Worried about my precious mom! Insight please!

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Shluli
Shluli Member Posts: 3
edited May 2015 in HER2+ (Positive) Breast Cancer

imageHello Warriors,

My mother (61 years old) was diagnosed with Breast cancer a few month earlier during a routine mammogram (then US & Biopsy).

In February 2015 she had a lumpectomy and Dr removed a 1.9 cm cyst from her left breast. They also removed 3 left aux lymph nodes, thankfully they came back negative.

The biopsy of the tumor showed that she was borderline for HER+ (score of 2--FISH study recommended), grade 3, ER+, PR+

The oncologist said that she will need 5 months of chemo with Herceptin, radiation and then hormonal treatment for 5 years. They also requested a CT scan (body) to make sure there were no metast.

The CT shows many enlarged lymph nodes. I can't understand how this could be if her lymph nodes were removed and were negative. Does this mean she may have positive lymph nodes now?The report also reads she has a cyst in her liver which really worries me! It could have been there all along, but how to know?!

I know that HER+ is a more aggressive form of BC which scares me even more. There was no talk of chemo and now there definitely will be. If the treatment will save her life, she must do what needs to be done to lower the rate of recurrence.

Anybody have insight with a similar diagnosis? This would be greatly appreciated. I know it's hard to give advice or insight since each case is different from the other.

Many many thanks in advance for your support,

Shelly

P.S. I've attached my mothers pathology report (not FISH yet). Any insight would be helpful.

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  • Moderators
    Moderators Member Posts: 25,912
    edited May 2015

    Well, no real insight from us, but you have our thoughts and guidance on the boards. We are thinking of you!

    You may find this helpful, though you do appear to have been reading up on things quite a bit.

    Guide to Pathology Report

    We're thinking of you and your mom!

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited May 2015

    Hi Shlull!

    I am triple positive and had the works (chemo, surgery, radiation, and hormonal therapy). You say that your Mom will be getting chemo with Herceptin. What chemo cocktail is she getting? If it's Taxol + Herceptin, that's fairly common for those diagnosed with early stage, HER2+ breast cancer.

    As far as her lymph nodes go, just because the surgeon removed a few that tested negative for cancer doesn't meant that there aren't nodes that might test positive. Cancer cells can break off from the primary tumor and land anywhere, as they travel through the lymph system and her blood supply.

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  • akgb1
    akgb1 Member Posts: 3
    edited May 2015

    I personally think that your mum's doctor suggested a good treatment (but as kayb just wrote, the doctor knows your mum's condition the best).

    HER2+ breast cancer has bad prognosis, but your mum is not in the HER2+ group, as this group with worse prognosis is also estrogen receptor and progesteron receptor negative, and your mum is ER-positive (ER+). She is thus classified in the group called "luminal B" breast cancer, which is HER2+/ER+, and this subgroup of breast cancer has better prognosis than HER2+/ER- group.

    Your mum's tumour was grade 3 and high Ki67 (marker for cell proliferation) and infiltrating and some other pre-cancerous lesions were found in the remaining breast - this is bad news. But good news is that no angiolymphatic invasion was detected (decreased chances of metastasis), the closest lymph nodes were negative, and whole invasive part of the tumor was removed.

    When it goes about lymph nodes, then usually the lymph nodes located closest to the tumour are removed. If they are negative then there is a high chance (but not 100% sure) that the further ones will be also negative as the cancerous cells tend to attack the closest ones first (that's why doctors first check them). There is sometimes a possibility to take a needle biopsies from other lymph nodes (e.g. enlarged ones) and to check them for presence of cancerous cells - you could consult the doctor about this possibility and ask whether that applies to your mum.

    Good luck!

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  • akgb1
    akgb1 Member Posts: 3
    edited May 2015

    @kayb - I deleted my two previous posts.

    @Shluli - Here you have a good reference for HER2+ cancer treatment: http://www.ncbi.nlm.nih.gov/pubmed/24799465

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  • Shluli
    Shluli Member Posts: 3
    edited May 2015

    THANK YOU!

    My mothers nodes were negative (PET scan) thank god. Next week she will begin 4 rounds of AC every two weeks, 12 rounds of weekly Taxol and Herceptin, Herceptin alone for the remaining year, 3 weeks of radiation and Tamoxifen for 5 years.

    She is very nervous about the chemo and is unsure if it is completely necessary. This is the treatment plan recommended to her by her onc.

    Any thoughts?

    TIA,

    Shelly

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited May 2015

    What was the oncologist's rationale for recommending chemo? Your Mom is getting the same regimen as I got, and I was essentially Stage IIIA (advanced localized cancer) with a 5 cm. lump and one compromised lymph node. It has long been thought that triple positive is a particularly aggressive form of BC, and Grade 3 means that it is replicating quickly. So, that may be the rationale. I found AC to be bearable, though there were a few rough days per cycle there. Taxol and Herceptin -- that gave me mild diarrhea and my taste buds were affected (everything tasted lousy). But, I lost 10 pounds on Taxol and Herceptin (and I could stand to lose 10 more), so I guess that was a plus. I'm on Herceptin alone now and I have no side effects. But, as they say, everyone is different, so I can't say that your Mom won't have a rougher or easier time than me.

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  • Shluli
    Shluli Member Posts: 3
    edited May 2015

    THANK you ladies so much. My mom is supposed to start tmrw morning with the prescribed regimen and is now having doubts about chemo. She may not feel all that bad, but I can't reassure her that she won't. I'm scared if she decides to refuse chemo all together bc she may be risking a chance of recurrence. Perhaps, she can receive a "lighter" regimen. She lives in Israel and I believe she's been prescribed what is being practiced world wide. Any thoughts?

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