her2+3.8/er-/pr- Oncologists wants to use Lupren

I thought that was only for er/pr+ as estrogen was feeding the cancer.

I would ask them why.

Jan

Well, Josie and ladies, I've been giving your question some thought and can offer my understanding for what it is worth, with the caveat that, truly, only you and your personal doctor can fully discuss the issue and decide together on the best course.

Lupron and Zoladex are both drugs which induce a medical menopausal state by ovarian suppression. The value of a medically-induced menopause state is almost exclusively in pre-menopausal, and perhaps some peri-menopausal "hormone-dependent breast cancers". These are breast cancers which demonstrate receptors for estrogen (ER+) or progesterone (PR+). My understanding is that even in a hormonally-sensitive cancer being ovarian suppressed, the impact and results of doing so are still being actively evaluated, although most feel the results will be favorable.

Regrettably, Lupron is not effective in similarly suppressing ER-/PR- breast cancer, which by definition, is minimally sensitive to estrogen. One might think there would be value of ovarian suppression in woman with pre-menopausal breast cancer, to interrupt the monthly brain-ovary hormonal interchange, since the breasts develop in puberty in response to the onset of this messaging. But this has not found to be so in hormonal insensitive breast cancers, simply because they do not have the receptors for estrogen or progesterone, which then evoke a series of events within the breast cancer cell itself. There is also no evidence that our brain is sensitive to endocrine therapy if our primary breast cancer is not, as suggested by ER-/PR- status. Lastly, HER2 is, as you already know, treated with chemotherapy and Herceptin and at times, newer drugs, but not hormone suppression.

I hope this has not confused you, putting you in an awkward place within your mind and your doctor. A discussion about this with he or she seems warranted. If that doesn't resolve the issue, then a second opinion might be wise.

One important point: while the resumption of your menses is indeed most likely due to re-awakening of your ovary-brain communication which was apparently temporarily suppressed by the chemotherapy, it would be good to see your Gynecologist and review the issue with him or her. Perhaps a uterine polyp or ovarian cyst has developed which needs attention, and pregnancy always needs to be considered in appropriate circumstances. I don't say this to increase your anxiety, but to remind us all that we need to not "assume" in this business of breast cancer, so as to help keep ourselves out of a potentially unpleasant additional situation.

I hope this helps,

Tender