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Topic: How many treatments 4 vs. 6

Forum: DCIS plus HER2-positive Microinvasion —

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Posted on: Mar 28, 2011 02:19PM

juleski wrote:

I was dx in Nov 2010.  43 yrs old.  No family history, perfect health, then BC.  I'm going through chemo right now, 4 treatments complete and 2 left.  Have been very lucky and have not been sick at all!  I have a little discomfort of aches and pains after my shot.  I am on a TCH regimen.  I'm just really apprehensive about doing 6 trtmts.  I feel like I'm being overtreated.  It did not go to my lymph nodes, I was told I would have to have chemo since I was HER2+.  Has anyone else had a similar diagnosis and treatment as I have?  I know there was a study done and presented at the Breast Cancer Symposium in San Antonio in Dec 2010 that studied 4 vs. 6 rounds of chemo.  I'm just scared of potential long term side effects and feel I'm too young to be overtreated now!  Any thoughts???

Dx 11/16/2010, IDC, 1cm, Stage I, Grade 3, 0/4 nodes, ER+/PR-, HER2+
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Mar 29, 2011 12:29PM Mountains1day wrote:

I had similar diagnosis....Stage 1 IDC, .7mm, Node Neg, Grade 2, Triple Highly Positive.  I had the same treatment (TCH) except 4 instead of 6 and Herceptin for 6 mnths verses 1 year based on the HERA study.  Onc agreed this was overkill but highly recommended the Herceptin as it had to be done with chemo because it was based on studies that proved it to be synergistic together.  In the future, chemo may be unnecessary as more biologic targeted therapies are discovered and proven effective with less toxicities. Kiss
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Mar 29, 2011 03:38PM Diane1960 wrote:

My mom's diagnosis was very similar to yours.  She also had 6 treatments of TCH.  She finished chemo in mid Feb and will continue with Herceptin until Nov.  A month after chemo she started to feel better and so far she hasn't noticed any residual side effects.

Here for my mom. She was diagnosed Aug 25 2010 - IDC, 1.3 cm, Stage1, Grade 3, 0 nodes, ER+/PR-, Her2+ Sept 3 - Lumpectomy, Sept 10 - Re-excision, Sept 24 - Unilateral mastectomy Chemo started Nov 4 -Taxotere & Carboplatin 6x, Herceptin 18x
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May 16, 2011 01:04PM rdg1959 wrote:

I have the same diagnosis as Mountains1Day. I start Chemo on May 26th: 6 treatments with 1 year of herceptin. Based on all the really negative info I've read on HER2+++ breast cancer and its aggresiveness, I highly recommend you complete your chemo. FYI, I had a bilateral MX on 2/28/11, with reconstruction. I opted for the BMX because of family history.  In addition to the one tumor biopsied, the detailed pathology found 3 more tumors in my left breast and one in my right - all too small to detect via mamogram. I consider myself very lucky to have caught it so early. God was watching out for me. Good Luck!

BMX March 2011 w/immediate DIEP flap reconstruction, TCHx6 w/ 1 yr herceptin Dx 2/7/2011, IDC, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2+
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May 16, 2011 02:48PM nupinkie18 wrote:

I just asked the question how is it determined how many treatments you get, still not sure but me and my mom came to the conclusion it must be based on the dx of the individual.  I was dx stage 1 IDC 11/18/10 and with all my other testing being negative (genetic, lymph nodes, and  2 biospies) it was contained in 1 spot (left) so I chose the lump. Had the surgery 12/23/10 all margins clear but HER2 is postive, recommended treatment 6 chemo treatments, herceptin for a year and radiation. I have heard stories from breast ca survivors that they didn't do the last treatment, they just felt like their body had had enough so again it just depends on the individual.  I just got my port done last thursday and my first treatment is this thursday and @ this point I plan to do the 6. So good luck on everything.

Dx 11/18/2010, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, HER2+
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May 16, 2011 03:15PM Beesie wrote:

Mountains1day, was your tumor 0.7mm in size, or 0.7cm (which would be 7mm)?  Just asking because I hadn't heard before of chemo being offered to someone with an invasive tumor that was a true microinvasion (i.e. 1mm in size or smaller).  

Renee, same question for you.  Was your tumor less than 1mm in size?  

It seems that the "line in the sand" for Herceptin and chemo is moving all the time. The NCCN treatment guidelines still suggest that chemo and Herceptin be considered for those who have invasive tumors that are 6mm in size or greater.  I know that quite a few women who've had tumors that are smaller - certainly 5mm or 4mm and sometimes even 3mm - have been offered chemo and Herceptin but for tumors that are any smaller, I haven't heard of these treatments being suggested before, except in rare cases where someone had several small invasive tumors. In fact for tumors that are smaller than 1mm in size, I'm surprised that they are able to accurately test for the HER2 status. I know that quite a few of us here with 1mm or smaller tumors have been told that our tumors were too small to be accurately tested.  It's certainly interesting how treatment progresses.   

Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole
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Feb 22, 2012 11:34AM boquin wrote:

Diagnosed 10/12 with IDC, ERS negative, Grade 2, Her2+. I was also recommended 6 TCH chemo treatments and have already gone 5 rounds. I have not responded well to any of the anti-nausea meds so have had a very rough time of it and have decided to only do these 5. My dr says studies on cure rates have only been for 6 treatments but I'll have huge benefits with 5. I'm done. This has been a nightmare every step of the way with every single side-effect known, every day. I haven't had a break between treatments. I will start radiation for 6 weeks, 5 days a week, and continue the herceptin for the year. I'm hoping for a little more tolerable road.

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Feb 28, 2012 05:55PM - edited Feb 28, 2012 05:56PM by Itzme

I am also receiving 4 TCH treatments and then herceptin for one year.  I will have radiation for 7 weeks, 5 days per week. My oncologist sees little difference between the results of those receiving 4 vs 6 treatments in reoccurrence rates.  He does not think exposing me to the side effects and/or toxicity of two extra treatments is worth it so I am going with 4.  Hope it's enough!! 

Dx 12/22/2011, IDC, 1cm, Stage I, Grade 3, 0/0 nodes, ER-/PR-, HER2+
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Mar 2, 2012 07:51PM - edited Mar 3, 2012 11:15AM by gwen1watkins

This Post was deleted by gwen1watkins.
Dx 9/11/2010, IDC, 2cm, Stage I, 0/2 nodes, ER+/PR+, HER2+
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Apr 13, 2012 12:42AM Itzme wrote:

Just a little update:  After completing my 4 TCH cycles, my oncologist suggested we do two more for a total of 6 TCH cycles.  He said for extra insurance against reoccurrence and the fact that I handled the TCH with little to no side effects influenced his decision.  A little bummed but if it improves odds against reoccurrence, I guess I will deal with it.  I may have no lymph node involvement but I am HER2+

Dx 12/22/2011, IDC, 1cm, Stage I, Grade 3, 0/0 nodes, ER-/PR-, HER2+
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Apr 26, 2012 11:25PM an30 wrote:

Itzme, I am 30 years old, have mastectomy in 4 days, so I don't know my complete pathology yet. According to biopsy of two areas in left breast, one showed DCIS the other IDC. Triple positive (ER+ PR+HER2+). My MO said my chemo would start a week after surgery and would be TCH x 6, then H 1 year. I asked how my treatment plan would change depending on results of pathology when breast is removed, he said treatment plan will not change. I had my pre-op with breast surgeon, and she felt the pathology could alter treatment. I should get results of BRCA soon, but no fam history and picture perfect health otherwise. Pet/ct showed no spread, blood tests show no tumor markers. I am concerned with the toxicity of chemo, especially with my fertility! Hoping to find statistics on 4 vs 6.

Good to hear your treatments have been ok, and you are almost done!

Dx 4/9/2012, IDC, 3cm, Stage II, Grade 2, 3/8 nodes, ER+/PR+, HER2+
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May 25, 2012 06:58PM maro wrote:

i was diagnosed as HER2 in april i had the tumor removed 1.5 2cm ,i had biopsy for glands,,,my next appointment is on 29may to discuss the results ,,,,but the doctor said that my brest might be removed,,,no one mentioned if had their breast removed when diagnosed with HER2,,,,willl someone plz tell me

i will need to go for chemo ,,i have no idea about it ,,

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Oct 5, 2012 06:40PM Pbrain wrote:

Juleski, if it helps, I'm pre-lumpectomy but from MRI and ultrasound, I am just like you.  IDC, stage 1, no lymph involvement.  I met with my oncologist for the first time today, and I got the exact same treatment regimen.  :-)

Jane~**~***~**~Put your head down and run like Walter Payton! And for those in treatment, this was my fight song Dx 9/26/2012, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (IHC) Surgery 10/16/2012 Lumpectomy: Left Targeted Therapy 11/9/2012 Herceptin (trastuzumab) Chemotherapy 11/9/2012 Carboplatin (Paraplatin), Taxotere (docetaxel) Chemotherapy 11/30/2012 Taxol (paclitaxel) Radiation Therapy 3/11/2013 Breast Hormonal Therapy 6/14/2013 Arimidex (anastrozole)
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Oct 3, 2016 10:52PM - edited Oct 3, 2016 10:53PM by Geege

I was HERS 2+ diagnosed exactly 5 years ago. My treatment was supposed to be 8 chemos. First 4, then the lumpectomy, and then the last 4. After the first 4 treatments I discussed not doing the last 4 with my oncologist as I felt it was over treatment since it thankfully did not hit my lymph nodes. He put all my stats in the computer and told me I should be fine with the 4 chemo treatments. Thank God.

i did still have to start on arimidex, had almost 7 weeks of radiation, and a full year of herceptin.

Speak to your oncologist about the amount of treatments you definitely need. But, of course, do what he says or ask another oncologist if that makes you feel better. I would not want you to regret not doing all you had to. I hope I made the right decision, and that you do too.

Good luck with everything and God bless.

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Oct 8, 2018 05:20AM Nisha517 wrote:

was anyone able to find the stud(ies) that show why 6 tchp is better than 4

Dx 7/11/2018, IDC, Left, Stage IIIA, 1/1 nodes, ER-/PR-, HER2+ Chemotherapy 8/9/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 8/10/2018 Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab)

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