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Topic: 6mm IDC Grade 2 ER- HER2+ 1/3 nodes - Advice please!

Forum: DCIS plus HER2-positive Microinvasion —

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Posted on: Mar 23, 2018 07:36PM - edited Mar 23, 2018 07:40PM by JRC46

JRC46 wrote:


I am posting on behalf of my mother to try and find out some more information for her to help determine next steps.

She is late 50's and was initially diagnosed with DCIS 6 months ago, from some calcium deposits on a routine mammogram. She had two local excision's which were unsuccessful.

The supporting report showed 6mm invasive ductal carcinoma, grade 2, ER negative, HER2 positive.

She has recently had a mastectomy with immediate reconstruction, but is now being told that Herceptin and Chemotherapy are recommended next steps.

I guess my questions are:

- Firstly, can anyone relate with a similar timeline of events/diagnosis?

- Are Herceptin/Chemotherapy the usual route with HER2+ at this stage, regardless of the 1/3 node and 6mm?

- Is the prognosis good? I'm trying to find some positives to take from this as from the initial DCIS diagnosis it seems to have got a lot more serious very quickly!

Also, if someone is able to explain the ER negative to me, and how this impacts/changes anything by being negative rather than positive, that would be great.

Many thanks in advance


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Mar 23, 2018 08:14PM ElaineTherese wrote:


It is not unusual for someone with DCIS to later be found to have some IDC. Yes, for any HER2+ tumor that is > than 5 mm, standard treatment would be Taxol + Herceptin, regardless of node status. HER2+ cancer is aggressive, but the discovery of Herceptin has meant that HER2+ breast cancer patients now have a very good prognosis. The survival rate for someone with your Mom's statistics would be 90+% in five years.

If your Mom tested negative for ER, then estrogen is not encouraging the development of her cancer. That means that she is unlikely to be prescribed Tamoxifen or an aromatase inhibitor, which help deprive cancer of the estrogen that feeds it. It means she has fewer options, but it also means that she won't have to take a med that not everyone tolerates well. ((Hugs))

Hope this helps!

DX IDC June 28, 2014, 5 cm., 1 node tested positive (fine needle biopsy); 0/20 after neoadjuvant chemo + ALND; Grade 3; ER+ PR+ HER2+ Neoadjuvant chemotherapy starting 7/23/14 ACX 4, Taxol X 12, Perjeta X 4; Herceptin: one year Chemotherapy 7/22/2014 AC Targeted Therapy 9/16/2014 Perjeta (pertuzumab) Targeted Therapy 9/16/2014 Herceptin (trastuzumab) Chemotherapy 9/16/2014 Taxol (paclitaxel) Surgery 1/11/2015 Lumpectomy: Right; Lymph node removal: Right, Underarm/Axillary Hormonal Therapy 2/24/2015 Aromasin (exemestane), Zoladex (goserelin) Radiation Therapy 3/8/2015 Breast, Lymph nodes
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Mar 23, 2018 08:14PM Peacetoallcuzweneedit wrote:

JRC - I think it is wonderful you are supporting your mom...

1) the time line question....I am not sure if initial biopsy showed the DCIS and then post surgery was the invasive component?? BUT I will say - it is not out of the ordinary for diagnoses to change once a final pathology is returned....mine did...from Stage 0 to Stage 1.

2) HER2+ are usually more aggressive cancers, and the 6mm, while small is larger vs a microinvasive definition, which is typically no more than any invasive component measuring more than 1mm. Herceptin is normal for HER2+ cancers...and I am hoping more ladies experiencing that treatment will come by and chime in because I have no experience with Herceptin. Search in the upper left about Herceptin...also if you are in the forum I think you are - go through some of the back and forth history...

3) ER and PR positive and negative have to do with the cancer cells and if they are strongly responsive/fueled by either Estrogen or Progesterone - many treatments for breast cancer have to do with blocking the hormone's ability to fuel the cancer cell and therefore it dies....called hormone therapies. The percentages are expressed from 0-100 and are just that...0% - 100%, the lesser the number the lesser the response to hormone therapies and therefore would need a systemic treatment like chemo to just kill all cancer cells...

There is no reason to think that your mom is not going to be ok J - keep asking your questions... other ladies will hopefully add more information and their experiences as well...sending a hug for you and your mom....

5/2017 Left Breast DCIS 6cm Grade 3 6/2017 Right Breast IDC Stage 1A, Tmic 0.5mm, 100% ER+/100%PR+/ HER2- 6/2017 BMX, SNB left, TEs x 2 8/2017 TE deflated -Replaced Oct 2017 Hysterectomy + ooph 11/2017 Implant Exchange June 2018 Nipples.
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Mar 27, 2018 02:03PM bluepearl wrote:

Chemo works very well on hormone negative. Given the small tumour etc. her prognosis is quite good...even if it is hormone negative a Her2+. Glad it was caught early too!

Dx 1/6/2011, IDC, 1cm, Stage I, Grade 1, 0/7 nodes, ER+/PR+, HER2- Surgery 2/12/2011 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Dx 2/2013, IDC, <1cm, Stage I, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 3/10/2013 Lymph node removal: Right, Sentinel; Mastectomy: Right Hormonal Therapy 3/18/2013
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Apr 1, 2018 06:22AM Daisy16 wrote:

hi , I was the same , my Tumor was 50mm and found after double mastectomy and recon . The great news is I'm now 3 and a half years on and fit and well ! I was 47 at diagnosis. I'm sure your mum will do well . Lots of love ❤️ xxx

Dx 10/24/2014, DCIS/IDC/Paget's, Right, 5cm, Stage IIB, Grade 3, 0/2 nodes, ER-/PR-, HER2+ Surgery 12/1/2014 Radiation Therapy Chemotherapy AC + T (Taxotere)
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Apr 1, 2018 07:04AM JRC46 wrote:

Many thanks all for your replies, they have been most helpful and informative.

Peacetoall... yes correct. Initial biopsy was DCIS and then post second local excision surgery the 6mm invasive was identified, as was Her2+. They advised to go ahead with a mastectomy due to 6mm size, and said that she was on the boarderline as to whether treatment would be required. Thanks - I will have a search to find out more about Herceptin.

Daisy16... Great to hear from someone who had a similar diagnosis, and great news that you are now fit and well! We are also located in the UK.

I see you all have "Stages" identified in your info... I assumed stage and grade were the same thing. I can't see stage mentioned anywhere on any of her paperwork, just that it is Grade 2...

She is due to start treatment in a couple of weeks and is going to try the cold cap. Any advice/tips regarding treatment? She is keeping positive, active and eating healthy, plenty of iron rich foods etc!

Thanks again!

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Apr 22, 2018 07:01PM Sassa wrote:

I was diagnosed with stage 1, ER negative, HER2+, grade 3 IDC (no nodes) in 2006.

Chemo and herceptin are life savers for us ER-, HER2+ women. It is very effective and your mother most likely will have a long time in remission (hopefully a permanent remission).

Dx 11/6/2006, IDC, 1cm, Stage IA, Grade 3, 0/9 nodes, ER-/PR-, HER2+
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Oct 3, 2019 04:47PM - edited Oct 3, 2019 04:49PM by Pinkpinkturk

'Hello sisters

I am stage1 a ( feb.14 2017 Mastectomy)

I am 39.

My tumor was 6 mm invasive and 1,5 cm dcis

MMargin And node negative

Dosedense chemo ( 4 Ac+4 Tchp)

Er 30 % , pr 40 %

Now exemastene and zoladex.

I Prayers for you.

Is there any recurence ?

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Oct 3, 2019 05:03PM MinusTwo wrote:

JRC: Yes, after original DCIS diagnosis, surgery often finds IDC. Once that happens, it is no longer referred to as DCIS. Sounds like your Mom is on a good treatment path. Below is a link about preparing for chemo. Also there are threads usually every month or every quarter on this site for people going through chemo. It was very helpful for me to communicate with others who were in the same place or had been recently. Look in the "active" posts for Chemo September 2019 or October chemo.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014

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