6mm IDC Grade 2 ER- HER2+ 1/3 nodes - Advice please!

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JRC46
JRC46 Member Posts: 3
edited October 2019 in DCIS plus HER2-positive Microinvasion

Hello

I am posting on behalf of my mother to try and find out some more information for her to help determine next steps.

She is late 50's and was initially diagnosed with DCIS 6 months ago, from some calcium deposits on a routine mammogram. She had two local excision's which were unsuccessful.

The supporting report showed 6mm invasive ductal carcinoma, grade 2, ER negative, HER2 positive.

She has recently had a mastectomy with immediate reconstruction, but is now being told that Herceptin and Chemotherapy are recommended next steps.

I guess my questions are:

- Firstly, can anyone relate with a similar timeline of events/diagnosis?

- Are Herceptin/Chemotherapy the usual route with HER2+ at this stage, regardless of the 1/3 node and 6mm?

- Is the prognosis good? I'm trying to find some positives to take from this as from the initial DCIS diagnosis it seems to have got a lot more serious very quickly!

Also, if someone is able to explain the ER negative to me, and how this impacts/changes anything by being negative rather than positive, that would be great.


Many thanks in advance

J

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited March 2018

    Hi!

    It is not unusual for someone with DCIS to later be found to have some IDC. Yes, for any HER2+ tumor that is > than 5 mm, standard treatment would be Taxol + Herceptin, regardless of node status. HER2+ cancer is aggressive, but the discovery of Herceptin has meant that HER2+ breast cancer patients now have a very good prognosis. The survival rate for someone with your Mom's statistics would be 90+% in five years.

    If your Mom tested negative for ER, then estrogen is not encouraging the development of her cancer. That means that she is unlikely to be prescribed Tamoxifen or an aromatase inhibitor, which help deprive cancer of the estrogen that feeds it. It means she has fewer options, but it also means that she won't have to take a med that not everyone tolerates well. ((Hugs))

    Hope this helps!

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  • Peacetoallcuzweneedit
    Peacetoallcuzweneedit Member Posts: 233
    edited March 2018

    JRC - I think it is wonderful you are supporting your mom...

    1) the time line question....I am not sure if initial biopsy showed the DCIS and then post surgery was the invasive component?? BUT I will say - it is not out of the ordinary for diagnoses to change once a final pathology is returned....mine did...from Stage 0 to Stage 1.

    2) HER2+ are usually more aggressive cancers, and the 6mm, while small is larger vs a microinvasive definition, which is typically no more than any invasive component measuring more than 1mm. Herceptin is normal for HER2+ cancers...and I am hoping more ladies experiencing that treatment will come by and chime in because I have no experience with Herceptin. Search in the upper left about Herceptin...also if you are in the forum I think you are - go through some of the back and forth history...

    3) ER and PR positive and negative have to do with the cancer cells and if they are strongly responsive/fueled by either Estrogen or Progesterone - many treatments for breast cancer have to do with blocking the hormone's ability to fuel the cancer cell and therefore it dies....called hormone therapies. The percentages are expressed from 0-100 and are just that...0% - 100%, the lesser the number the lesser the response to hormone therapies and therefore would need a systemic treatment like chemo to just kill all cancer cells...

    There is no reason to think that your mom is not going to be ok J - keep asking your questions... other ladies will hopefully add more information and their experiences as well...sending a hug for you and your mom....

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  • bluepearl
    bluepearl Member Posts: 961
    edited March 2018

    Chemo works very well on hormone negative. Given the small tumour etc. her prognosis is quite good...even if it is hormone negative a Her2+. Glad it was caught early too!

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  • Daisy16
    Daisy16 Member Posts: 16
    edited April 2018

    hi , I was the same , my Tumor was 50mm and found after double mastectomy and recon . The great news is I'm now 3 and a half years on and fit and well ! I was 47 at diagnosis. I'm sure your mum will do well . Lots of love ❤️ xxx

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  • JRC46
    JRC46 Member Posts: 3
    edited April 2018

    Many thanks all for your replies, they have been most helpful and informative.

    Peacetoall... yes correct. Initial biopsy was DCIS and then post second local excision surgery the 6mm invasive was identified, as was Her2+. They advised to go ahead with a mastectomy due to 6mm size, and said that she was on the boarderline as to whether treatment would be required. Thanks - I will have a search to find out more about Herceptin.

    Daisy16... Great to hear from someone who had a similar diagnosis, and great news that you are now fit and well! We are also located in the UK.

    I see you all have "Stages" identified in your info... I assumed stage and grade were the same thing. I can't see stage mentioned anywhere on any of her paperwork, just that it is Grade 2...

    She is due to start treatment in a couple of weeks and is going to try the cold cap. Any advice/tips regarding treatment? She is keeping positive, active and eating healthy, plenty of iron rich foods etc!

    Thanks again!

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  • Sassa
    Sassa Member Posts: 1,588
    edited April 2018

    I was diagnosed with stage 1, ER negative, HER2+, grade 3 IDC (no nodes) in 2006.


    Chemo and herceptin are life savers for us ER-, HER2+ women. It is very effective and your mother most likely will have a long time in remission (hopefully a permanent remission).

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  • Pinkpinkturk
    Pinkpinkturk Member Posts: 18
    edited October 2019

    image

    'Hello sisters

    I am stage1 a ( feb.14 2017 Mastectomy)

    I am 39.

    My tumor was 6 mm invasive and 1,5 cm dcis

    MMargin And node negative

    Dosedense chemo ( 4 Ac+4 Tchp)

    Er 30 % , pr 40 %

    Now exemastene and zoladex.

    I Prayers for you.

    Is there any recurence ?

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited October 2019

    JRC: Yes, after original DCIS diagnosis, surgery often finds IDC. Once that happens, it is no longer referred to as DCIS. Sounds like your Mom is on a good treatment path. Below is a link about preparing for chemo. Also there are threads usually every month or every quarter on this site for people going through chemo. It was very helpful for me to communicate with others who were in the same place or had been recently. Look in the "active" posts for Chemo September 2019 or October chemo.

    https://community.breastcancer.org/forum/69/topics...


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