an excellent point the hormonals need develoment especially since we all suffer on them so....

Orange,

The information on recurrence that I discussed is from a new study on treatment with herceptin. The study showed that the benefit of the herceptin treatment disappears about 3 1/2 years after herceptin treatment ends.  At that point, the recurrence pattern of the hormone status of your cancer comes into play.

Sassa-

"At that point, the recurrence pattern of the hormone status of your cancer comes into play."

Based on the updates to the studies I've seen (the major adjuvant studies - BCIRG006 and the combined analysis studies), it is credible that benefit of herceptin treatment is diminished after about 3 1/2 years.  However, I have not seen any data supporting the statement you made that I quoted above.  I would be grateful if you could please provide a source.  I am sure many of us may consider the Neratinib trial if we thought our risk long term risk is significant.

Thanks so much. 

KarenDunn,

I am going out on and limb about your question about the "best/worst" cancer, and this just my opinion based on previous knowledge of drug trials before my retirement and BC diagnosis and new data that has since come out.  Here goes:

I think that in the future, there will be a shift in the prognostic indicators at the time of diagnosis of early stage BC.  As more data is collected about the long time survival of  ER/PR negative women  that are HER2+ and, hopefully triple negative, (the early public data that I can read now on the PARP inhibitors sounds resoundingly familiar to data that was submitted to FDA in the early trials of herceptin that I saw in my working days) and more data is collected about the long term recurrence rate (out beyond the 5 year cut off point) of ER/PR positive women, I feel that being ER/PR negative will be a positive prognosis indicator instead of the bang on the head that it now is for hormone negative women.  Ditto for the HER2 + status (and hopefully, for the triple negs if the PARP inhibitors play out well).

As for myself now that I am out beyond my 3 years point of post chem (2 1/2 fears herceptin), I feel that I had the best possible diagnosis (early stage, ER/PR negative, HER2+) for not having a recurrence.  My chemo was highly effective because of my grade 3 cells, the herceptin did the clean up.  My oncologist was not crazy when she looked me in the eye and told me I was very lucky in being HER2+.  This opinion was also stated by an oncologist I saw in Maryland who provided me with my herceptin in my frequent visits to see my daughter.  He went so far as to pull out  his charts and data that he had been collected and told me that he felt my recurrence chance at that point was extremely low.  He was also of the opinion that in the future, herceptin treatment would not be for a year and reduced down to 3 -6 months.

 Orange,

I came across the study on the ER/PR status being important after herceptin treatment fairly recently on this board.  I will see if I can find it again.

Lexislove,

Nodal status?  I don't know.  It probably wouldn't make a difference in stage 1 or 2, more critical in stage 3.

Lexislove,

I am trying to find it - no luck so far.  I believe it might have been done in England (or somewhere in Europe)and was a data collection from treatment files (looking to see when recurrence happened (or didn't in same time frame) and the hormone status of the women involved.  Maybe it was as far back as the conference in Switzerland last summer.

It stuck in my memory because of the statement about hormone status and I am ER/PR negative and, therefore, would fall under the triple negative statistics as time goes by.

Hi mmm5,

Doing good - as far as I know. Have to go to the Onc soon again (beginning of March) so that makes me slightly nervous. But I think (hope) all will be well. I am back at work full-time, taking care of the kids, etc. I do still think that my memory and information processing skills are not what they used to be. I don't know. Chemobrain? Side effect of the AI? I feel kind of dumb but fortunately no-one at work seems to notice! LOL. Good thing we all have some reserve capacity.

Hi Orange, thanks for your answer. I too think that extended treatment will be a new standard. I wonder if they will end up doing it 'pulse like'. For example, 5 years on AI, 6-month break, another 5 years, etc. 

I just started an aspirin 'regimen' last week. 81 mg 3 times a week. If nothing else it should protect my heart.

Good idea about the prilosec since we are in it for the long haul. 

Best to you too - I hope you stay in touch with the boards,

Helena.

I don't think "hoping" to be anything achieves very much-you won't know how you will respond to treatment until you have had it. What is succesful and useful for one person will be of no use whatsover to another-so "hoping" to be either her+/- is not going to be constructive for you. I would suggest that you try to stand back from it all for a while-and when you know exactly what your diagnosis is, then you can start to ask questions-and get answers which will be pertinent to your situation.Taking a  step at a time is advise I always give to newbies-otherwise you tie yourself in knots-it's not easy, but at the moment you are in danger of going around in circles, and getting information which will ultimately be of no use to you.