HER2+, HR +, Stage I

Mtn - I'm surprised that your doc is not recommending neo-adjuvant chemo since you are HER2+. That does make a difference. Perhaps that's based on the strength level of your HER2 tests?? Also it was my understanding that Herceptin works best when it is combined for a "kick-start" with Taxotere or Taxol. I started chemo at 70, and that wasn't a problem. You don't say where you are located, but it might be a good idea to get a second opinion.

Seconding Elaine about the port. I loved my port and kept it for 4 years with no problems.

rainne - SInce you are HER2+,yes that does involve chemo - and usually before any more surgery. Have you talked to an oncologist? Once it's determined you need chemo, that is the doc that drives the bus. Well, good luck tomorrow. Hope all goes well.

MtnHiker, my chemo (I was 63 at the time--now that seems young!) wasn't that difficult and I had my port in for one year and then Had it ripped out (so to speak) 3 days after my last chemo. No, I did not consult my oncologist about it--I didn't know that was in his purview! He was a little surprised! If it were me, I'd be more comfortable with a study that lasted longer then 3 years but then again, treatment has changed since I went thru it in 2009. Good luck.

I've included a link for an editorial, "Are We RESPECTing Older Patients With Breast Cancer?" ,in the American Society of Clinical Oncology (ASCO) Journal. ASCO is highly regarded. There is really good information in this editorial. This is from the summary:

"To conclude, on the basis of the results of the RESPECT trial, it is possible to consider that adjuvant trastuzumab monotherapy could be an option for a subset of patients, particularly those who may have a higher risk of toxicity with chemotherapy and those with a lower anatomic risk of disease recurrence (stages I or IIA). It is important to stress, however, that the choice of therapy in older patients should never be made on the basis of age alone. Comprehensive geriatric assessment is the standard of care for evaluation before chemotherapy and should generate a care plan to be implemented during treatment to minimize the risk of complications and maintain QoL and functionality."

MtnHiker your pathology is similar to mine IDC, Stage 1b, small screen detected tumor, 0 nodes, margins clear. I may be older than you (I am 68) and I have done 2 rounds of Kadcyla so far. This second one was rough. I live alone and usually am tough as nails but feeling so bad, no appetite, losing weight fast, etc. has been scary. I posed that question of Herceptin only and was told there is no data for that?

Honestly, quality of life and functioning is important to me. I saw a University based oncologist for a 2nd opinion who I love but that infusion center is too far away. If peripheral neuropathy or heart failure becomes an issue , I will stop chemo. Sometimes I think oncologists treat the diagnosis and not the patient. I want to hear more about equal statistics in older women having to bear the toxic effects of chemo heading into the 70's vs. perhaps whole breast radiation and aromatase inhibitors as the plan if you cannot tolerate chemo. I would love to hear if others have done just Herceptin (which can also cause changes in cardiac echo) for HER2+ and how you have done? Such a risk/benefit to all of this for each modality, when older.

Wow, you give me some hope that "older" ladies survive this chemo journey. I hope you have been doing well!! Thank you.

I am 32 and had an awful time with chemo and quit early. If I had a recurrence I would never do chemo again, so for sure at age 70 it would be a H e double hockey sticks NO..

I am young and have had lingering chemo effects to this day! I couldn't imagine being 77 and dealing with after effects, etc, after 7 years like I am now. I want to be on a boat or cruising my RV and go out with a bang.