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All TopicsForum: HER2/neu Positive Breast Cancer → Topic: How do You know what is Your chance of recurrence??

Topic: How do You know what is Your chance of recurrence??

Forum: HER2/neu Positive Breast Cancer — Testing, Herceptin (trastuzumab) treatment, side effects, and more.

Posted on: Jul 17, 2009 11:07PM

sylwiamolik wrote:

Hello Ladies,

I'm curious about it. How do You know what will be Your recurrence chance with treatment or without it? 

I'm writing to you from Poland, Europe. In our country we dont have such a big breast cancer internet message boards so i decided to sign up here :)

I was diagnosed with <1 cm IDC, negative nodes (0/15), grade 2, HER2+, ER-, PR-

My onc said that i'm going to have 4x AT chemotherapy (doxorubicin+ docetaxel) and after that, 1 year of herceptin treatment.

I see most of You know the percentage chance of reccurence, but personally i have no clue how to measure it:( Please help me! 

THANKS, WISH YOU THE BEST AND SORRY FOR MY ENGLISH :)

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Posts 1 - 14 (14 total)

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Jul 17, 2009 11:34PM, edited Jul 17, 2009 11:37PM by lexislove

Dobre dan!!

Going by your stats..you have a low..low chance of recurrence. The Herceptin will be key for you! I did the same chemo as you too, and that is one strong regime. Usually your onc can go on a program adjuvantonline.com or you can too and put in your info and the computer will come up with a percent.

But really...everything is a crapshoot.You either will recur or wont.

Hope this helps!

Oh ya..adjuvantonline says you have to be a doctor to sighn in ect...just make up a name we all do it...ha!

Dx:2007, 2B, Triple+, June 2008:Lupron,Zometa,Tamox.Jan 2010:Poor metabolizer of Tamox switch to Femara.Feb 2010: cyp2d6 test reliable? Back to Tamox. Ooph soon.

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Jul 18, 2009 08:53AM sylwiamolik wrote:

Dzień dobry Lexislove for You tooLaughing

And thank You so much for Your replySmile  You're right, most of us spent many sleepless nights searching the net for info, collecting medical data or at least thinking of what it will be in the future, so we can say that we're almost an unwritten doctors Wink So this adjuvantonline software is dedicated for us!  :) 

Wish You the best, we must fight these ugly bugs from our bodies, no other choice :))

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Jul 18, 2009 09:50AM lexislove wrote:

Yes, check out that site. I'm sure you will be just fine.

Be well!! Smile

Dx:2007, 2B, Triple+, June 2008:Lupron,Zometa,Tamox.Jan 2010:Poor metabolizer of Tamox switch to Femara.Feb 2010: cyp2d6 test reliable? Back to Tamox. Ooph soon.

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Jul 18, 2009 01:15PM Sassa wrote:

Be careful with the percentages with adjunctonline.  Unless the site has been updated, there is no allowance for the use of herceptin in HER2+ BC.  Herceptin is a huge factor in cutting recurrence risks.

Dx 11/6/2006, IDC, 1cm, Stage I, Grade 3, 0/9 nodes, ER-/PR-, HER2+
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Jul 18, 2009 04:01PM lexislove wrote:

Thanks Sassa..

I forgot to mention that Herceptin is not included in adjuvantonline yet...hurry up!!!

Dx:2007, 2B, Triple+, June 2008:Lupron,Zometa,Tamox.Jan 2010:Poor metabolizer of Tamox switch to Femara.Feb 2010: cyp2d6 test reliable? Back to Tamox. Ooph soon.

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Jul 18, 2009 07:04PM bluedasher wrote:

Sylwiamolik, I'm sorry you have to deal with this but I'm glad you found us. Don't worry about your English, it is much better than my Polish. We have some other women from Europe here and some from Asia. We are all in this together

The problem with Adjuvantonline is that it doesn't take into account HER2 status as Sassa has pointed out. Being HER2+ really increases our chance of recurrence without chemo. In December of 2008, two retrospective studies released recurrence statistics for women with tumors less than 1 cm who didn't get chemo and the recurrence is much higher when the tumor is HER2+. When the tumor was HER2+, the 5-year disease free survival was 77% so recurrence was about 23%. Distant recurrence (mets) was about 14%. I'd call that pretty high making chemo a good choice. (For HER2- tumors, those numbers were about 7% and 3% respectively.)

Link to the poster with the MD Anderson study data

On the other hand, I don't think a therapy that includes Adriamycin (doxorubicin) is good for small HER2+ tumors. Adriamycin and other anthracyclines have too much heart risk. About 2% of the women who get a therapy with it can't get Herceptin after because the anthracyline has lowered there LVEF (left ventrical ejection fraction) too much. TCH therapy (Taxotere, Carboplatin and Herceptin) has been show to be about as effective at reducing recurrence and it has lower side effects and lower long term risk - especially less risk to the heart. TCH was studied in the BCIRG 006 study along with AC-TH and AC-T therapy. You can find a slide set on this at:

http://www.bcirg.org/Internet/Studies/BCIRG+006.htm 
scroll down to where it says: 2nd analysis presented at SABCS 2006

The whole world is a narrow bridge and the main thing is to not fear.

Dx 9/2008, IDC, <1cm, Stage Ib, Grade 2, 0/5 nodes, ER-/PR-, HER2+
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Jul 18, 2009 07:09PM bluedasher wrote:

lexislove, adjuvantonline doesn't even include HER2 status - it has a box to indicate ER positive or negative but not one for HER2 so it produces very misleading results.

The whole world is a narrow bridge and the main thing is to not fear.

Dx 9/2008, IDC, <1cm, Stage Ib, Grade 2, 0/5 nodes, ER-/PR-, HER2+
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Jul 18, 2009 07:27PM lexislove wrote:

I thought that it ASKS for Her2 status but it doesn't factor in herceptin tx? I haven't been on it in over a year...lol.

My Polish friend...you either will 100% recur or 100% won't. There is no crystal ball.Now how about some Pieroski recipes...Kiss

Dx:2007, 2B, Triple+, June 2008:Lupron,Zometa,Tamox.Jan 2010:Poor metabolizer of Tamox switch to Femara.Feb 2010: cyp2d6 test reliable? Back to Tamox. Ooph soon.

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Jul 18, 2009 10:51PM bluedasher wrote:

I forgot to put the good news in the post above. The BCIRG 006 interim results above show disease 4-year free survival (DFS) for node negative HER2+ at 93% with TCH chemo. I think the study required tumor size over 1 cm so this was for women with larger tumors than us. While the chance of recurrence without chemo is rather high, with chemo and Herceptin bring it down quite a lot.

The whole world is a narrow bridge and the main thing is to not fear.

Dx 9/2008, IDC, <1cm, Stage Ib, Grade 2, 0/5 nodes, ER-/PR-, HER2+
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Jul 19, 2009 12:32AM, edited Jul 19, 2009 12:46AM by sylwiamolik

Hello to Everybody :)

Lexislove i promise i will prepare and paste here my special recipe, just for You :) But, in turn, You have to give me Your strictly protected, secret formula for tasty grilled burgers Tongue out

BluedasherSmile  Thank You so much for info, i've just noticed that there's lack of her2 status on this adjuvantonline as well as herceptin factor in treatment options. But i concluded if her2 is negative factor and herceptin in fact eliminates this negativity, so we can estimate the result is zero (maybe). You're right about the results of MD Anderson study data but look at what i have found for You :

1.

Note that in this study no patient received trastuzumab, and maybe only a part of them received chemotherapy in the adjuvant setting. (Copy and paste it into your browser because the link doesn't work):

http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=31608   

2. and this (look what they wrote about patients T1a,b who received chemotherapy, during the follow up period only 1/25 recurred which is 4 %, and they didnt take herceptin)

http://www.abstracts2view.com/sabcs06/view.php?nu=SABCS06L_976

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Jul 20, 2009 06:10PM noellech wrote:

Try this site. It includes Her2 status;

http://cancer.lifemath.net/breastcancer/therapy/index.php

Dx 6/21/2008, IDC, <1cm, Stage Ia, Grade 1, 0/6 nodes, ER+/PR+, HER2+
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Jul 20, 2009 07:21PM lexislove wrote:

Deal !!!

Dx:2007, 2B, Triple+, June 2008:Lupron,Zometa,Tamox.Jan 2010:Poor metabolizer of Tamox switch to Femara.Feb 2010: cyp2d6 test reliable? Back to Tamox. Ooph soon.

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Jul 20, 2009 08:58PM rayhope wrote:

I believe the lifemath site includes her2 status but doesn't include herceptin as a treatment.

Began TCH 12/18/08

Dx 12/2/2008, ILC, 4cm, Stage IIa, Grade 2, 0/3 nodes, ER+/PR+, HER2+
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Jul 22, 2009 04:05PM Jaimieh wrote:

It doesn't include herceptin and I didn't see TCH either. 

Dx 12/24/2008, IDC, 1cm, Stage I, Grade 3, 0/2 nodes, ER-/PR-, HER2+