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PCR after neoadjuvant for HER2+

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vee36
vee36 Member Posts: 4
edited November 2021 in HER2+ (Positive) Breast Cancer

To all mu Her2 positive sisters, i was wondering did you receive a complete pathological response to chemo and still feel the tumor?

I finished chemo and did an ultrasound today which showed a significant reduction in size and shape of the mass but it is not completely gone; i was kind of hoping to hear out your experiences

Thanks a million💗

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  • aram
    aram Member Posts: 320
    edited April 2021
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    Vee36, I have not completed the chemo yet so I don't have an answer for you but I wanted to know what kind of chemo did you have if you don't mind sharing?

  • vee36
    vee36 Member Posts: 4
    edited April 2021
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    Hi Aram, i did the AC Dose dense and then weekly taxol with herceptin perjeta every three weeks

  • aram
    aram Member Posts: 320
    edited April 2021
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    Our plan is very similar, I just have 16 weekly taxol. By the way have you seen this thread? It might be related to your question:

    https://community.breastcancer.org/forum/80/topics/874047

  • melbo
    melbo Member Posts: 266
    edited April 2021
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    Vee you also PM’d me, but I will respond here too. I had a PCR to TCHP — I couldn’t feel my tumor anymore after the 4th round of chemo or so and the post chemo ultrasound showed no evidence of a mass.

  • beesy_the_other_one
    beesy_the_other_one Member Posts: 170
    edited April 2021
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    Vee, I've read and heard that tumors don't necessarily shrink as we might think--they can shrink in a way that makes them look like swiss cheese. That gave me some comfort, when after six rounds of chemo, I could still feel something. They'd done ultrasounds and said it was shrinking, but it was still very much there. My final pathology after surgery found no live cancer cells and only a "tumor bed." I remember thinking as I drove to surgery at zero dark thirty that what I was still feeling had to be the tumor, but it wasn't. Until that point, no one had explained to me that there is something left there, even if there are no live cells at the site. Here's hoping for a pCR for you!

  • deniseml
    deniseml Member Posts: 68
    edited May 2021
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    Vee, I did still feel something after completing 6 rounds of TCHP. Had a breast MRI immediately following last treatment & no cancer was detected . I, too had pCR in breast & lymph nodes.

  • Jammicoo
    Jammicoo Member Posts: 1
    edited August 2021
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    I had a PCR to TCHP. I could not feel the tumor after the second round and completed four rounds and then stopped, mostly because of my concern about potential long-term damage being done by the TCHP, But also because I felt the tumor had disappeared. MRI showed complete clinical response. At surgery the pathology showed that I had had a PCR and no positive nodes.

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited August 2021
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    Bumping this.

    I just came from speaking with my breast surgeon about my post chemo ultrasound. Although the tumor shrank to less than half its size, they couldn't say if it was still cancerous, and the radiologist didn't want to commit to saying that the one positive node resolved. The results says it shrank as well. My breast surgeon said that he was probably trying to avoid blame if he was too positive about the results, hence the vagueness in the report. My breast surgeon said not to worry too much because I could still achieve a complete response.

    Did any one of you have a similar experience prior to surgery? He says for my subtype, there is a good chance it will just be scarring left over. I hate that I am worrying all over again like before I was diagnosed.

    I am trying to remain positive. Additional chemo would really be frustrating because I had issues with my port and picc, and finally got approved for Phesgo shots instead. It would be a huge setback for me and a logistical problem.


  • minustwo
    minustwo Member Posts: 13,078
    edited August 2021
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    I had a BMX for DCIS & reconstruction - and I'll add with totally clear margins. Two years later I discovered a lump at my collar bone that turned out to be recurrent cancer, but now IDC & HER2+. I had neoadjuvant TCHP without PCR and then ALND surgery. So then I had AC chemo even though they got clean margins again!!!. Then back to Herceptin for a year along with 5 weeks of radiation. I loved my port and it served me well. All that was 7 years ago and I am still NED. Sometimes it's hard to believe it's been that long.

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited August 2021
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    Thanks for the input Minus Two. I am just a little frustrated because of the port issues. I actually didn't mind having it in. It made it so much easier for infusions. I am really clinging onto what my breast surgeon says, not only because it's a better outcome, but because I seem to be that unicorn where everybody says, well I haven't really seen that! On top of being in the 4 percent that are ER/PR neg HER+, I am done being a unicorn! I wanna be in the majority this time, since outcomes for HER2+ have been a lot better than in the past. Grrr.

  • WC3
    WC3 Member Posts: 658
    edited August 2021
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    This thread is a few months old but I'll chime in since I had a pCR. The tumor had soften significantly after my third infusion and the MRI I had after my 4th infusion showed a spot where the tumor had been but the report stated no signs of cancer. I'm not sure if it was missed or just no longer had characteristics of malignancy.

    The surgical pathology report stated a small bit of DCIS had remained but it is still considered a pCR because no residual IDC was found.

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited August 2021
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    Thanks WC3. My biopsy pathology says there is also comedo DCIS present as well as the IDC. It's interesting that could still be left over.

  • LGR239
    LGR239 Member Posts: 7
    edited August 2021
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    Hi AlwaysMe,

    Some context, I'm triple positive with multiple chonkers and lymph node spread but they started shrinking after first round and now the only thing I feel in my breast is my actual boob so have also been holding on to unicorn hopes.

    I can't speak to final result (i.e. a complete pathologic response) since my surgery is scheduled for next month, but I had my post-chemo (6 TCHP) MRI and mammogram last Friday and when I read the results posted on my chart midweek, it showed the lymph node tumor was completely resolved but there was a 2.1 cm residual viable tumor for one breast tumor and 5 cm distribution of micro calcifications where the other was so obviously I was bummed about that.

    Fast forward to Friday when I had an appointment with my surgeon who comes in smiling and is like I have great news for you and proceeds to tell me that the test results show a complete clinical response. Apparently those masses were just residue/scarring and necrotic tumor cells - but obviously have to wait till surgery to confirm plus a cCR doesn't guarantee cPR, so I think its definitely possible radiologist was just being cautious.

    Tl;dr: Have a bunch of stuff left in my boob per my post-chemo scans but still considered a complete clinical response per my doctors

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited August 2021
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    Hi LGR239, I hope your surgery and path results turn out well. Mine is scheduled next month also. Thanks for sharing your experience with me.

  • LGR239
    LGR239 Member Posts: 7
    edited August 2021
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    Same to you! The waiting game is tough, I need to stop googling so much haha....when is yours scheduled?

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited August 2021
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    Mine is scheduled the third week of September, I forgot the actual date. I'm glad they were able to schedule it, since I heard that some breast cancer surgeries were being postponed. The doctor said they could reserve the operating room because it was a surgery after chemo. I really feel for the women/men who don't get chemo, but do surgery first, especially if they don't know yet what they are dealing with.

  • LGR239
    LGR239 Member Posts: 7
    edited August 2021
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    Mine is September 21 so same…I know its not that far off but also it feels like forever when waiting to find out if there’s still anything left.

    That’s so crazy that they are postponing cancer surgeries, I’m glad you were able to get a date! Is it due to COVID?

  • aram
    aram Member Posts: 320
    edited August 2021
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    I will be having BMX some time in October. The tumors are not palpable anymore which made my oncologist and surgeon very happy. I am anxiously waiting for the surgery and crossing my fingers for PCR.

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited August 2021
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    LGR239, yes it's because of Covid. The main reason is oxygen conservation, followed by saving bed space, then limiting exposure.

    Aram, best to you that you get a pcr. We're the same sub type and started at around the same time, so I have been following your posts as well. I hope your surgery goes smoothly.

  • WC3
    WC3 Member Posts: 658
    edited September 2021
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    I forgot to answer the original question. I was no longer able to feel the tumor after chemotherapy but the area felt thicker/denser than the surrounding tissue to me.

  • kimm992
    kimm992 Member Posts: 28
    edited September 2021
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    I had an ALMOST complete response. The large tumor that I could feel very obviously started to hurt and throb after my 2nd round of chemo. By the 5th round I could no longer feel it. At the time of surgery it had gone from 1.7cm to being just a tiny "spatter" of cancer cells. My oncologist said that this was a very good indication that the cancer responded well to the treatment.

    I will be 6 years out from diagnosis next month!

  • AlwaysMeC
    AlwaysMeC Member Posts: 107
    edited October 2021
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    Kimm992, congratulations on 6 years. I hope you have many more decades ahead!

    For anyone reading this thread, the chemo resolved the invasive tumor in the breast, but there was DCIS left over, which was removed as well. So the lump I could feel at the tumor bed was that DCIS left over.

  • aram
    aram Member Posts: 320
    edited October 2021
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    AlwaysMeC, that is good news :)

  • LGR239
    LGR239 Member Posts: 7
    edited October 2021
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    Wahooo congrats AlwaysMeC!

  • aram
    aram Member Posts: 320
    edited November 2021
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    I got my results today. PCR! :) I am happy. I know it doesn't guarantee anything but I want to take it one day at a time and be happy for the moment!

  • melbo
    melbo Member Posts: 266
    edited November 2021
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    Aram — that's awesome news!!!! Woohoo!

  • minustwo
    minustwo Member Posts: 13,078
    edited November 2021
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    Aram - GREAT news.

  • aram
    aram Member Posts: 320
    edited November 2021
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    Thank you Melbo and Minustwo!

  • pchyen
    pchyen Member Posts: 96
    edited November 2021
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    Hi Aram, great news, congrats on PCR!

  • aram
    aram Member Posts: 320
    edited November 2021
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    Thank you Peter! How is Nicole doing?