Her2++ breast cancer mets in colon?

jackiemm · August 2021

I'm wondering if anyone has had HER2+ cancer spread to their colon? Was it found through colonoscopy? How did they determine that it was breast cancer mets rather than primary colon cancer? I am a 13-year cancer survivor who just had a colonoscopy where large (over 3 cm and probably cancerous) polyps were found. I am interested in hearing the experiences of anyone who has had something similar. Thanks for any info you share!!

exbrnxgrl · August 2021

Jackie,

Colon mets are uncommon with breast cancer, HER2+ or otherwise. I can’t think of anyone off the top of my head who has colon mets but I hope someone who has experience with this pops in soon. Take care.

jackiemm · August 2021

Thank you, exbrnxgrl! My research told me it was extremely rare, although more and more articles are being published about it. I am the unfortunate person who always has the rare response/rxn/condition in any situation. I'm waiting for the biopsy results, but the gross examination of the polyps at the time of colonoscopy are consistent with pre-cancerous and cancerous growths. I guess we'll see.... Thank you, again!

ShetlandPony · August 2021

I’ve only heard of colon mets from ILC, which is usually ER positive and Her2 negative. I suppose you are waiting for a pathology report. I hope you have a short wait and a reassuring report!

RebzAmy · August 2021

jackiemm - maybe this is a new primary, and it might be that it's better if it is. I've never heard of anybody have mets to their colon from HER2+ breast cancer. They'll be able to tell from the biopsy whether it's a primary or a secondary. When are you expecting the results?

jackiemm · August 2021

Thanks. Yes, expecting patho report early part of next week. Just impatient and looking at all possibilities.

jackiemm · August 2021

So, colonoscopy revealed 3 polyps: tubular adenoma 2 mm, in cecum; sessile serrated lesion 8mm, in ascending colon; and a giant 3 cm pedunculated villotubular adenoma in the sigmoid colon. The last was resected and margins were free of adenoma. The final report was that the cancer was a second cancer, not breast mets - and that this is becoming more prevalent among women with HER2++ cancer. After conferring with my oncologist and surgeon, no further surgery or treatment will be necessary. The future now holds a colonoscopy every other year - and the worry that second cancers may crop up.

ShetlandPony · August 2021

Jackie, thank you for letting us know the outcome. Many people never do. I'm glad to hear it because as yucky as it is to have to deal with this, it is so much better than mets!

I'm so curious about the doctor's comment that "this is becoming more prevalent among women with HER2++ cancer." Did he mean that people with Her2 positive bc have a higher incidence of colon cancer? Because of their biology or because of Her2 therapies? Or maybe they are just living long enough to get this very common cancer, now that herceptin etc. are available?

Now that you have had two kinds of cancer, will your oncologist be recommending genetic counseling and possible testing? It may be there is extra screening or prevention available if genetic testing shows you are at higher risk for certain cancers.

Anonymous · August 2021

great questions, SP. Would love to know this info myself. I’m about to get my first colonoscopy real soon

ShetlandPony · August 2021

Olma, I am supposed to but I just can't bring myself to do it.

Anonymous · August 2021

I can relate. They were trying to get me to do it when I first was being diagnosed - I was already 59. I said let me see if I don't die first, okay? Then once I was in treatment, I have felt like I'm being poked and prodded enough and why wouldn't my PET scan detect any colon cancer?

But...my onc has been insisting I see a gastroenterologist because my iron was low with no known reason. Apparently in post menopausal women the suspected cause would be gastric bleeding. And of course, the first thing the gastroenterologist wants is the colonoscopy. So here I go....

Incidentally my sister recently had hers and did have what they termed “pre cancerous" polyps removed

And my iron is now normal after taking prescribed tablets

ShetlandPony · August 2021

I have a freaking Lynch mutation (elevated colon cancer risk), but I just don't want to deal with any more "procedures" and I can't imagine doing the prep with the big D from my treatment meds. I'm sure you are being smarter than I.

jackiemm · August 2021

ShetlandPony, Good questions, all.

The surgeon who did my colonoscopy is the same one who has done numerous ERCPs in the past on me due to a pancreatic abnormality and frequent pancreatitis. The concern was perhaps pancreatic cancer. My paternal grandmother died from cancer in her gall bladder and pancreas.

After the colonoscopy, I met with my oncology surgeon for my regular BC follow up, and he was the one who mentioned the correlation between HER2+ BC and Secondary Colon Cancer. He mentioned several recent studies, so I did some research where I found several articles on this topic.

I was also referred back to my oncologist/hematologist who had an opening 6 weeks away - so it's a waiting game, now. I intend to ask about genetic testing and Lynch's. Worrying about BC mets is one thing, but now I'm also watching for pancreatic cancer and colon cancer, too. Hope the genetic testing might provide some answers. August has been an exhausting month!

ShetlandPony · August 2021

Jackie, the official NCCN statement at this time is that there is insufficient evidence to say that breast cancer is a Lynch cancer. BUT, there is definitely some data that shows it could be, and some top cancer genetics docs who believe breast cancer should be on the list for Lynch cancers, especially PMS2 and MSH6 mutations. I firmly believe this will eventually be considered proven. I agree with you that with breast, pancreatic, and colon in the same branch of the family, they should test for Lynch genes. The good thing is that if one is found there are screening and prevention steps that can be taken. (Even if someone like me doesn't take them all because she is too busy dealing with bc! I have relatives which the Lynch mutation who do not have a cancer diagnosis and are doing all that is recommended.)

Investigating the Link Between Lynch Syndrome and Breast Cancer

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138356/

MSH6 and PMS2 germ-line pathogenic variants implicated in Lynch syndrome are associated with breast cancer

https://www.nature.com/articles/gim2017254

I'm still confused about what you are relating about what your doctor said, because the word "secondary" is used (especially in the UK) to refer to mets. Are you talking about an association between primary Her2+ breast cancer and primary colon cancer, or primary Her2+ breast cancer and breast cancer mets to the colon?

jackiemm · August 2021

ShetlandPony,

So, I should have been clearer - it was a SECOND primary cancer and not bc mets. My doctor was clear that this was not directly related to breast cancer, but that recent studies were beginning to show a correlation.

Thank you for the links on Lynch Syndrome. I had not heard of it (and the doctors have not mentioned it) until I began researching the possibility of breast cancer mets to the colon. I'm definitely going to ask more questions of my oncologist.

ShetlandPony · August 2021

Thank you for the clarification, jackie.

Her2++ breast cancer mets in colon?

Comments

Categories