TRIPLE POSITIVE GROUP
Comments
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TonLee...
You're right. I'm never really confident that the mammo results are accurate since I've become familiar with the subject. Lots of stories like yours.
I believe my BS's office generally uses the same system Eileen. 's does. You come have your yearly mammo the day of your yearly check up and you and your BS get the results the same day and discuss it during the visit.
My feeling is that for the first year at least you should get a call from your BS or his staff to discuss results the day they become available. This is just compassionate common sense.0 -
Ashla,
I just got a card in the mail last time. lol The military isn't exactly concerned with compassion at the expense of expediency. At least not in my experience.
Solt,
I was in tx with women who started Herceptin with heart damage (heart issues earlier in life and currently on meds) that had no problem on herceptin. Even with a family history of heart disease, or actual heart disease, there doesn't seem to be any way to determine who will get damage and who won't. At least not now.
I for one, do not mind if you vent your dark days here. Better here where one can get up and walk away than in real life where it is not so easy. Besides that, we've all been there. So feel free....
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Jenn: Wow what a long surgery. Sending you healing wishes and hugs.
Tonlee: I love both your pics. Sorry for being nosy about the other one! Lol
My reduction operation: My nine year old is in `Snow White and the seven dwarves' pantomine at our local theatre in Dec. She has just been selected. It means I have to postpone my op of the 15th Nov. I need to be mum taxi and all that comes with that so will go for it in Jan now.
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Jenn- yay! So glad it all went well. You topped my surgery of 8 1/2 hrs! Wow! 12 hrs. Stay on top of your bowl movements. I know, TMI. But really muralax worked great. Colace, not at all. Have to wake them up after a long surgery. And esp painful after tram.
Yay that they look great!
TonLee- the MRI caught mine, the mammo came back normal!
So after having bmx, with tram reconstruct, are annual mammo, ultrasound, or MRI necessary?0 -
Soltantio I think for you it might be diagnostic Mammo and MRI every 6 months swtiching off. So basically something every 6 months.0
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wishing you a speedy recovery jenn!
i just had a pre-op mammo and mri. If i was keeping the girls i was told annually and i would be getting mammos and mri's due to breast density. I said why a mammo if it didnt show this tumor? appparently it is better at showing microcalcifications then an mri. I would insist on a mri for dense breasts.
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I have no clue what my follow up will be. My surgery, heart problem and Dr vacation mean I won't get to talk to my onc till a week from this Thursday. I know there won't be MRI, cause I have a pacemaker, don't see how they could do a mammo without a boob on one side and only a te on the other. my onc didn't do any scans as I had no positive nodes. So I guess I will just be getting lab tests and checkups. Speaking of labs, I have had weekly labs since this whole mess started. I have been down magnesium almost every week, potassium sometimes I have had two blood transfusions. Now that I won't be having my herception, have no clue how this will go. Guess I will find out. Kind of scary being kicked out of the nest! LOL
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Moon I just get physical exams. I have implants
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Solt, that's funny! Thinking its ONLY a chemopause se! LOL Man, do our expectations change with bc! LOL. When you think its a relief that its an SE, rather than something else! LOL
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…stresses that more than 80 percent of women who develop breast cancer will not experience a recurrence or die of the disease. "A woman diagnosed with breast cancer," she says, "has much better odds that she will never hear from her disease again than women with most other common cancers." linky
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Excellent article Lago.....one I'll read over and over.
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We tend to focus on the recurrence numbers rather than the NED numbers. This article, although can't say we're cured does indicated that most of are.
Today I am speaking at a press conference as a survivor/volunteer for the ACS. I hope I don't get nervous. I'll be talking about my experiences as a volunteer and survivor… for 2 minutes.
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good article...still confused as to why i hear the "25-30% of all early stage BC will return" - that number is tossed around a lot on these boards
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Just read the results of the new Herceptin Trial. ONE YEAR IS BEST..
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Hey....I too just found the abstract...it's confusing to me b/c of the statistical stuff and double-negative wording...a little help here? I think it means they could NOT show 6 months as just as good as Eileen said, but not sure.
En Jarez/FR, 10Rheims/FR, 11Vandoeuvre Les Nancy/FR, 12Angers/FR, 13Limoges/FR, 14Perigueux/FR, 15Perpignan/FR, 16France/FR, 17Lille/FR
Background: Since 2005, One year trastuzumab (T) treatment has been providing survival benefit to patients with early breast cancer and HER2 overexpression. However, the optimal duration of T has been debatable due to concerns forcardiac toxicity and results from the FinHer trial which showed that 9 weeks of T provided a similar magnitude of benefit than the 1-year treatment. The French National Cancer Institute (INCa) initiated an academic randomised non-inferiority trial aiming to compare a shorter T exposure of 6 months versus the standard 12 months. This trial, named PHARE for ‘Protocol for Herceptin® as Adjuvant therapy with Reduced Exposure' [NCT00381901] was approved by an independent ethics committee with regularly planned IDMC meetings.
Patients and methods: Patients with HER2 + early breast cancer who received at least 4 cycles of (neo)-adjuvant chemotherapy were eligible. Randomization 1:1 using a minimisation algorithm was stratified on concomitant or sequential T administration with chemotherapy, oestrogen receptors (ER) status and center. The
primary objective was to compare disease free survival (DFS). Overall survival (OS) and cardiac toxicity were investigated as secondary aims. An absolute loss of 2% in DFS in the experimental arm was defined as the non-inferiority margin (1.15 in relative terms) and required 3400 patients with alpha = 0.05 and 80% power.
Results: Between 5/2006 and 7/2010, 3382 patients were randomized to 6 or 12 months of T following the IDMC recommendation for accrual interruption and extended follow-up. Disease and treatment characteristics were well balanced between
the 2 arms: median age 55 years (range 21-86), median tumour size 20 mm (0-270), node involvement 45%, SBR grade III 56%, ER positive 58%, radiotherapy 88%; concomitant T administration 58%, anthracyclin and taxane containing chemotherapy 73%. The data-base was locked on July 30th, 2012. Median follow-up
is 47.2 months since the start of T treatment. The DFS HR is 1.28 (95% CI: 1.05-1.56). The non inferiority of 6 months of trastuzumab compared to 12 months could not be demonstrated as the lower bound of the 95% CI crosses the prespecified non inferiority margin of 1.15.
Disclosure: X. Pivot: The study of the abstract has received funding and sponsorship from the French National Cancer Institut (INCa). All authors have declared no conflicts of interest.0 -
Hey....I too just found the abstract...it's confusing to me b/c of the statistical stuff and double-negative wording...a little help here? I think it means they couldn't show 6 months as just as good as Eileen said, but not sure.
En Jarez/FR, 10Rheims/FR, 11Vandoeuvre Les Nancy/FR, 12Angers/FR, 13Limoges/FR, 14Perigueux/FR, 15Perpignan/FR, 16France/FR, 17Lille/FR
Background: Since 2005, One year trastuzumab (T) treatment has been providing survival benefit to patients with early breast cancer and HER2 overexpression. However, the optimal duration of T has been debatable due to concerns forcardiac toxicity and results from the FinHer trial which showed that 9 weeks of T provided a similar magnitude of benefit than the 1-year treatment. The French National Cancer Institute (INCa) initiated an academic randomised non-inferiority trial aiming to compare a shorter T exposure of 6 months versus the standard 12 months. This trial, named PHARE for ‘Protocol for Herceptin® as Adjuvant therapy with Reduced Exposure' [NCT00381901] was approved by an independent ethics committee with regularly planned IDMC meetings.
Patients and methods: Patients with HER2 + early breast cancer who received at least 4 cycles of (neo)-adjuvant chemotherapy were eligible. Randomization 1:1 using a minimisation algorithm was stratified on concomitant or sequential T administration with chemotherapy, oestrogen receptors (ER) status and center. The
primary objective was to compare disease free survival (DFS). Overall survival (OS) and cardiac toxicity were investigated as secondary aims. An absolute loss of 2% in DFS in the experimental arm was defined as the non-inferiority margin (1.15 in relative terms) and required 3400 patients with alpha = 0.05 and 80% power.
Results: Between 5/2006 and 7/2010, 3382 patients were randomized to 6 or 12 months of T following the IDMC recommendation for accrual interruption and extended follow-up. Disease and treatment characteristics were well balanced between
the 2 arms: median age 55 years (range 21-86), median tumour size 20 mm (0-270), node involvement 45%, SBR grade III 56%, ER positive 58%, radiotherapy 88%; concomitant T administration 58%, anthracyclin and taxane containing chemotherapy 73%. The data-base was locked on July 30th, 2012. Median follow-up
is 47.2 months since the start of T treatment. The DFS HR is 1.28 (95% CI: 1.05-1.56). The non inferiority of 6 months of trastuzumab compared to 12 months could not be demonstrated as the lower bound of the 95% CI crosses the prespecified non inferiority margin of 1.15.
Disclosure: X. Pivot: The study of the abstract has received funding and sponsorship from the French National Cancer Institut (INCa). All authors have declared no conflicts of interest.0 -
Hey....I too just found the abstract...it's confusing to me b/c of the statistical stuff and double-negative wording...a little help here? I think it means they could NOT show 6 months as just as good as Eileen said, but not sure.
En Jarez/FR, 10Rheims/FR, 11Vandoeuvre Les Nancy/FR, 12Angers/FR, 13Limoges/FR, 14Perigueux/FR, 15Perpignan/FR, 16France/FR, 17Lille/FR
Background: Since 2005, One year trastuzumab (T) treatment has been providing survival benefit to patients with early breast cancer and HER2 overexpression. However, the optimal duration of T has been debatable due to concerns forcardiac toxicity and results from the FinHer trial which showed that 9 weeks of T provided a similar magnitude of benefit than the 1-year treatment. The French National Cancer Institute (INCa) initiated an academic randomised non-inferiority trial aiming to compare a shorter T exposure of 6 months versus the standard 12 months. This trial, named PHARE for ‘Protocol for Herceptin® as Adjuvant therapy with Reduced Exposure' [NCT00381901] was approved by an independent ethics committee with regularly planned IDMC meetings.
Patients and methods: Patients with HER2 + early breast cancer who received at least 4 cycles of (neo)-adjuvant chemotherapy were eligible. Randomization 1:1 using a minimisation algorithm was stratified on concomitant or sequential T administration with chemotherapy, oestrogen receptors (ER) status and center. The
primary objective was to compare disease free survival (DFS). Overall survival (OS) and cardiac toxicity were investigated as secondary aims. An absolute loss of 2% in DFS in the experimental arm was defined as the non-inferiority margin (1.15 in relative terms) and required 3400 patients with alpha = 0.05 and 80% power.
Results: Between 5/2006 and 7/2010, 3382 patients were randomized to 6 or 12 months of T following the IDMC recommendation for accrual interruption and extended follow-up. Disease and treatment characteristics were well balanced between
the 2 arms: median age 55 years (range 21-86), median tumour size 20 mm (0-270), node involvement 45%, SBR grade III 56%, ER positive 58%, radiotherapy 88%; concomitant T administration 58%, anthracyclin and taxane containing chemotherapy 73%. The data-base was locked on July 30th, 2012. Median follow-up
is 47.2 months since the start of T treatment. The DFS HR is 1.28 (95% CI: 1.05-1.56). The non inferiority of 6 months of trastuzumab compared to 12 months could not be demonstrated as the lower bound of the 95% CI crosses the prespecified non inferiority margin of 1.15.
Disclosure: X. Pivot: The study of the abstract has received funding and sponsorship from the French National Cancer Institut (INCa). All authors have declared no conflicts of interest.0 -
And here is the 1 yr vs 2 yrs that shows 1 yr is best.
[4:15 PM] LBA6_PR | HERA TRIAL: 2 years versus 1 year of trastuzumab after adjuvant chemotherapy in women with HER2-positive early breast cancer at 8 years of median follow up R.D. Gelber1, A. Goldhirsch2, M. Piccart3, M. Procter4, E. De Azambuja3, H. Weber5, M. Untch6, I.E. Smith7, L. Gianni8, C. Jackisch9, D. Cameron10, R. Bell11, M. Dowsett7, B. Leyland-Jones12, J. Baselga1
1Boston/US, 2Milan/IT, 3Brussels/BE, 4Kingussie/UK, 5Basel/CH, 6Berlin/DE, 7London/UK, 8Milano/IT, 9Offenbach/DE, 10Edinburgh/UK, 11Geelong/AU, 12Sioux Falls, SD/US
Background: One year (yr) of trastuzumab (T) significantly improves disease-free (DFS) and overall survival (OS) in patients with HER2-positive early breast cancer (EBC) and is considered the standard of care. HERA is the only randomized trial investigating whether longer duration of T can further improve efficacy outcome.
Materials and methods: HERA (BIG 01-01) is an international, multicenter, phase III randomized trial involving 5102 women with HER2-positive EBC. Pts were randomized, after completion of primary therapy [surgery, chemotherapy and radiotherapy as indicated], to T every 3 weeks for 1 yr, 2 years (yrs), or observation.
This landmark efficacy analysis compares the outcome of pts randomized to either2 yrs or 1 yr of T who were disease-free at 1 yr after randomization (N = 1553 for 2 yrs, and N = 1552 for 1 yr). The primary endpoint is DFS and secondary endpoints are OS and time to distant recurrence (TTDR). Updated efficacy analyses of the T arms vs. observation at 8-yrs of median follow-up (FU) are also presented.
Results: On 12 April 2012 HERA reached the target number of 725 DFS events needed for 80% power to detect a true hazard ratio (HR) of 0.80 for the comparison of 2 yrs vs. 1 yr of T. The unadjusted HR for an event in the 2-yr vs. 1-yr T arms was 0.99 (95% CI 0.85-1.14; P = 0.8588). OS in the two arms was comparable [HR = 1.05 (95% CI 0.86-1.28; P = 0.6333)]. TTDR results were similar. The primary cardiac endpoint* was comparable (0.96% vs. 0.83% for 2-yr and 1-yr arms, respectively), but the secondary cardiac endpoint** was higher in the 2-yr arm (7.17% vs. 4.10%). Importantly, the durable benefit in DFS and OS for both 1 yr and 2 yrs of T compared with observation remains stable at 8 yrs of median FU.
Conclusions: These results confirm that 1 yr of adjuvant T remains the standard of care for HER2-positive EBC pts. It is also reassuring that the significant improvement in DFS and OS persists over time and that the incidence of cardiac endpoints remains low at a median FU of 8 yrs. *Cardiac death or severe CHF (NYHA class III or IV, confirmed by a cardiologist, and a significant LVEF decrease) ** An absolute decline ≥10% points from baseline LVEF and to <50%
Disclosure: M. Piccart: Roche - Genentech: Consultancy, honoraria M. Procter: Marion Procter's institution has received funding in relation to the HERA trial E. De Azambuja: I have received travel grant form Roche. I have received honoraria from Roche. H.Weber: Stock options from Roche, Employment from Roche I.E. Smith: Honoraria from Roche L. Gianni: Roche: Advisory board, GSK: Advisory board C. Jackisch: Speakers Bureau Roche & GlaxoSmithKline D. Cameron: Personal and institutional reimbursement from Roche for advisory boards, consultancy and grants. M. Dowsett: Roche: Grant, advisory board, lecture fees J. Baselga: Advisory board memberships of Roche and GlaxoSmithKline. All other authors have declared no conflicts of interest.0 -
Lago
My experience with public speaking is that I'm very nervous until I actually start talking. I also bring numbered notecards with BIG writing with key points just in case I get really flustered. Never needed them.
Familiarity and comfort with the subject are important. This is a subject you are very familiar with. It will come from your heart .
Break a leg...0 -
Thanks, dance!
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Lago, I have no doubt you will do great. Wish I could be in the audience
Dance, thanks forinfo posting. Its confusing.
Was this report just on the length if time for herceptin benefits, or was it to include info about which types of her 2 + benefit from herceptin and which types are less likely to respond? Maybe that is some other future study im thinking about.0 -
The Herceptin Results are very confusing. The only thing that I understand is that ONE YEAR is BEST. Can anyone break this report down into terms that are easy and clear to understand ? I see my MO on wednesday along with getting my herceptin. I will try to get her to explain what all these numbers mean..
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shore, it was just on the length of time best for herceptin. Study 1 was 6 mo vs 12 mo. Study 2 was 1 yr vs. 2 yrs.
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OK, here's a news story that summarizes the two articles in laymen's terms. Yep, looks like both studies showed 1 year should remain the standard of care. Bummer for me, as I wanted to stop at 6 months...
Cancer trials show one year on Roche's Herceptin is best
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You will be great Lago!
Soltantio-sorry it has taken me so long but I wanted to let you know that I just finished tx number 5 and was just telling my MO the other day that after number 4 my heart felt like a caged animal trying to get out/lots of heart palpitations. We know I have an echo coming up and discussed other Symtoms...he took note if what I was telling him but did not seem overly concerned. It has since settled down. Thank God! That and the throwing up this last would have been too much. Might have been a coincidence that we both had those symptoms after tx 4 but I thought I would let you know that mine subsided just in case. I will let you know what the results of my echo are when we get that set up:)
Interesting about the herceptin trial. Kind of a bummer. I was hoping 6 months would be just as good also. Well, I will look it as though at least I still have time to try to get on a trial while still on herceptin:)0 -
Oh and Jenn! I am so glad surgery went well! 12 hours!!! Yikes! I am so happy to hear that you are happy with the results. Heal quickly:)
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Jenn--I'm so happy u'r surgery went well, but like everyone says 12 HOURS wow a long one--but it seems like u'r OK with the results so that's good. Aren't u glad it's over?
Lago I'm sure u will do great, no doubt in my mind. Good Luck tho.
And Sol I would call right away--Not to worry about it, but to relax about it.
And I think I must have gotten Nulasta, cuz my whites were always very low, but I don't remember having concern about them. But it made me think-hahaha, I know----the last 2x I was in the hospital in this last July I got a shot in the stomach every day--(not nulasta) but a shot of something. and I told u when I had oral surgery last week my oral sureon had to talk to my onc?? forst to hae it OK'd and since I was already on an antibiotic it helped--but he did ask me how man rads I had befor he took x-rays--he explained but I really told him I didn't care just get the teeth out. My Usual--goofy questions he asked (to me) and I'm still all purple--the purple is still a pretty color tho. So it's fine. LOL
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lago - You are a great spokesperson - good luck!0
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HELP!!!
At the time I saw mysurgeon initially he was able to tell me that I was ER/PR+ over 80%. The HER2 wasn't back yet. This morning I finally got acess to me path reports and the supplemental report was added. This is what it says...
Results show a HER2 to centromere 17 ratio of 7.7 following a HER2 breast FISH protocol. This is a positive result according to the ASCO/CAP guidelines.
I know this is not good and i just need a little help understanding. I don't see the surgeon again until Thursday and I may lose my mind by then. Any knowledge is greatly appreciated.
Thanks
Cindyloo
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