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Topic: Different HER2 status on 2 different tumors in the same breast

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Nov 25, 2019 06:56PM - edited Nov 26, 2019 06:52AM by bkerber

bkerber wrote:

I had a biopsy 10/23 which came back Her2 negative. A few weeks later I had another biopsied which showed Her2 positive. Same breast.
Also, the first biopsy showed er positive, pr negative. The second one showed er positive, pr positive.
Is this possible or could it be an error.

Dx 10/23/2019, DCIS/IDC, Right, 2cm, Stage IB, Grade 2, 0/5 nodes, ER+/PR-, HER2- (FISH) Dx 11/18/2019, IDC, Right, 2cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2- (FISH) Surgery 11/26/2019 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 1/13/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Nov 25, 2019 07:48PM ElaineTherese wrote:

Hi!

This variation is entirely possible because biopsies just take samples of the tumors, and tumors are heterogenous, which means that they often contain some cells that have a characteristic and some cells that don't. My cancer was found to be 95% ER, which means that 95% of my cells were receptive to estrogen, and 5% were not.

After your lumpectomy, your surgeon should order a pathology report which will better define your cancer type. Good luck with surgery!


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 7/23/2014 AC Targeted Therapy 9/17/2014 Perjeta (pertuzumab) Targeted Therapy 9/17/2014 Herceptin (trastuzumab) Chemotherapy 9/17/2014 Taxol (paclitaxel) Surgery 1/12/2015 Lumpectomy: Right; Lymph node removal: Right, Underarm/Axillary Hormonal Therapy 2/25/2015 Aromasin (exemestane), Zoladex (goserelin) Radiation Therapy 3/9/2015 Breast, Lymph nodes
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Nov 25, 2019 09:16PM ElaineTherese wrote:

Oh, and also, two lumps might have different characteristics, even if they're in the same breast. Sounds crazy, right? But, you'll have a better idea of what you're dealing with after surgery. ((Hugs))

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 7/23/2014 AC Targeted Therapy 9/17/2014 Perjeta (pertuzumab) Targeted Therapy 9/17/2014 Herceptin (trastuzumab) Chemotherapy 9/17/2014 Taxol (paclitaxel) Surgery 1/12/2015 Lumpectomy: Right; Lymph node removal: Right, Underarm/Axillary Hormonal Therapy 2/25/2015 Aromasin (exemestane), Zoladex (goserelin) Radiation Therapy 3/9/2015 Breast, Lymph nodes
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Nov 26, 2019 10:47AM bkerber wrote:

Thank you Elaine!

Dx 10/23/2019, DCIS/IDC, Right, 2cm, Stage IB, Grade 2, 0/5 nodes, ER+/PR-, HER2- (FISH) Dx 11/18/2019, IDC, Right, 2cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2- (FISH) Surgery 11/26/2019 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 1/13/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Nov 26, 2019 09:09PM Bejeweled wrote:

Mine was like that. I had 2 biopsies on what was felt to be 2 separate masses. One was ER+ PR- HER2+ and the other was ER+ PR- HER2-. After my lumpectomy, the pathologist said that they were actually connected, and it was considered one single focus of disease. My MO asked for repeat HER2 testing, and it came back negative. I don't really know what to think. I don't know how much of the mass was really sampled and if the previous results matter. It's all very confusing.

I start chemo next week and will see the MO and discuss at that point I guess.


Dx 8/27/2019, IDC, Left, 4cm, Stage IIA, Grade 3, 1/3 nodes, ER+/PR-, HER2+ (FISH) Surgery 10/28/2019 Lumpectomy: Left; Reconstruction (left); Reconstruction (right) Chemotherapy 12/4/2019 AC + T (Taxol)
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Nov 30, 2019 11:46AM bkerber wrote:

Thanks for the replies. Just had my lumpectomy. BS will retest to get a better idea of what Im dealing with.

Dx 10/23/2019, DCIS/IDC, Right, 2cm, Stage IB, Grade 2, 0/5 nodes, ER+/PR-, HER2- (FISH) Dx 11/18/2019, IDC, Right, 2cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2- (FISH) Surgery 11/26/2019 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 1/13/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Dec 1, 2019 09:50AM windingshores wrote:

I had a positive HER2, an equivocal and a negative. I had a 3rd opinion who tested with 60 cells instead of 20. My tumor was mixed ductal and lobular, with the ductal areas being more intense with HER2. The Oncotype Dx test will also help clear things up for you. That tests on the gene level and I have been told that heterogeneity doesn't affect the results.

I was also told that having a lot of DCIS in a biopsy sample may result in a false positive HER2. I am grateful I got other opinions. Otherwise I would have had unnecessary chemo and Herceptin. I am 5 years out so far.


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
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Dec 1, 2019 11:28AM ElaineTherese wrote:

Windingshores is spot-on. Seek multiple opinions before you get sucked into chemo. Hope you're recovering well from your surgery!

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 7/23/2014 AC Targeted Therapy 9/17/2014 Perjeta (pertuzumab) Targeted Therapy 9/17/2014 Herceptin (trastuzumab) Chemotherapy 9/17/2014 Taxol (paclitaxel) Surgery 1/12/2015 Lumpectomy: Right; Lymph node removal: Right, Underarm/Axillary Hormonal Therapy 2/25/2015 Aromasin (exemestane), Zoladex (goserelin) Radiation Therapy 3/9/2015 Breast, Lymph nodes

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