Unbeleivable! Just diagnosed HER2+

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Lena_Margaret
Lena_Margaret Member Posts: 25
edited September 2016 in Stage IV/Metastatic Breast Cancer ONLY

I should explain: first diagnosis was TNBC in 2010, second was ER+, PR+, HER2- in Jan 2015. Just got the final biopsy results and my recurrence/metastatic situation is...HR-, HER2 +.

I am thankful to have targeted treatment vs TNBC and no targeted treatment. BUT, seriously??? A third type of breast cancer?? I must be a cancer mutant.

Oh well, time to suck it up and be a big girl. First chemo for this situation was this morning, Carboplatin. I will be meeting with the Onc on Monday to discuss addition of Herceptin, etc...

I guess I was meant to be a breast cancer expert, first hand. So be it, LOL

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  • Bestbird
    Bestbird Member Posts: 2,818
    edited September 2016

    Your head must be spinning!

    Actually, it's not all that unusual for breast cancer to change its profile, and/or for different tumors (or portions of the same tumor) to express different clinical presentations.

    The good news is that being HER2+ will provide you with many treatment options.

    Below from my MBC Guide is a list of intialtherapies.You (and others) are welcome to request a complimentary copy of the 120+ page booklet by visiting the top of this page:https://community.breastcancer.org/forum/8/topics/831507?page=2#idx_32

    • HER2-targeted therapy is recommended for patients with HER2-positive advanced breast cancer, except for those with clinical congestive heart failure or significantly compromised left ventricular ejection fraction, who should be evaluated on a case-by-case basis. Trastuzumab (Herceptin), pertuzumab (Perjeta), and taxane for first-line treatment and T-DM1 for second-line treatment are recommended. In the third-line setting, clinicians should offer other HER2-targeted therapy combinations or T-DM1 (if not previously administered) and may offer pertuzumab, if the patient has not previously received it. Optimal duration of chemotherapy is at least 4 to 6 months or until maximum response, depending on toxicity and in the absence of progression. HER2-targeted therapy can continue until time of progression or unacceptable toxicities. For patients with HER2-positive and estrogen receptor–positive/progesterone receptor–positive breast cancer, clinicians may recommend either standard first-line therapy or, for selected patients, endocrine therapy plus HER2-targeted therapy or endocrine therapy alone. From: http://www.instituteforquality.org/systemic-therapy-patients-advanced-human-epidermal-growth-factor-receptor-2–positive-breast-cancer

    It should be noted that this first-line therapy may be effective even for patients who were pre-treated with Herceptin.From: http://oncologypro.esmo.org/Meeting-Resources/ESMO-2014/Breast-Cancer-Metastatic/Efficacy-of-anti-HER2-retherapy-with-trastuzumab-at-first-relapse-and-or-first-occurrence-of-metastases-of-HER2-positive-breast-cancer-in-clinical-routine-4th-interim-analysis-of-the-non-interventional-study-NIS-ML21589


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  • nbarkach
    nbarkach Member Posts: 16
    edited September 2016

    On my right breats I have a 3 cm tumor that is HER2+ grade 3, and a 10 cm area of several little areas of DCIS. During an MRI they also found a 9 MM tumor which is HER2+ grade 2 on my left side, plus a couple other areas they did not biopsy becuase we are just going to do a double mastectomy. I don't feel like it's shrinking enough with chemo also. I've had 3 of 6 treatments so far. I'm kinda freaking out. I too feel like a cancer mutant so you are not alone. It's crazy!

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  • Lena_Margaret
    Lena_Margaret Member Posts: 25
    edited September 2016

    Thank you, Bestbird. Your information is wonderful and you graciously sent me your MBC guide a week or so ago. Many thanks! I am reminding myself of the wonders of directed treatment at this juncture. My head is definitely spinning. I have seen some studies on receptor disonace (thanks to Constantine on Inspire) and will continue to look for studies on this situation. I haven't had the opportunity to see the actual path report, but will be interested to see the specifics.

    Ebarkach, a cancer mutant is definitely not a good thing. Here's hoping the mutant situation works to our benefit.

    Blessings!

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  • pajim
    pajim Member Posts: 2,785
    edited September 2016

    Lena_Margaret, I suspect that in every tumor there are cells which are HER2+, HER2-, ER+, ER-. The testing just brings back the predominant one. Then you treat it. So you killed off the ER+ tumor cells, leaving the HER2+ cells behind. etc.

    Or there's always the case that these are three de novo cancers.

    It is kinda head-spinning. You must be one of those people who has a very heterogeneous cancer (lots of different types of cells)

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  • Lena_Margaret
    Lena_Margaret Member Posts: 25
    edited September 2016

    Pajim, it is possible that all three are very different. The first and second cancers were vastly different (the first was IDC, the second was an IDC/ILC mix). I have not yet seen the pathology report. I assume I will see it on Monday to see how this cancer has shown itself. I might be a person with heterogeneous cancer cells. My best guess is that the BRCA I mutation is rearing it's head in this confusion.

    I think I am a bit less surprised now and just ready to do what has to be done.

    Blessings!

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