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Topic: Her2+ and Her2- in the same tumor?!?!

Forum: Mixed Type Breast Cancer — Meet others who have mixed type breast cancer.

Posted on: May 17, 2016 02:39PM

smlowry7 wrote:

Hello!

I am wondering if anyone else has experienced what I am as far as the pathology of their CA goes. I was dx in Feb 2016 and due to the size and the wavy edge of part of my tumor the radiologist wanted a biopsy from both sides of my tumor. The results were biopsy at 9o'clock: 100% ER+, 90% PR+, Her2+++. Biopsy at 3o'clock: 100% ER+, 95% PR+, Her2-. The comment on the path report said that 90% of the tumor cells in the first biopsy was completely her2-, but 10% of the tumor cells show strong membrane reactivity and so the result is regarded as her2+.

I saw my MO's partner today because she was out of town for an emergency. She mentioned that she thought my tumor would have melted more by now since I have treatment #4 of 6 of TCHP tomorrow and my tumor is her2+. I explained my "unique" situation and she went over my path report with me. I asked if maybe the HP had taken care of the 10% that was her2+ and now only her2- was left. I also asked if it would change my treatment plan or if I would need another chemo treatment that is her2- specific. She said she would talk to my regular MO about a biopsy now vs waiting until surgery after chemo is done. She also said that her2- would have a different combo, but since i had her2+ as well getting the HP was important. I asked if I could do a her2- specific chemo treatment for extra coverage and she said it wasn't protocol, but my situation was complex. She didn't say no so I'm hoping they will give me extra coverage. They sent my specimens for blueprint and it was inconclusive due to not having enough tissue sample and they couldn't find any cancerous cells in the tissue they received.

Has anyone had a similar situation of her2- and her2+ in the same tumor or breast? If so, what was your tx plan to address both aggressively?Thanks in advance!

Dx 2/11/2016, IDC, Right, 6cm+, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Targeted Therapy 3/15/2016 Herceptin (trastuzumab) Targeted Therapy 3/15/2016 Perjeta (pertuzumab)
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May 17, 2016 02:47PM BarredOwl wrote:

Hi smlowry7:

This could represent "tumor heterogeneity" rather than "mixed". Here is a relatively recent thread that may be of interest to you:

https://community.breastcancer.org/forum/80/topics/843606?page=1#post_4709292

BarredOwl

Stage IA IDC, 9/2013 BMX. Right: IDC (1.5 mm, grade 2) with DCIS (5+ cm), 0/4 nodes, pN0. Left: DCIS (5+ cm), 0/1 node, pN0(i+).
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May 18, 2016 03:55PM smlowry7 wrote:

Thank ladies, I will look into the other forum! I wasn't sure where to start to ask about this!

Dx 2/11/2016, IDC, Right, 6cm+, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Targeted Therapy 3/15/2016 Herceptin (trastuzumab) Targeted Therapy 3/15/2016 Perjeta (pertuzumab)

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