85 y.o. Her2 pos

farmerlucy - good to see you, sorry for the reason. And yay for the 10 years! Can you clarify the size of the ILC portion? Is it 2mm, or .2mm? Anything under 5mm is up for grabs as far as how to treat with a Her2+ tumor - some oncologists might opt for more aggressive treatment than others, but particularly for an 85 year old, careful thought should be a consideration. NCCN guidelines indicate systemic treatment should be considered, but it is not an automatic. Grade is low for a Her2+ mass, it may have been driven more by the hormonal aspect, as grade in Her2+ tumors is usually higher. As far as the Her2 being 3+, that is the test scoring method that indicates positivity - anything less is equivocal or negative. Here is the info from BCO explaining:

"IHC test (ImmunoHistoChemistry): The IHC test uses a chemical dye to stain the HER2 proteins. The IHC gives a score of 0 to 3+ that measures the amount of HER2 proteins on the surface of cells in a breast cancer tissue sample. If the score is 0 to 1+, it's considered HER2-negative. If the score is 2+, it's considered borderline. A score of 3+ is considered HER2-positive. If the IHC test results are borderline, it's likely that a FISH test will be done on a sample of the cancer tissue to determine if the cancer is HER2-positive."

It appears that the plan includes Herceptin, but not chemo. There should still be an echocardiogram done prior to starting to determine cardiac health, especially in light of her age. Additionally, she should have a current Dexa scan before starting an AI to see what the condition of bone density is. The AI can cause some issues with arthralgia and bone density loss, but Tamoxifen might be a possibility as it can build bone in postmenopausal women as long as there is no clot risk in her medical history.

Wishing you both the best!

Hey, FarmerLucy,

I’m so sorry to read this about your stepmom. I hope whatever RX she lands on is kind to her.

I hardly am on bco anymore after they started advertising and showing our posts. I thought I would check in and see how people are doing.

Herceptin is much kinder than the Herceptin/Perjeta mix for > stages.

I hope she does well.

The thing about tamoxifen is the accumulating data, and trials investigating, that it may not work well against ILC, compared to an aromatase inhibitor.