How many treatments 4 vs. 6

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juleski
juleski Member Posts: 2
edited October 2018 in DCIS plus HER2-positive Microinvasion

I was dx in Nov 2010.  43 yrs old.  No family history, perfect health, then BC.  I'm going through chemo right now, 4 treatments complete and 2 left.  Have been very lucky and have not been sick at all!  I have a little discomfort of aches and pains after my shot.  I am on a TCH regimen.  I'm just really apprehensive about doing 6 trtmts.  I feel like I'm being overtreated.  It did not go to my lymph nodes, I was told I would have to have chemo since I was HER2+.  Has anyone else had a similar diagnosis and treatment as I have?  I know there was a study done and presented at the Breast Cancer Symposium in San Antonio in Dec 2010 that studied 4 vs. 6 rounds of chemo.  I'm just scared of potential long term side effects and feel I'm too young to be overtreated now!  Any thoughts???

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  • Mountains1day
    Mountains1day Member Posts: 102
    edited March 2011
    I had similar diagnosis....Stage 1 IDC, .7mm, Node Neg, Grade 2, Triple Highly Positive.  I had the same treatment (TCH) except 4 instead of 6 and Herceptin for 6 mnths verses 1 year based on the HERA study.  Onc agreed this was overkill but highly recommended the Herceptin as it had to be done with chemo because it was based on studies that proved it to be synergistic together.  In the future, chemo may be unnecessary as more biologic targeted therapies are discovered and proven effective with less toxicities. Kiss
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  • Diane1960
    Diane1960 Member Posts: 32
    edited March 2011

    My mom's diagnosis was very similar to yours.  She also had 6 treatments of TCH.  She finished chemo in mid Feb and will continue with Herceptin until Nov.  A month after chemo she started to feel better and so far she hasn't noticed any residual side effects.

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  • rdg1959
    rdg1959 Member Posts: 7
    edited May 2011

    I have the same diagnosis as Mountains1Day. I start Chemo on May 26th: 6 treatments with 1 year of herceptin. Based on all the really negative info I've read on HER2+++ breast cancer and its aggresiveness, I highly recommend you complete your chemo. FYI, I had a bilateral MX on 2/28/11, with reconstruction. I opted for the BMX because of family history.  In addition to the one tumor biopsied, the detailed pathology found 3 more tumors in my left breast and one in my right - all too small to detect via mamogram. I consider myself very lucky to have caught it so early. God was watching out for me. Good Luck!

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  • nupinkie18
    nupinkie18 Member Posts: 6
    edited May 2011

    I just asked the question how is it determined how many treatments you get, still not sure but me and my mom came to the conclusion it must be based on the dx of the individual.  I was dx stage 1 IDC 11/18/10 and with all my other testing being negative (genetic, lymph nodes, and  2 biospies) it was contained in 1 spot (left) so I chose the lump. Had the surgery 12/23/10 all margins clear but HER2 is postive, recommended treatment 6 chemo treatments, herceptin for a year and radiation. I have heard stories from breast ca survivors that they didn't do the last treatment, they just felt like their body had had enough so again it just depends on the individual.  I just got my port done last thursday and my first treatment is this thursday and @ this point I plan to do the 6. So good luck on everything.

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  • Beesie
    Beesie Member Posts: 12,240
    edited May 2011

    Mountains1day, was your tumor 0.7mm in size, or 0.7cm (which would be 7mm)?  Just asking because I hadn't heard before of chemo being offered to someone with an invasive tumor that was a true microinvasion (i.e. 1mm in size or smaller).  

    Renee, same question for you.  Was your tumor less than 1mm in size?  

    It seems that the "line in the sand" for Herceptin and chemo is moving all the time. The NCCN treatment guidelines still suggest that chemo and Herceptin be considered for those who have invasive tumors that are 6mm in size or greater.  I know that quite a few women who've had tumors that are smaller - certainly 5mm or 4mm and sometimes even 3mm - have been offered chemo and Herceptin but for tumors that are any smaller, I haven't heard of these treatments being suggested before, except in rare cases where someone had several small invasive tumors. In fact for tumors that are smaller than 1mm in size, I'm surprised that they are able to accurately test for the HER2 status. I know that quite a few of us here with 1mm or smaller tumors have been told that our tumors were too small to be accurately tested.  It's certainly interesting how treatment progresses.   

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  • boquin
    boquin Member Posts: 1
    edited February 2012

    Diagnosed 10/12 with IDC, ERS negative, Grade 2, Her2+. I was also recommended 6 TCH chemo treatments and have already gone 5 rounds. I have not responded well to any of the anti-nausea meds so have had a very rough time of it and have decided to only do these 5. My dr says studies on cure rates have only been for 6 treatments but I'll have huge benefits with 5. I'm done. This has been a nightmare every step of the way with every single side-effect known, every day. I haven't had a break between treatments. I will start radiation for 6 weeks, 5 days a week, and continue the herceptin for the year. I'm hoping for a little more tolerable road.

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  • Itzme
    Itzme Member Posts: 7
    edited February 2012

    I am also receiving 4 TCH treatments and then herceptin for one year.  I will have radiation for 7 weeks, 5 days per week. My oncologist sees little difference between the results of those receiving 4 vs 6 treatments in reoccurrence rates.  He does not think exposing me to the side effects and/or toxicity of two extra treatments is worth it so I am going with 4.  Hope it's enough!! 

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  • gwen1watkins
    gwen1watkins Member Posts: 2
    edited March 2012

     I originaly was diagnosed with DCIS HER 2 positive with no treatment except a lumpectomy, that i didnt even know was done. My doc made it seem like it was a biopsy to test the tissue so i never followed up or was offered radiation...well moving on a year and a half later with several mamograms i ended up with stage 1 her 2 positive getting a double mastectomy with reconstruction following on Feb.3, 2012. My question is i have to go thru chemo and have had one fill so far (spacers). Can i hold off on getting the rest filled until after chemo? Is there a risk of infection leaving the reconstruction until chemo is done? I started my reconstruction in Fresno and since i have no one to help me during chemo had to come to Los Angeles. It is hard for my sisters to take off work to travel to Fresno when there already making a schedule to take off work for my chemo treatments (i have two sisters). So putting off the fill was the only thing i can think of. City of Hope said they would not do my reconstruction since i started it with another doctor. My mother died of breast cancer and me being in Fresno i wasnt there to help with all the doctor visits and feel guilty that once again my sisters have to arrange there life. Dont get me wrong they done mind but my guilt is so much that im not thinking right.

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  • Itzme
    Itzme Member Posts: 7
    edited April 2012

    Just a little update:  After completing my 4 TCH cycles, my oncologist suggested we do two more for a total of 6 TCH cycles.  He said for extra insurance against reoccurrence and the fact that I handled the TCH with little to no side effects influenced his decision.  A little bummed but if it improves odds against reoccurrence, I guess I will deal with it.  I may have no lymph node involvement but I am HER2+

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  • an30
    an30 Member Posts: 9
    edited April 2012

    Itzme, I am 30 years old, have mastectomy in 4 days, so I don't know my complete pathology yet. According to biopsy of two areas in left breast, one showed DCIS the other IDC. Triple positive (ER+ PR+HER2+). My MO said my chemo would start a week after surgery and would be TCH x 6, then H 1 year. I asked how my treatment plan would change depending on results of pathology when breast is removed, he said treatment plan will not change. I had my pre-op with breast surgeon, and she felt the pathology could alter treatment. I should get results of BRCA soon, but no fam history and picture perfect health otherwise. Pet/ct showed no spread, blood tests show no tumor markers. I am concerned with the toxicity of chemo, especially with my fertility! Hoping to find statistics on 4 vs 6.



    Good to hear your treatments have been ok, and you are almost done!

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  • maro
    maro Member Posts: 2
    edited May 2012

    i was diagnosed as HER2 in april i had the tumor removed 1.5 2cm ,i had biopsy for glands,,,my next appointment is on 29may to discuss the results ,,,,but the doctor said that my brest might be removed,,,no one mentioned if had their breast removed when diagnosed with HER2,,,,willl someone plz tell me

    i will need to go for chemo ,,i have no idea about it ,,

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  • Pbrain
    Pbrain Member Posts: 863
    edited October 2012

    Juleski, if it helps, I'm pre-lumpectomy but from MRI and ultrasound, I am just like you.  IDC, stage 1, no lymph involvement.  I met with my oncologist for the first time today, and I got the exact same treatment regimen.  :-)

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  • Geege
    Geege Member Posts: 2
    edited October 2016

    I was HERS 2+ diagnosed exactly 5 years ago. My treatment was supposed to be 8 chemos. First 4, then the lumpectomy, and then the last 4. After the first 4 treatments I discussed not doing the last 4 with my oncologist as I felt it was over treatment since it thankfully did not hit my lymph nodes. He put all my stats in the computer and told me I should be fine with the 4 chemo treatments. Thank God.

    i did still have to start on arimidex, had almost 7 weeks of radiation, and a full year of herceptin.

    Speak to your oncologist about the amount of treatments you definitely need. But, of course, do what he says or ask another oncologist if that makes you feel better. I would not want you to regret not doing all you had to. I hope I made the right decision, and that you do too.

    Good luck with everything and God bless.

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  • Nisha517
    Nisha517 Member Posts: 88
    edited October 2018

    was anyone able to find the stud(ies) that show why 6 tchp is better than 4

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