How much does Herceptin improve HER2/neu + prognosis?

Thanks Ladies. It will be what its meant to be:)

Hi Nancy

I had a double mast and as you can see by my sig line I had a small grade 3, stage 1 no node, no LVI tumor. I went to highly respected panel and they could not answer either way but I asked 2 of the female docs there (surgeon, radiologist, once) what they would do if they were me and they all stated mastectomy. We have a pretty good prognosis with this aggressive cancer due to Herceptin and I don't have ANY scientific research to back up my next statement but I will tell you I have been reading these boards for 3 years and every time I see a local recurrence it is from a lumpectomy and they always say they wished they would have done a mast. I was 42 at dx and never looked back on the surgery, I missed my hair more than my breasts. Of course there are reasons to keep breast tissue but with a grade 3 her2 tumor those cells move fast and you just can't always see everything. I wanted to do everything I could to keep cancer free.

Nancy - I have wondered about that as well. I had no previous understanding of bc, and was in total shock when dx.  So the surgeon said "You will be having a lumpectomy" and I said "Ok" and that was that.   She also said "You will be having chemotherapy, radiation and a year of Herceptin" so maybe the lumpectomy just blended into that big long list. And I never questioned it at the time at all.

But then I went to a bc support group down in Baltimore, and of the 7 ladies at the table, I was the ONLY one with my own breasts. And I did start to wonder.

I have a friend on this site who is from CA, and her surgeon was part of the "breast preservation project" at UCLA (I thikn that was the name of it) where they try to do less mastectomies. She was her2+ and had a lumpectomy as well.  Supposedly the life expectancy for lump vs mast is the same. But I tend to drown in statistics, so I can't back that up.

I know that I am glad I have my breasts (although in the beginning, I did have strong impulses to tell them to 'just take them both OFF' and I was sure I would never feel comfortable with them again. But I do. I guess time does heal all wounds.  Now if I can just stay cancer-free and enjoy life, all will be perfect.

I went with my BS recommendation of a lumpectomy for my multifocal BC.My path showed stage 2 Her2 with positive nodes and at no stage have any of my medical team suggested a mastectomy, I was 39 at Dx. After completing Chemo and Herceptin I am very glad not to be facing further recon surgery.

I'm coming up to 2 yrs since dx in Feb, my Onc is really positive about Her2 BC treatment and gives me the impression that I will never have to worry about BC again (here's hoping).

I finally feel really fit and healthy again and don't have any long term SE's from treatment, it took a good while after finishing Chemo for the neuropathy pain to go and my joints to recover.

In some ways BC gave me the kick up the ass to get on and live life to the full, I was very good at making excuses to put things off.  I'm having so much fun trying new things and travelling to new places, the bank balance is hurting but life is good!

Hi ladies,

The overall survival prognosis is the same for lumpectomy with rads as a mast, however the risk of a local recurrance goes up slightly.

My surgeon left the decision to me, but I knew little at that time and chose a lumpectomy and I'm still doing fine five and a half years later and thank herceptin for that:)

Tricia xx

TriciaK is correct, statistically, lump+rads = mast BUT those stats are for single tumors not multifocal.  For multifocal, multicentric the equation is tipped in favor of mast.  No matter what, it's really what you're comfortable with doing. 

keeppositive,

My mom's BS recommended a lumpectomy.  After the biopsy results came back with no clear margins she went in for a re-excision.  The second biopsy also came back with no clear margins. The BS said that he could go in a 3rd time but being that Her2 is so agressive, my mom choose to have a mastectomy.

keepposit....i too went for the lumpectomy.My surgeon was from MSK.and she gave me 2 choices,I was going for the mastectomy,and I read between the lines as she was talking to me,she felt I didn't have to go that drastic.I thought I would give it one chance for clear margins,and they were.I also did have a full axillary dissection.I couldn't belive how aggressive this cancer was.I go yearly for mammos.

Hey, Keeppositive, in another thread a woman has posted links to two studies showing a 0% recurrence rate for stage 1 HER2+ node negative BCs *treated with Herceptin (maybe TCH too?). 

The thread is located here: http://community.breastcancer.org/forum/80/topic/763528?page=1#idx_3 

My mammogram found microcalcifications that were surgically removed. Lesion was fine, but LCIS showed up. They told me to take tamoxifen for 5 years. I settled in on a breast specialist who wasn't happy with that answer. Said LCIS just screams danger, danger. She ordered MRI which showed another spot right near the other one. Did an ultrasound biopsy. All clear. Next day she called and said that she and the pathologist weren't happy with that as they thought it was too clear, so off to another surgical biopsy. Turned out to be very small IDC. I chose bilateral mastectomy as my breast were very dense and hard to see.

BS said that survival rate is the same for either choice of lumpectomy or mastectomy (7%) but recurrence rate is higher with lumpectomy (up to 15%).

After the pathology report from mastectomy came back, all was clear except it noted that in my uninvolved breast there was a non-cancerous fibroadenoma. This did not show up on mammo or mri, so it reinforced the feeling that my decision for me was the right one.

Now, since I am her2 positive, it is on to taxol, 12 weeks, once a week and herceptin.

Wow, none of my doctors have said the words 'cure rate' to me.  Best of luck to you, fluffqueen. 

After a lumpectomy, TCH x6, rads, and H for 18 tx, my onc has given me a recurrance rate of 7 - 10%.  That's not bad, but what does that translate to over a period of 10 years, for example.  I've decided to have a BLM to further reduce the odds of local recurrance.  While I've been told it's not necessary, I thought it was something as my Onc. looked quite relieved when I told her of my decision.  As well, a nurse told me it was her opinion that I made a good decision.  All I know is, it's the best decision for me.

How are you doing? I also was diagnosed with the same type of cancer. I had two breast sparing surgeries that were unsuccessful, After being told I needed a mastectomy, after careful consideration, thinking about my history and dense breast tissue and scar tissue from 4 previous surgeries many years ago for benign tumors in my other breast, I opted to have a bilateral mastectomy and reconstruction, chemo with 12 weeks of Taxol and Herceptin for 1 year. In March I will be 2 years cancer free! I was wondering how things went for you?

I pray this doesn't return. I exercise, try to eat right, and take care of myself. I hope it NEVER comes back. I was 49 when I was diagnosed with IDC stage IA ER- PR- Her2neu+ 3+ AMPLIFIED. Scary!! I never imagined this would happen to me. I thought I was taking good care of myself , but this type of cancer doesn't seem to care. I've never smoked, I don't drink, I always exercised and maintained a healthy weight. What happened? What are my chances of getting a reocurrance? Only 5%? Is there anything else I can do? What have you or anyone else done? I wish I could just moved forward, but it's like a black cloud hanging over my head. Most days I'm ok, but I have my days where I'm unsure.

Thanks for your support

bcsurvivor

IDC Stage 1A node neg ER- PR- Her2neu high grade 3+

dja625 I have read that HER2+ most likely recurs if it's going to in the first 3 years. If you are ER-/PR- your probability of it recurring goes way down after 3 years. You are doing great and it seems like  you have an excellent chance of beating this. Being node negative is a huge break for you as well.

From what I have read the most important things we can do is maintain a healthy weight, limit alcohol ( or just don't drink),  of course don't smoke ingest 2nd hand smoke, exercise and don't sit for long periods of time. This is even more important than all the other environmental factors people worry about.

Congratulations on 2  years. I just pasted my 1  year this August. Am I worried about recurrence. No as long as I do what I'm supposed to. My feeling is I won't worry about it till I get some symptom that lasts for 4 weeks. I mean I don't spend my life worrying about dying yet some day I know I am going to die. No need to worry about breast cancer coming back because I don't know if that is going to happen. (Hope that makes sense). I just want to enjoy my life now that I've been treated and feel fine.

Fluff I've also had a glass of wine a week ago Friday night and 2 the following night. That's more than I drink typically in 2-3 months. I hope I have some leeway too I think we're going to be fine. No one is perfect.

Thank you lago for the inspirational pep tal! I am doing everything I can to stay cancer free. I feel like l won the lottery, or dodged a bullet!! For the most part, I don't think about getting a reoccurance, and if I do, I reason with myself. I know someday we're all going to die, and while I'm alive, I want to live life to the fullest.

Sometimes when I'm alone or I wake up at night, I think about all that I went through, and I think about if I got a reoccurance. I beat this cancer and I am so fortunate to have been pro-active about my health. It made all the difference for me. I also feel grateful to have an amazing team of doctors, nurses and other professionals in my corner that have helped me through the entire process.

I am going to go to bed feeling comforted by what you wrote. That's what support is all about.

Thanks again!

dja

IDC stage 1a, Er- Pr- Her2neu 3+ High Grade 3 Diagnosed Nov. 30, 2009. Have been cancer free since March 10, 2010!