HER2 Positive 2+

I just found out I was HER2 positive today.  I am being treated at Sloan.  My medical oncologist (on the phone today - my appointment is not until March but I was inquiring about my pathology since surgery was done at another hospital and Sloan did not have the results when I had my last appointment) said that for me the side effects of Herceptin would outweigh the benefits for me.  I was 3mm part DCIS part invasive - biopsy removed entire invasive portion, lumpectomy removed the DCIS.  Clear margins and sentinel node negative.  Am curently having radiation and am very concerned now that I know my HER2 status.  I am low ER/PR but they are re-doing the test at Sloan using my slides.  

HI ladies!  Just thought I'd chime in since I'm Her2+ also.  As far as I know, herceptin is only given with chemo (though I've read some anecdotes that there are places starting to do it without, but I don't know where they are). 

Use of chemo depends on the size of your tumor (usually used if >1cm), and if nodes are involved (usually used if pos. nodes, though some neg. node cases can get it too... read on). 

ER/PR status determines whether use of drugs like tamoxifen will be helpful in using against recurrence.  In your case, Jaydee.. you could benefit from their use.

By "slow growing", I assume you mean the grade of your cancer must be low, like a 1 or 2.  This is how much your cancer cells look like normal cells (one-- it's pretty close, 3--- nothing at all they are some "crazed" cells!).  As I understand it, chemo use looks mostly at tumor size and node involvement, not grading.

But as we know every case of BC is individual.  Here's my story as an example:

I am er/pr negative (so use of hormones will not help me for lowering recurrence risk).  My cancer was 4mm with DCIS surrounding it.  All IDC was removed with lumpectomy, DCIS with mastectomy.  Nodes were negative with SNB.  So, I shouldn't have needed chemo, which meant no herceptin, too.  A second opinion/look by UPenn's pathology lab found some additional IDC areas of 1-2mm each, all in my original lump-- so then they said I had "mutlifocal IDC" in the DCIS.  At first I was told since nodes negative and 4mm area only of cancer... chemo would be greater risk than benefit, so I would not be doing it.  Then, when determined I actually had multifocal IDC, and therefore a larger area of cancer but one that they couldn't exactly quantify now... chemo would be a much more prudent choice since I was HER2+ and thus had a higher risk of recurrence.  If chemo was going to be done, then herceptin would be part of it.  I am currently halfway through chemo with concurrent herceptin infusions.  Herceptin will continue by itself after chemo for a full year.  They also took into account that am 37. Being young with an aggressive cancer type (HER2+ and grade 3), they felt it was best to hit it now with everything and avoid recurrence in the future.  Even though my SNB was negative.. you never know if one little cancer cell got through.

So, I'd say, ask questions and maybe get another opinion or another pathologist to verify the original dx and typing.  But remember, you still have the benefit of tamoxifen or other similar drugs (see Jenn Z above) to help you out if you don't get chemo/herceptin.

My mom had DCIS left breast with .5mm of invasive cancer.  She is Her2+++, no node involvement, mastectomy, clear margins.  That was in 2004.  At that time they didn't give Herceptin to people who were node negative, so because of being her2 the tumor board decided she should do chemo, she did 4 rounds A/C.  In Sept 2007, she was dx with Stage IV mets to liver and bones.  She is now on Herceptin/Taxol/Zometa, she is doing very well....cancer has done a dramatic turn around and she only has a few spots left to go and she will be NED.

I would definitely pressure someone into giving you Herceptin, if you are Her2++.  I wish they had given it to my mom.

Take Care,

Michelle

Hi ladies,

I am currently taking Herceptin along with Taxol weekly and will continue with herceptin for a total of one year.  My tumors were 2 cm and under but grade three aggressive.  I was told by my oncologist that Herceptin is now given in early stage BC ( I was stage one, no nodes) in hopes of preventing recurrence.  I had a bilat. mastectomy with clear margins so my understanding was that it was stricly a preventive measure to take Herceptin.  I have had no side effects at all with it.  Hope this helps but as I am noticing, there are so many different cases out there and every doctor has their reasons for prescribing different protocols.  Suz

Hello,am new to the community .I was diagnosed in may06,aged 44,infiltrating lobular breast cancer,2 1/2 cm lump,grade 3,(aggressive nasty pasty tumor)er/pr+,her2+3, node negative,was so lucky that node negative and it was caught early,had WLE, fec chemo and radiotherapy,was about to have herceptin to reduce the risk of recurrence but muga scan showed the risk to heart problems was greater than having the herceptin,so could not have it,am currently on tamoxifen and am N.E.D..almost 2 years from diagnosis....Am fine and doing well,sending my best wishes to everyone ,Pepper.

My mom is Her2++ but they won't give her Herceptin because she is fish Neg. Does anyone know what this means? We have been told Herceptin woudn't do her any good because she is fish neg.

Sorry--I should have added that I had a lumpectomy and 30 rads.  I am supposed to start Tamoxifen, but I am being a bit of a stubborn girl so far.

Krista

ejohn,



The FISH test stands for Fluorescence In Situ Hybridization. It measures the amount of amplification of the Her2 gene in breast cancer cells. When the first Her2 test is done - and results come back equivocal (ex: 2+) it gets sent out for FISH testing. That is a more detailed and precise test that tells whether the breast cancer cells show "amplification" or "non-amplification of the Her2 gene." See the website below to read more about this.



From my own experience, I would ask the oncologist to have the test done again. 2++ is questionable for Her2 negative. I am not a doctor, nor a medical professional - but have had tests recently that have had conflicting results. One of them is my current Her2 test. Unfortunately, mistakes get made.



http://breastcancer.about.com/od/diagnosis/p/her2_diagnosis.htm



Best of luck to your mom.