How aggressive is HER2+ (Positive)

Yes, HER2+ is considered more aggressive and is generally faster growing, but as mentioned, there are new treatments that are working well. In an attempt to turn a negative into a positive, faster growing tumors respond better to chemo.

Also, I have often wondered about the ones with small, slowing growing, grade one tumors who go onto mets. How does that happen. I've read that slower growing tumors have been in the body a long time before dx, thus they have had more time to spread. Fast growing tumors = less time/opportunity for cells to spread.

So while there is no "good" cancer, I've tried to make peace with my dx and accept that its aggressive but hopefully treatable.

Yes, that is my take on the hole thing as well Debiann. The more positive and aggressive the more options for treatment pretty much. This is so very comforting.

My nurse tells me, due to the new medications for HER2+ pretty much takes this group to the statistics for survival to the HER2-. which are very good. Also the HER2+ patients are the first group that have a possibility for total cure. They are apparently researching a lot at the moment for not "overmedicating" this group since most patients respond very well to Herceptin and now also Perjeta. There are also other sets of medication in case this does not work so the options seems to be many. Research is also moving quickly. Luckily it also moves quickly in the triple negativ group that has less options at the moment but hopefully that will also change soon.

hip - there are a lot of us on BCO who were diagnosed and treated before Perjeta was approved, and we only had Herceptin added to our chemo regimens. We are still here and doing fine - I am six years out from diagnosis with node positive Her2+.

@hiphophoray I too was hoping for a different answer. By the way what is METS?

hazel - Perjeta is currently only FDA approved for neoadjuvent use, unless your oncologist can appeal to your insurance company, or you have an advanced situation - close margins, lots of nodes, etc. Some MOs have been able to get Perjeta approved for adjuvant use with less, but your insurance has an out due to the current FDA status.

Ok...so if I get "just" Herceptin now, if, you know, 30 years from now (don't wanna think about it sooner) they find more cancer, can I get herceptin with perjeta then? Or can I not get herceptin again since I am getting it this time?

Thanks Elaine. Is there a "plus" to me not getting Perjeta this time? Or should I has my MO why I'm not? I've been trying to read some of the studies, but not being a medical person, a lot of it is beyond me. It looks like originally a few years ago it was only approved for metastatic BC, but it looks like in the last 2-3 years they have done more studies showing it can help other HER2+ people too. I'm in Canada, so I haven't been able to find anything saying it's approved up here for non-matastatic cases, but that could be my lack of searching skills.

Leslie - I am in Ontario as well and I believe that Perjeta is for people with tumors larger than 2cm.

I didn't get it either since my largest tumor was 1.7cm so didn't quite make it.

There are different schools of belief when it comes to PCR and Elaine is correct when she says the studies on PCR haven't made as big of an impression in Canada. There are some experts who believe that people who achieve PCR are people who would have had positive outcomes regardless.

I had FEC x3 and then DH x3 and at the time of surgery had what they referred to as a "tiny spatter" of cancer cells remaining. They said it was an ALMOST complete response and were very happy with the results.

I had both neo-adjuvant Herceptin & Perjeta along with Taxotere & Carboplatin. I did not have a pCR so after surgery I got more chemo - Adriamycin & Cytoxan. So I had a break from the Herceptin. Adriamycin also can cause heart problems so they don't give the two together. When I started Herceptin again, I was offered the opportunity to continue with the Perjeta, but I'd already lost 60lbs with extreme diarrhea so I looked like a skeleton, had extremely low blood work, and also acquired CIPN of both my feet & hands. From everything I read at the time, I decided to pass on continuing the Perjeta and just took the Herceptin alone for the rest of the year.

If I had to guess, I'd say I was offered the continuing Perjeta a) because this was already a recurrence; b) because I didn't have a pCR; and c) because I was hormone negative so there were no other treatment options (except Rads, which I did have).

Good luck Kattis.

Kattis - I can't answer you exact question because I was ER/PR negative. But the HER2+ treatments are interesting. I had 6 rounds of neo-adjuvant TCHP without a pCR. I don't remember the dimensions after the TCHP. So after surgery - supposedly with clear margins - the MO scheduled me for 4 rounds of Adriamycin/Cytoxan. You can't take Adriamycin and Herceptin at the same time due to heart risks, so I started the Herceptin back up once the 2nd chemo was finished. And then rads. I have been NED for 3 years now.

Being hormone positive, you're able to have anti-Hormone treatments. Hope everything works well for you.

Hi Kattis:

I'm triple pos. I don't know if I had a complete response to chemo or not because I had adjuvant therapy (there was a mistake in my initial pathology report so I didn't get to do neoadjuvant even though I would have qualified). I did, however, read a lot about the frequent lack of complete response to chemo for triple positive. I was upset and brought this up with my onc. She said not to worry because with hormonal therapy we will likely end up in a similar spot as those who had a complete response to chemo (generally the ER-/PR- group, as others have mentioned. ) I'm choosing to believe her so that I don't lose my mind. I wish you peace. Take care.

chocomousse, I believe that statistic that you give is dated (and/or reflects those who do not undergo treatment) There is better news reflected in more recent research results of those treated with herceptin and chemo There is at least one, if not more women, on these boards who participated in that clinical trial with dramatically improved outcomes. I'm grateful to the brave women who paved the way for the rest of us. Check out the NEJM article:

http://www.nejm.org/doi/full/10.1056/NEJMoa1406281#t=article

I am 75 years old. I have Her2 positive did anyone not do treatment