TRIPLE POSITIVE GROUP

Dancetrancer- it is a really strange scenario from 4 years ago as my EF did drop during the treatment but by the time I ended my treatment and had my last echo in early 2010 my rate had come back up to EF 60. I did have different technicians who did all of the echos and my cardiologist says they are very subjective. My cardiologist says this is definitely from the herceptin and my MO says it is not. So I have two professionals with differing opinions and I am not sure who is right. In the end I don't guess it really matters.

I will just do the taxol and pray that it works. Taxol does not seem to be very cardio toxic so I should be able to tolerate it okay. I am not staring until mid Sept because they are allowing some time to heal after the radiation. I am grateful to have a few weeks of down time!

BabyRuth:  I know about the Coreg.  I was on it too and couldn't figure out why I couldn't exercise like before...it was because my pulse wouldn't go above 58.  I'm off it now and EF staying at 65 (before treatments it was 73ish.  It just takes time.  Good luck with your treatments.  They are moving so fast with treatments.

Baby Ruth, I did weekly taxol + Herceptin and had very few side effects. I hope that will be the case for you too! Mostly I had constipation, but there's plenty of good stuff that works for that little annoyance. Neuropathy is also a common problem with taxol; there are supplements that can help with that. I have two more Herceptin infusions and then I'm done with my year. I'm grateful my EF hasn't dropped, but your situation is worrisome - showing up years later. And you had no symptoms, right?



I'm one of several women here who used cold caps to save hair. The caps worked perfectly for me with weekly taxol - I lost almost no hair at all. If you want more information there's a cold cap thread in the "help me get through treatment" section, or just ask.

Baberuth, conngrats on finishing Rads. My EF dropped to 42 . I was pulled off herceptin at the halfway mark. It went back up to 63 about three months later.

Babyruth that is so good to hear and I hear good things about this procedure too. I'm glad u can keep busy, but don't forget to take some time for u;rself too.

Oh, and I just wanted to tell all of those currently getting chemo or who are recently finished--keep the faith!  I finished on Feb. 22nd of this year and 2 months ago I couldn't even participate in my company's Global Walk for Children with Aids, which was ~ 2 miles.  Fer cryin out loud, I was still weak and dragging.

Today my dog and I walked for miles and nothing hurt, I wasn't gasping for air, I didn't feel like I was 107 years old.  Besides still having really short hair, a super sore boob from radiation, a few warm flashes from the arimidex and many new extra pounds, I think I'm myself again!    So seriously, know you will feel good again too!

Pbrain, I am so glad you are feeling like your old self, and I love the new picture!

Nicky, glad you have your energy back too!

Always good to hear positive reports!

Thanks guys!  I so wish I felt like this this spring when it was the big garden clean up.  I never had a "garden reveal" this year because it looks like crap!  I did nothing during that important time except plant some pretty annuals (and sleep and play online bingo--lazy a$$).

Moon, hmmmm, yeap I have formed stools.  Not every day, but recently most days.  I guess I will just keep taking immodium and try probiotics, go get some Activia.  I wanted to get off of the immodium because it finally is causing me constipation (during chemo it was like a sugar pill; I took 8 one day and knew it just wasn't working...)

I hope you are doing a-ok after your reconstruction surgery :-)  This leads me to a question for everyone--if you were 54 (like me) no boyfriend in sight and done with the dorks still left out there, tired of all of this bc crap and you needed a mastectomy, would you consider not going through reconstruction?  What are the pros and the cons?  I kind of think of this because my external beam radiation makes me no longer a candidate for a lumpectomy if this comes back...

PBrain - I am 55, married and had to have UMX due to extent of breast involvement and previous lumpectomy. I haven't had reconstruction and am considering not having it. At the moment I just feel like I have had enough, maybe I'll reconsider later. I am just looking forward to finally being through Herceptin in October and hopefully getting 'de-ported' after that.

BTW just to let everyone know who is currently going through treatment… you will feel like yourself again and look good. It's hard to believe but you will. Sure you will have a few changes but we all change… it's called living. The other day I met a gal from this site. She lives on the east coast but originally from here. The first thing she said to me was how healthy I looked. It's almost 3 years (August 31st) since I started treatment (surgery first). I feel great, granted 7lbs heavier but who's counting.

pbrain - you have to eat a lot of Activia to get the probiotic benefit - 2 servings a day, that is a lot of dairy.  I have tried to stay away from dairy if possible because it is basically the product of a lactating animal and full of hormones, antibiotics, etc.  IMHO you would be better off with a supplemental probiotic without the dairy and added calories of the yogurt.  I just checked the strawberry flavor - it has 17 grams of sugar per serving.  I had Big D as a SE throughout chemo, 10 days each tx.  It was my most frequent, and longest lasting, SE.  During Herceptin only the onc nurse recommended I start a supplemental probiotic since I was still having issues - fixed me up very quickly, still take it.  As far as recon, Moonflower and I took the "scenic route" but I have no regrets.  I have a husband, but I did it for myself, he would have loved me without it.  The pros for me are that I feel more like myself with it, the cons are in my signature line, lol!

Honeybair, a HUGE congrats on getting through your surgery. Hope the pain levels continue to be manageable;

BabyRuth, so glad that the cyber knife radiation has gone well. Keep the faith!!

Here is an article about a particular biomarker for which we can be tested. After finishing five years of Tamoxifen, if this biomarker's measurement is high, it indicates that the likelihood of recurrence is greater in women who were lymph-node negative, ER-positive.  SOLUTION: Take letrozole. Read and enjoy:

Prediction of Late Disease Recurrence and Extended Adjuvant Letrozole Benefit by the HOXB13/IL17BR Biomarker

Dennis C. Sgroi, Erin Carney, Elizabeth Zarrella, Lauren Steffel, Shemeica N. Binns, Dianne M. Finkelstein, Jackie Szymonifka, Atul K. Bhan, Lois E. Shepherd, Yi Zhang, Catherine A. Schnabel, Mark G. Erlander, James N. Ingle, Peggy Porter, Hyman B. Muss, Katherine I. Pritchard, Dongsheng Tu, David L. Rimm, Paul E. Goss

Abstract

Background Biomarkers to optimize extended adjuvant endocrine therapy for women with estrogen receptor (ER)–positive breast cancer are limited. The HOXB13/IL17BR (H/I) biomarker predicts recurrence risk in ER-positive, lymph node–negative breast cancer patients. H/I was evaluated in MA.17 trial for prognostic performance for late recurrence and treatment benefit from extended adjuvant letrozole.

Methods A prospective–retrospective, nested case-control design of 83 recurrences matched to 166 non-recurrences from letrozole-and placebo-treated patients within MA.17 was conducted. Expression of H/I within primary tumors was determined by reverse-transcription polymerase chain reaction with a pre-specified cut point. The predictive ability of H/I for ascertaining benefit from letrozole was determined using multivariable conditional logistic regression including standard clinicopathological factors as covariates. All statistical tests were two-sided.

Results High H/I was statistically significantly associated with a decrease in late recurrence in patients receiving extended letrozole therapy (odds ratio [OR] = 0.35; 95% confidence interval [CI] = 0.16 to 0.75; P = .007). In an adjusted model with standard clinicopathological factors, high H/I remained statistically significantly associated with patient benefit from letrozole (OR = 0.33; 95% CI = 0.15 to 0.73; P = .006). Reduction in the absolute risk of recurrence at 5 years was 16.5% for patients with high H/I (P = .007). The interaction between H/I and letrozole treatment was statistically significant (P = .03).

The clinical applications of our findings apply to many women with ER+ early breast cancer. First, 5 years of adjuvant tamoxifen remains the standard adjuvant therapy for premenopausal women most of whom are menopausal after chemotherapy and 5 years of tamoxifen and are therefore potential candidates for extended AI therapy. Second, although upfront AI adjuvant therapy has become more common, 5 years of tamoxifen remains a common adjuvant therapy among postmenopausal women globally. Identifying which patients are vulnerable to a late recurrence and who among them will benefit from extended therapy is of substantial clinical value. Our biomarker should allow many women to avoid unnecessary treatment and for the focus to center on those in most need of therapy. This, in turn, could improve compliance with medication and further improve outcomes.^[21–24]

DISCUSSION: . . . . In conclusion, we have demonstrated in a prospective–retrospective analysis of the MA.17 trial that patients with primary tumors with a high H/I index who are disease-free after 4.5 to 6 years of adjuvant tamoxifen therapy receive benefit from extended adjuvant letrozole therapy. Performance of H/I in predicting treatment benefit from extended AI therapy for women who have used tamoxifen for less than 5 years and those who have taken upfront AI without any tamoxifen for 5 years awaits prospective–retrospective analyses of currently ongoing trials such as MA.17R, NSABP42, and others.^[25,26]

Conclusions In the absence of extended letrozole therapy, high H/I identifies a subgroup of ER-positive patients disease-free after 5 years of tamoxifen who are at risk for late recurrence. When extended endocrine therapy with letrozole is prescribed, high H/I predicts benefit from therapy and a decreased probability of late disease recurrence.

QUESTIONS I HAD: No HER-2+ gals were in the study, so how much does it relate to us? No mention of if patients received radiation treatments or not; again, for those of us who have been radiated, how much do the results relate to us?  Yes, questions abound, but at least when you meet your oncologists, you can ask to have the biomarker measured.  A big issue for all of us taking endocrine therapy is are we being overtreated?  If we can reduce this issue, so much the better.  Have a great day, everyone.

Lago i don't know how I missed these pics--Great and how nice of u'r DH for taking care this job--U 2 sound so together in life. Wonderful

Cypher PBrain will totally explain Cdiff---but again it has to do with a big D problem that causes chronic D-it's easily taken care of but sounds disgusting unless they came up with a new way. I think it's bacteria formed. I've been thr so many tests I really don't remember if that was just a stool test.????? Cypher u know I can't explain well.

Ok I need to ask this...so since Im 32...I know they prefer not to take out your ovaries bc of heart etc...but lower chance of recurrence correct? So who in here had ovaries removed? Or all u ppl thru menopause? Really hoping to not get my menstrual back...bc this could cause chance of recurreonce and Im trying to prevent all ways possible

Goutlaw I'm with you. No way do I want my monthly cycle back. I had two of them through chemo (TCH x6) and that was enough. I am 50yrs old and have always been on schedule so I'm hoping it will stay away. My Onc said time will tell and for me not to worry about it which is easier said than done. I'm sorry for all your going through at such of a young age. I know it's terrifying and I think all of the woman here put up a very strong front, and after awhile that's all we can do. I didn't realize, or even think much about how I was dealing with it, until I finally sat down and cried. Last chemo was May 9th, but I still get Herceptin every three weeks and the last one is scheduled for January 16th. I was in the Onc office last Thursday for regular check up and could not stop tears from forming in my eyes. I don't remember being that sad or worried, but a friend said "there you go let it out. All of us have been waiting for you to get it out?". That only made it worse. Everyone means well, but if they aren't going thought it they really don't know how it feels. Unfortunately, where I work there have been 10 of us that have cancer and diagnosed within the last 3 years. Seems like its running ramped now or that I'm just now paying more attention to it. Anyway, I'm with you and if we have to endure all of this treatment we should not have to put up with a monthly cycle. Keeping you in my prayers.



Rhonda