Newly Diagnosed, Ultrasound Question, Looking for Hope

Hi whippetiggy:

I am sorry to hear of your recent diagnosis. I am wondering if you have your HER2 test results back yet? If you were HER2 negative (HER2-), then with ER- PR-, that would be triple-negative disease. On the other hand, if the HER2 test result was positive, it would be HER2+ disease (ER- PR- HER2+).

Sorry in advance if you already know all this, but just in case, please note the following. For either triple-negative disease or HER2+ disease, with a tumor ~ 2.2 cm in size and lymph node involvement, you are a possible candidate for systemic drug treatment prior to surgery, known as "neoadjuvant" (preoperative) therapy (either chemotherapy prior to surgery for "triple-negative" disease OR chemotherapy plus HER2-targeted therapy for HER2+ disease).

In the appropriate case, for those with extensive disease, shrinkage of the tumor may permit the option of lumpectomy plus radiation in lieu of mastectomy. Neoadjuvant treatment may also reduce disease burden in the lymph nodes, sometimes enabling less extensive axillary treatment (please confirm this).

Another potential advantage of neoadjuvant treatment is that it can provide information about "pathological response", meaning they can monitor during treatment and at later surgical removal, if the tumor responds / responded to the chemotherapy regimen (shrinks or disappears completely (i.e., "pathological complete response")). If the response is not adequate, this information allows a switch to a different regimen.

In the case of HER2+ disease, with neoadjuvant treatment, there is better access to and more likely insurance approval for pertuzumab (Perjeta) in addition to trastuzumab (Herceptin), and receipt of both HER2-targeted therapies may be beneficial (if indicated).

If you have not already consulted with a Medical Oncologist, please request a referral as soon as possible for an appointment (prior to surgery) to obtain expert advice about the option of neoadjuvant therapy, to ensure you have an opportunity to make an informed decision about this important option.

Best,

BarredOwl

I had stage 2 with a positive node. Surgery was 1 year, 8 months ago and I'm doing fine.

Best of luck!

Ypu are in the most challenging mental phase now. The waiting. Whether you do chemo before or after surgery, be sure to hop over to the chemotherapy board and find the group for the month you're starting. Those gals allowed me to plow through chemo and vent when needed to people who understood. I am still close with my chemo groups and am actually meeting a few gals in Vegas in 2 weeks to run a half marathon (my profile picture is from last year's half when we met in Vegas). It does not seem like it now, but there IS life after cancer treatment.

You CAN do this. If you have questions, pleas ask

I'm over two years into my recovery. I had chemo first, so staging accurately was more difficult but I was either stage 2 or 3 and had one positive node. You can get through this!

whippetiggy, that's great. You really can get through this.

Hi whippetiggy:

Good and good luck at your appointment on Tuesday morning. I am a good note taker, so I took handwritten notes at appointments. Others request permission to record the appointment on their cell phone.

BarredOwl