We are 225,712 members in 82 forums discussing 158,413 topics.

Help with Abbreviations

Topic: Tumor 20% Her2 positive and some weak ER+ cells -- How to treat?

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

Posted on: Dec 1, 2019 08:58AM

dono7392 wrote:

My 2 cm tumor has a focal area of Her 2+ (20% of tumor) and some ER weakly positive (15%) and negative cells. Local oncologists want to treat it like Triple Negative and Her2 positive (with AC-TH) but out-of-town oncologists would treat like Her2+ (Carboplatin+Herceptin). Supposed to start chemo next week but not sure what to do! Please let me know if you have any experience with this or input--thank you

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Page 1 of 1 (15 results)

Posts 1 - 15 (15 total)

Log in to post a reply

Dec 1, 2019 09:13AM windingshores wrote:

This is a tough one. I had a positive HER2 test, an equivocal and a negative. Then I had someone test again using 60 cells instead of 20 and got a negative, tough at the high end of normal. I have mixed ductal and lobular and the ductal areas were higher in HER2 expression. Someone told me that DCIS is even higher so that can affect results-?

I am 5 years out but still wonder if I was undertreated, but I don't think about it much.

Can you have the 20% of your tumor retested? How do you know it is 20%?

I would keep seeking opinions until you feel good about your decision. I had other contradictions and ended up seeing 4 oncologists. The last one really did everything possible to make me feel safe going forward.

I also talked with oncologists about risks of Herceptin versus benefit. Hard call.

Sympathies!


Dx 2/2015, DCIS/ILC/IDC, Right, 1cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery Lymph node removal; Mastectomy: Right Surgery Mastectomy: Left; Prophylactic mastectomy: Left Hormonal Therapy
Log in to post a reply

Dec 4, 2019 06:02PM dono7392 wrote:

windingshores. Such a difficult position to be in. I am just over the cusp of positive for Her2+ so fear I am being over treated and possibly not focusing on triple negative portion of tumor. I feel like I’m making a life or death decision! I take it you determined the risks outweighed any benefits? My drs are not very good about explaining that aspect to me.

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Dec 4, 2019 06:27PM MinusTwo wrote:

dono - Triple Negative means ER negative, PR negative and HER2 negative - so you aren't that. You are fortunate to be HER2+ because there are good treatments available now. Treating for HER2 + (even if it's mild) will likely take precedence because it's more virulent. There are lots of different treatments for ER/PR negative. They aren't usually as critical and can be complementary to the HER2 positive treatment and most given at the same time - like I had.

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
Log in to post a reply

Dec 5, 2019 07:04AM dono7392 wrote:

MinusTwo: The Her2 positive portion is a small "focal"' area of the tumor with the rest being Her 2 meg. Wouldn’tthe 80% that is ER/PR/HER2 negative be triple negative and treated as such?

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Dec 5, 2019 07:06AM dono7392 wrote:

MinusTwo: The Her2 positive portion is a small "focal"' area of the tumor with the rest being Her 2 neg.Wouldn't the 80% that is ER/PR/HER2 negative be triple negative and treated as such?

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Dec 5, 2019 08:34AM MinusTwo wrote:

dono - I don't remember & can't tell by your signature line - aren't you getting all this information from biopsies? Since only small samples are taken, you don't know how much will be HER2+. I'm not a doctor, but never the less starting HER2+ treatment along with chemo is the standard option.

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
Log in to post a reply

Dec 5, 2019 10:20AM dono7392 wrote:

I put the information in my profile, so not sure why it isn't showing up but.....I had surgery and they examined the entire tumor "block"

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Dec 5, 2019 11:37AM santabarbarian wrote:

Just another data point, I was TNBC and treated with Carboplatin and Taxotere, both often given with HP to Her 2 + people.

Carboplatin is fine to treat TNBC even w no Her 2 positivity. High grade, basal or basal-like TNBC cancers respond well to Carboplatin.

pCR after neoadjuvant chemo w/ integrative practices Dx 7/13/2018, IDC, Left, 3cm, Stage IIB, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 8/12/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/27/2018 Lumpectomy: Left Radiation Therapy 2/11/2019 Whole-breast: Breast, Lymph nodes
Log in to post a reply

Dec 5, 2019 04:45PM MinusTwo wrote:

dono - you have to select to make your information 'public' and not private.

As SB said - TC is a good choice. I was ER/PR negative and HER2+. I had taxotere & carboplatin in conjunction with the herceptin & perjeta for HER 2+. Long days but all infusions given in one day every 3 weeks for 6 sessions.

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
Log in to post a reply

Dec 8, 2019 05:41PM windingshores wrote:

Just to clarify, the final 60 cell count on the ductal areas of my IDC, ILC, DCIS tumor (where the HER2 was stronger), ended up being negative. With a positive, a negative, and equivocal and finally a negative with 60 cell count, I went with no Herceptin and no chemo. My Oncotype was low and I was highly positive for ER/PR so I went with anti-hormone treatment only.

Dx 2/2015, DCIS/ILC/IDC, Right, 1cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery Lymph node removal; Mastectomy: Right Surgery Mastectomy: Left; Prophylactic mastectomy: Left Hormonal Therapy
Log in to post a reply

Dec 8, 2019 06:09PM dono7392 wrote:

Thanks for clarifying. That’s wonderful that you didn’t need chemo!

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Dec 9, 2019 05:04PM WC3 wrote:

My cancer center is very reputable and does not give Herceptin and Adriamycin together due to the risk of heart damage. I'm not sure if that applies when giving them sequentially though. I kind of think it might because I have seen a study that showed Adriamycin and cyclophosphamide worked better against HER2+ cancer than a taxane and carboplatin and I would think if there were a way to safely combine the AC with Herceptin then my cancer center would have, but they seem to feel the taxane and carboplatin is the safer choice with Herceptin. It would definately be something to discuss further with an oncologist.

Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 6/1/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/15/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab)
Log in to post a reply

Dec 9, 2019 08:27PM dono7392 wrote:

Yes! My concern as well. I already have a bicuspid heart valve and I'm very frightened of heart damage by A + H. I have to decide by tomorrow which regimen to choose!

Surgery 10/8/2019 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
Log in to post a reply

Dec 9, 2019 10:45PM Cowgirl13 wrote:

Dono, I had Taxotere and Carboplatin with my herceptin. With heart problems to begin with, I would be very careful about the Adriamycin.

Be the kind of woman that when your feet hit the floor each morning the Devil says: 'Oh crap! She's up! Dx 5/28/2009, IDC, Left, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/16/2009 Chemotherapy 8/3/2009 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/21/2009 Hormonal Therapy 2/23/2010 Arimidex (anastrozole)
Log in to post a reply

Dec 10, 2019 06:39PM MinusTwo wrote:

Dono - I too had taxotere & carbo with herceptin & perjeta. I had heart echo tests every 6 weeks. I did not have a complete response, so after surgery I had AC chemo. Herceptin was halted for the duration of that and not started again until more echos. It's my understanding that any heart damage from Herceptin is usually reversable, while that from adriamycin is often permanent.

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

Page 1 of 1 (15 results)