I had a lump in my right breast and the biopsy showed a "marginally HER2+ tumor" which was 2.1 cm in size. After the diagnosis I was started on a 6 dose program of TCHP at 3 week intervals as an adjuvant approach after which I would have surgery and then radiation and Herceptin for a year. Due to concern about the first biopsy, a second was done by a different lab and the result was NOT HER2+. I had had only one treatment of TCHP which they stopped and then gave me ONE treatment of Taxotere only and I then had surgery 3 weeks later during which the tumor was removed along with 6 sentinel lymph nodes.
The results of the surgery was amazing! The tumor had shrunk to only .3 cm (3 mm) and showed no HER2+ results in biopsy, the margins were clean and none of the lymph nodes showed any cancer.
This was considered great news but it also caused a great deal of confusion for the oncologists. Their conclusion was that it MUST have been at least partially HER2+ in order to have responded so well to the treatment and their future treatment would reflect that with 2 more treatments of Taxotere, 3 week apart and then 5 weeks of daily radiation concurrent with Herceptin treatments to last 12 months.
I am concerned with the 12 months of Herceptin.
First, with 3 biopsies, 2 of which were HER2 negative and one only "marginally" positive yet they proceed as if it were HER2+.
Second, I was given only ONE treatment of Herceptin AND Perjetta. What are the statistical chances that a "marginally HER2+" tumor could have virtually disappeared with just ONE treatment?
There is a history of heart failure in my family and I understand that Herceptin can cause heart problems. Is the risk worth the slim possibility that Herceptin is needed here? And on top of that, the ONE treatment included Perjeta and IF one treatment did do the trick, why isn't Perjeta given equal credit?
Thank you for your help.
Kathleen
Reply # - June 21, 2015, 11:13 AM
Hi Kathleen and welcome to
Hi Kathleen and welcome to Grace. I'm so sorry about the confusion on top of the diagnosis. I will make sure your questions get answered though it will most likely be tomorrow before we hear from our faculty. I will just say that cancer can and will do anything. If you know much about cancer you've probably heard someone say that there are as many different types of cancer as there are number of people with cancer; so yes anything is possible. I hope you have pretty smooth sailing once your questions are answered and you have a plan that makes sense.
Best of luck and hopes,
Janine
Reply # - June 22, 2015, 08:30 AM
Dear Kathleen,
Dear Kathleen,
There are many considerations. Some tumors can be "mixed" with some areas being HER2-positive, other areas less positive and some areas negative. It's difficult to know what you mean by marginally positive. Also, some tumors that are HER2-negative, particularly those that are also ER-negative can have a rapid response to chemotherapy as yours appears to have done. And when tumors have a rapid response and multiple drugs have been given it's impossible to say what did the trick. Also, sometimes imaging overestimates the size of the initial tumor. I think you need to have a formal second opinion in which the consulting physician reviews all of your imaging and pathology and makes a recommendation based on that review as well as your personal health history.
Dr. Cianfrocca
Reply # - June 22, 2015, 09:19 AM
Thank you so much Dr.
Thank you so much Dr. Cianfrocca. I am going to schedule a consultation with a Dr. at Dana Farber in Boston where I had the surgery done. That is where I obtained a second opinion on the initial diagnosis which was done at my local hospital in CT. Thank you for your insight and help. I will let you know what comes out of this visit.
Sincerely, Kathleen