Newly diagnosed and researching treatment
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Hi all, Here is my story. On Dec 19, 2014 I felt a large lump on my left breast while showering. My NP got me in the following Monday 12/22. She ordered a mammogram which I received that same day. I am 47 and was waiting until age 50 to start mammos. Anyway, Diagnostic mammo on left breast where the lump was, and screening mammo on rt. They came back in and said, we need to do a diagnostic on the rt breast, because radiologist found something he wants to look at more closely. OK. That done. Ultrasound followed to check out the 2 inch lump on left breast...Just a cyst. Was told that I had extremely dense breasts and numerous cysts, but they were concerned about calcifications on the rt breast. (BiRad 4). So MRI guided biopsy scheduled. Went through that. Results, DCIS, grade 2 cribriform. Scheduled with BS the following week. I had never heard of any of this! Scared out of my wits! But when I got to the consultation BS says, no big deal, just pre-cancer and we will do a lumpectomy. Lumpectomy on 1/28. Results on 1/30. (Merry Christmas and Happy New Year to me!!) Nurse navigator calls...well, there was a 7mm mass IDC, cauterized on the edge of the margin. (ER+/PR+ - and something called Her2neu pending on path report - she says great news) Another surgery to get clean margins and now to check lymph nodes. Great! Surgery on 2/18. SNB and re-exicision. Call back on 2/20. Clean margins, Clean lymph nodes (0/3)!!! Yay...no chemo, just RADs with a possibility of 3D conformal RT. So excited. Skip to today...Nurse navigator calls to confirm my follow up appt tomorrow, can't get me scheduled with RT onco until next week. OK, but have an appt with a Med Onco too? Then she says, in a very quiet voice,...your HER2 came back positive and this will change your treatment plan. I had totally forgotten about the pending results on this. So how does this change my treatment? I have read Herceptin, but what does that entail? Do you have to have Chemo with it? What are the results? I want to go into next Thursday armed with knowledge and questions that I should ask. Any advice would be greatly appreciated.
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Hi, Lisa! I'm not Her2+, but thought I'd at least stop and bump your thread for you, so that it will stay on the "Actives List" a bit longer. I do know that Herceptin is normally given with chemo, but I'm sure your specific stats will factor into what is recommended for you. I would think that your Stage I Grade I dx would be in your favor for less aggressive tx; but, OTOH, it looks like this is your second go-round with bc (DCIS previously?), so I'm sure your onc will take all that into account.
Hope you get all the answers you need, and good luck with your tx! (((Hugs))) Deanna
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Generally speaking an invasive component over 5mm will come with the recommendation of chemo and Herceptin, due to the aggressiveness of Her2+ disease. Because your mass is relatively small I would ask your MO about Taxol and Herceptin, rather than the harsher AC-TH or TCH combos. Here is a link to some study info and a thread with ladies with stage 1 Her2+ tumors doing Taxol and Herceptin.
http://www.breastcancer.org/research-news/20140207-4
http://www.ascopost.com/ViewNews.aspx?nid=10846
https://community.breastcancer.org/forum/80/topic/818370?page=23#post_4316418
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Hi!You don't mention the grade of your IDC (Grade 1, Grade 2, or Grade 3?). That may have an impact on your treatment plan as well. If it was Grade 3, MO might want to be more aggressive with the chemo. But, I agree with SpecialK that you're probably looking at Taxol/Herceptin infusions. Taxol/Herceptin infusions are generally tolerated fairly well; I had 12 myself, and experienced relatively mild side effects compared to some of the harsher chemos. I also got Perjeta because I'm HER2+, but that's because my IDC was locally advanced (5 cm + with one node involved). You're unlikely to get that, given the small size of your IDC.
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