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How fast do Her2+ tumors grow?

Slainte
Slainte Member Posts: 55

I know that "they" say that breast cancer tumors grow slowly, but I feel like my tumor grew quite quickly , like say over months rather than years. Growth is probably related to grade , lower grade slower growing. Just wondering what others opinions are on this thought.



Take care,



Christine

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Comments

  • omaz
    omaz Member Posts: 4,218
    edited August 2012
    Slainte - My tumor was barely a shadow on a screening mammo.  They called me back for additional views but said it was ok.  Fast-forward 15 months later and I felt the lump at over 2 cm.  So in 15 months it grew from undetectable to over 2 cm.  That seems pretty fast to me.  I think the Ki-67 gives an estimate of the number of cells within the tumor that are actively dividing at any given time if you had that measured with your biopsy.  This is an interesting topic.
  • markat
    markat Member Posts: 502
    edited August 2012

    I started noticing a fullness in my right breast about a year before I finally went to the doctor. It was noticeably bigger than my left breast (spillage over cup). Six months later I felt the lump. I was stupid or naive, 29 years old and thinking it was because I drank too much coffee. My BS said it probably started 4-6 years earlier. Obviously at 25 I wasn't getting mammos and was breast feeding my baby. So who knows? It sure seems like it grew faster than that.

  • omaz
    omaz Member Posts: 4,218
    edited August 2012
    markat - My surgeon also told me that mine probably started ~5 years earlier .... but they couldn't see it on mammo I guess.
  • Sassa
    Sassa Member Posts: 98
    edited January 2013

    Mine was growing very fast.  My KI-67 was 70% which means 70% of the tumor cells were in the process of dividing at any point in time.

    My BC was not detected by mammogram, ultasound or breast exam that I had done as a first step in having a breast reduction.  It was only because I wanted to have breast reductions that I was sent in to have guide wires and dye put in any area that looked remotely different to a radiologist and then have those areas removed.  This was done because a plastic surgeon needs to know exactly the status of the breast tissue before a reduction will be done and I had no qualms about starting to whittle down my breast size before the reduction.

    Embedded in one of the lumps removed was my small highly aggressive BC.  I promptly opted for a mastectomy.

    I feel to this day that if I had waited the 3 months to my regularly scheduled mammogram and exam,  I probably would have been diagnosed at stage 3 or 4.

    I cringe everytime I hear someone being reassured that BC grows slowly and that they have months before surgery and treatment needs to be done.

  • lkc
    lkc Member Posts: 180
    edited August 2012

    There are different kinds of tumors with different markers and proliferation rates . Hormone positive tumors tend to be slow growing over years. However HER2 amplified tumors are typically rapid growing!

  • omaz
    omaz Member Posts: 4,218
    edited August 2012

    yes indeed, 90% ER+ 

  • lintrollerderby
    lintrollerderby Member Posts: 70
    edited August 2012

    Hi, ladies. I hope you don't mind my joining the discussion even though I'm not Her2+, but rather Triple Negative. I've learned that Her2+ and Triple Negative women often have similar experiences.

    I don't feel that breast cancer always takes years to develop. Sure, that is often the case if: the tumor is hormone positive, Grade 1, low Ki-67 score, and the patient is post-menopausal. But, for those of us who don't fit that description (or any part of it), we can often have very, very rapidly-developing tumors. I have a history of cysts and had my first mammogram at age 29. I had a second one at 33 and it was clear except for a couple of simple cysts. I found my lump by accident and even though I acted on it immediately, no doctor took me seriously because of my age (34 at the time last year) and a completely clear family history and clear mammogram a few months earlier. I knew in my heart that this was different than the cysts I'd dealt with and pushed for an excisional biopsy against the urging of my breast surgeon. He made me jump through hoops and wait a month and a day from the time I discovered the lump until he'd actually take it out. In that time, the lump went from only detectable when I was laying down, to a visible mass pushing against the skin of my breast when I looked at myself topless in the mirror. Approximately 10 days before I found the lump, I did a self exam and felt nothing. When you compare that with about 5 weeks later, being able to visibly see it, then I know it was growing like crazy. I had a Ki-67 score of 76% which is very high. To me, the myth that breast cancer always takes years to develop is akin to the harmful statement that doctors perpetuate about how breast cancer lumps don't hurt. It's untrue. Even my PCP who I went to the next day after finding it now tells me that had I listened to the radiologst's opinion to "come back in 6 months for repeat imaging", I'd likely have been seeking treatment before the 6 months for symptoms of metastatic breast cancer because it was so fast-growing.

    I now tell every one I talk to about breast cancer that the idea of breast cancer being a slow-growing process is not always true for everyone.

    I'm sorry for my intrusion on your topic. I strongly feel that if any of you ladies feel your tumor was fast-growing, then you're probably right. This is scary stuff.

  • lkc
    lkc Member Posts: 180
    edited August 2012

    Yep, Your absolutely right on. It depends on the type and Subtype of BC !

  • Sassa
    Sassa Member Posts: 98
    edited August 2012

    LintRollerD,

    You are absolutely right about triple negative BC being fast (and welcome to the thread Laughing).  My friend had a clear mammogram but still felt something was wrong.  She nagged at her MD for several months before he sent her for another mammogram.  You guessed it : stage 3 triple negative BC.

    She is now 5 years out from mastectomy, chemo and rads and is doing great.

  • 2miraclesmom
    2miraclesmom Member Posts: 38
    edited August 2012

    Mine went from my ob not being able to palpate it to me finding it 2 months later and it being 2.5 cm. So they were in a pretty big hurry to get it out. As far as how fast it actually grew, we do not know. Cancer is not in my family and I am not 40 yet so there was never a reason for a mamo. 

  • markat
    markat Member Posts: 502
    edited August 2012

    I'm not sure if I had the ki-67 test, so I don't know those numbers. I think my er is 50%. I always get confused about my type of cancer because er+ is supposed to be *good* but her+ is bad and aggressive. I just take my tamoxifen and get my herceptin every 3 weeks and hope for the best :)

  • sydneybased
    sydneybased Member Posts: 25
    edited August 2012

    I had a very high KI-67 score and my tumor wasn't detected 9 months previously. I believe mine was fast-growing, although my oncologist did say a week or so ago that it was probably there but not detected.

  • lintrollerderby
    lintrollerderby Member Posts: 70
    edited August 2012

    Hi, everyone, and thanks for the welcome. Smile

    lkc: Yup, I absolutely do think it's all about the type and subtype. I think it's also about the sub-subtype. I believe that helps explain why some ER+ cancers are quite aggressive and don't seem to behave like the traditional hormone-positive cancers tend to behave.

    Sassa: I'm sorry to hear about your friend, but glad to hear she's doing great! I see you live in Homosassa. I was born and raised in Ocala and just moved to South Florida last month. Small world!

    2miraclesmom: This stuff is so scary. I'm there with ya; I was 34 last year when diagnosed and had no family history. This garbage came out of nowhere, it seems.

    markat: I could be wrong, but I beleive that Luminal B cancers are generally hormone-positive and HER2-positive, and tend to behave more aggressively than other hormone-positive breast cancers (I think those are Luminal A, but I could be confused).

    Sydneybased: I strongly believe that if you feel your tumor grew quickly, then it probably did. The pre-packaged answer that oncologists give about taking years to develop is, in my humble opinion, flawed. I think we'll eventually see oncologists move away from describing all breast cancers that way.

  • orange1
    orange1 Member Posts: 92
    edited August 2012

    LintRoller - Congratulations for saving your own life.  You provided a valuable lesson about being aggressive in advocating for ourselves.  Thanks!

  • lopsided_blogger
    lopsided_blogger Member Posts: 10
    edited August 2012

    Like others on here, my cancer grew fast. My ob/gyn didn't feel it at my annual exam, then five months later, I found the two, 2.5 cm tumors! I've always felt that there are some tumors, especially in young women, that don't act like the typical tumors. They are in fact much more deadly. Sadly though, they develop in women who are too young for even mammograms and this tool is especially limited in young, dense breasts anyway. So yeah, we need better screening tools for all young women. Like 80 percent of us, I had no family history and no apparent reason to ever suspect this could happen. The truth is that no one--other than hopefully you--is watching out for this. I think we should tell young women this in no uncertain terms. "Yes, I know you are busy with work, raising kids, helping family, keeping up with friends and trying to build and pay for a life, but you also have to check your breasts. Really, even if you sometimes can't find time to brush your teeth, you must check your breasts."  

  • omaz
    omaz Member Posts: 4,218
    edited August 2012

    Well-said!

  • mistral1960
    mistral1960 Member Posts: 2
    edited August 2012
    Definately, the more amplification of her2, the fast the tumor grows.

    I am very her2 positive and my tumor grew very rapidly and I developed IBC overnight. On December 13 I was undressing to go to bed and noticed that my breast was inflammed. I thought perhaps my underwire bra had caused some kind blockage. The next morning, it looked better, but I promised myself I would call the clinic. I was very busy at work getting ready to leave for Christmas vacation and didn't call the Breast Clinic until Thurday afternoon. It was too late to do imaging so we agreed that I would come in the clinic when I returned. My last mammogram prior to dx was March 2011 so I told myself that it was probably a cyst that I felt because a tumor couldn't possibley that big.  As soon as I was back in town on the 27th,  I went to the the Breast Center to find out why my breast was all red and enlarged and discovered that I had a >7cm tumor and enlarged sentinal lymph node. I was biopsied for both and results came back positive for grade 3, er/pr negative, very her2 positive breast cancer with IBC.

    I was put on a clinical trial of Herceptin and Tykerb. My tumor responded immediately. By the second cycle it had reduced by more than half, but the 6 week interval, it was too small to biopsy for the study. I had surgery (modified radical) on July 3rd. They found 2 small nodes less than .8 cm and 4 of 27 lymph with cancer (still grade 3), but had nice clear margins. I started adjuvent chemotherapy on August 16.
  • jackboo09
    jackboo09 Member Posts: 780
    edited August 2012

    LintrollerDerby: Im just picking up on a point you made about damaging perceptions about tumours. In particular you mentioned the idea perpetuated in the medical fraternity that breast tumours are painless. In my case it was breast pain that alerted me to my tumour.

    My breast had felt unusually heavy for a few weeks but I put it down to PMS. However I developed an intense pain which I hoped was mastitis. It was actually a cancerous intra mammary lymph node causing pain. Went to the doctor who pointed out a suspicious flattening on the bottom U shaped part of my left breast. Following the pain I had spotted this myself. My point is this: it was pain that alerted me, not a lump I could feel or see. 

    All women need to be aware that tumours can be fast growing, can be painful and unfortunately can sometimes be missed on mammos.

    Liz

  • CelineFlower
    CelineFlower Member Posts: 145
    edited August 2012

    i am going for a biopsy tomorow..

    8 weeks ago i found a egg size lump with bse..

    i do it quite often.. weekly.. even daily sometimes..i know.. obsessive..

    but one day.. there it was

    after U/S and mammo... i am a birad 5 

  • omaz
    omaz Member Posts: 4,218
    edited August 2012
    Good luck Celine.
  • lintrollerderby
    lintrollerderby Member Posts: 70
    edited August 2012

    orange1: Thank you! That's exactly what my MO said the first time she met me and asked how all this started. We absolutely have to be our own best advocates because we have the greatest amount of skin in the game.

     jackboo009: I'm sorry about all you've been through. You're absolutely right that breast pain can alert us to a possible malignancy. When I found my lump and went to my PCP the next day, it hurt when she pressed on it. She said that was good news and meant it wasn't cancerous. The surgeon she eventually referred me to also repeated the same thing. There are several threads here on BCO that discuss that very myth and many of the women had pain and were told that breast cancer lumps don't hurt. It's scary because so often there are no or very limited symptoms to alert us that we have this going on and to be told that pain means we can discount malignancy is an awful disservice. We really do need to make sure that women know that some of these myths perpetuated by doctors are absolutely NOT TRUE. Breast cancer can hurt and it can develop quite rapidly. I mean, look at some of the stories of women diagnosed with IBC.

    CelineFlower: Good luck!

  • Cucho
    Cucho Member Posts: 18
    edited August 2012

    I had an ultrasound of my lump in sept 2011 which described it as 0.5cm and benign. I was 32 years old. It hurt like hell and I kept looking for new doctors opinions. Last week of november 2011 I finally had a needle biopsy with an IDC result. Tumour was removed in January measuring 1.5cm. It tripled in size in just 3+ months. Technicians agreed first ultrasound was read wrong and it was never benign. My ONC says ultrasound is not the same as excision in terms of measurement accuracy, ok sure but it also was very close to my skin and yes, I did feel it easily w my fingers and yes from touch I could feel that it tripled in size in a very short time. I am lucky I had a lot of pain in my breast cuz if I hadn't I would not have returned to see doctors for more tests AND I would have likely ended up being diagnosed w advanced BC before the age of 35.

  • marjie
    marjie Member Posts: 365
    edited August 2012
    I found my tumour while showering....4cm.  Within a month I had had it biopsied, diagnosed and removed.  I remember at my biopsy, commenting that I couldn't believe I didn't notice it before, and the doctor saying it was likely not there.  It was a very aggressive, fast growing tumour and I cringe when I hear about ladies who are told to they are going to "watch" for 6 months Yell
  • rava
    rava Member Posts: 11
    edited September 2012

    My tumor was very fast growing. I found it during showering as well the 20.9.11. I knew right away that this was Bad... Just 6 weeks prior we had been on vacation in Croatia and I had been putting on sun lotion many times a day also on my breast never feeling any lump.



    With no family history and low age (!) 38 at that point, my doctor would not refer me to mammo and UL. She wanted to wait for 1-2 months. But, she wanted me to come to her for a new excam after two weeks. In the two weeks one of my underarm lymph nodes exploded in growth. I could actually feel it like a hard lumph when my arm was hanging down in a neutral position. The breast tumor was measured to be 3,5 cm whith UL. The lymph node 2,1 cm. When the pathology report came the breast tumor was measured to be 2,2 cm... It came back er- pr - and her2 + subtype medullary carcinoma, 7 pos nodes ki67 84% .....

    I still have 8 Herceptin rounds left. Here in Norway they don't do any scans or pet/ MRI after treatment. Only on suspicion. My follow up will be the yearly mammo an UL. A little scary, but I strongly believe I'm cancer free and will stay cancer free :)

  • septembersong
    septembersong Member Posts: 153
    edited September 2012

    rava,

    The protocol at the hospital where I am followed is the same. I've never had a scan, and only had an MRI before surgery and then once after treatment when the radiologist doing my mammogram saw something too small to be resolved with ultrasound. (It was nothing.) It's been four years since diagnosis for me, and my anxiety decreases with every good checkup. It will for you too.

    Glad you're feeling well! And the end is in sight.

  • nevo84
    nevo84 Member Posts: 55
    edited September 2012

    Dear all

    Unfortunately Her2+ tumors grow so fast and if they are grade 3 either the growth is even worse. My moms tumor was 1cm in June and in  October it growed to 6cm. Also in Her2+ patients there are more than 1 tumor and its common. But the good news is if Her2+ gals don't have recurrance in first 3 years the chance of recurrance drop nearly to ZERO.

  • Slainte
    Slainte Member Posts: 55
    edited September 2012

    My tumour was very superfical and I found it accidentally not during a self exam. It was 2.1 cm in size. Even though I could feel it, it didn't show up in mammogram even with a little lead bead placed to show where it was. It only showed up on ultra sound. I am quite convinced it grew quickly. Not surprising condsidering it was a high grade , her2+ tumour. I agree with you all that education should move away from "breast cancers are slow growing tumours"



    Christine

  • shadow2356
    shadow2356 Member Posts: 93
    edited September 2012

    This in an interesting thread. I had a mammo in November of 2008. Negative. In July 2009 I felt something in my breast. It was not a lump, more like a thickening. It was tender. They always say breast cancer doesn't hurt, but this did.

    I had 4 tumors. One 1.7cm, one 5 mm, one 6 mm and 5 cm of DCIS. Can all of this be missed in a mammo? Everyone looked at those films since and no one could see anything suspicious. I was also told that the cells were there for at least 5 years. Even if that is true something caused them to grow pretty quickly in a short time. Even though they could see it on a mammo it wasn't that evident. It was glaring on the sonogram.

    It is scary. I don't think I believe it is slow growing either.

  • maryannecb
    maryannecb Member Posts: 74
    edited September 2012

    Mine doubled every 2-3 weeks.

  • ohiobecky
    ohiobecky Member Posts: 2
    edited October 2012

    I had a normal manual exam Nov 2011. Mid Feb 2012 I had a 10cm plus tumor. I was 38 at diagnosis, no family history so I had never had a mammogram.