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Topic: TRIPLE POSITIVE GROUP

Forum: HER2+ (Positive) Breast Cancer —

Testing, treatment, side effects, and more.

Posted on: Jan 31, 2011 06:30AM - edited Dec 10, 2012 07:55AM by TonLee

TonLee wrote:

This is primarily for people who find themselves with THREE +'s by their diagnosis. 

If you are new to breast cancer, please click on the link below and read.  It is "What I Wish I Knew At the Beginning of Treatment."

http://community.breastcancer.org/forum/6/topic/797454



IDC, 2cm, Stage IIIa, Grade 2, 4/4 nodes, ER+/PR+/HER2+, Skin Sparing uni-MX with TE, TCH, Rads Dx 9/14/2010, IDC, 2cm, Stage IIIA, Grade 2, 4/4 nodes, ER+/PR+, HER2+
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Feb 27, 2020 07:45PM - edited Feb 27, 2020 07:47PM by ElaineTherese

Re: ovary removal....

I was 47 when I finished radiation and began ovulation suppression (Zoladex) + Aromasin (AI). My OB/GYN wasn't too keen on ovary removal because she says that women who keep their ovaries live longer. She prefers to remove ovaries "with problems," like painful cysts.

At 47, I thought I was fairly close to going through menopause as the average age of menopause is 51. So, I agreed to do ovulation suppression, thinking I could stop once I was menopausal. Well, last spring, I did a Zoladex vacation, and I still wasn't menopausal. So, here I am, entering my fifth year of ovulation suppression and my AI.

I don't really mind OS + AI. I had some mood swings at the beginning; my MO prescribed Celexa, and those went away. Perhaps the worst side effect has been osteoporosis. Since being on Prolia, however, my bone density has improved to where I now just have osteopenia.

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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Feb 27, 2020 08:24PM SpecialK wrote:

For those with trigger fingers/thumbs, I got relief from using coban wrap (like what they use after you have a blood draw - the stick to itself stretchy stuff) on the trigger joint, tight enough to allow a little bend, but basically immobilizing. It took about a month of doing this and the trigger resolved.

vijiya - chemo drugs suppress the immune system and inhibit healing - you wouldn’t have enough time between now and your start of chemo date to heal enough from surgery. Most who have an oopherectomy do it after chemo is finished and the discussion about treating the ER+ aspect happens

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC) Dx 9/27/2010, DCIS, Stage 0, Grade 3
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Feb 27, 2020 08:35PM LaughingGull wrote:

Here is an analysis on the long term effects of ovarian removal. I got my ovaries removed and I am happy about it, but I also had ovarian cysts and constant pain. The biopsy of my ovaries found a bit of endometriosis too. I made the decision after discussing with MO and oncologic ob-gyn

https://ascopost.com/issues/november-10-2017/model-emphasizes-long-term-risks-of-ovarian-ablation-plus-aromatase-inhibitor/

ACx4, THPx4, HP (to complete 1y); Nerlynx (1y); AI (expected 10y), Surgery: BMX + ALND, Reconstruction, Oophorectomy. Radiation. Dx 10/26/2017, IDC, Right, 3cm, Stage IIB, Grade 3, 2/6 nodes, ER+/PR+, HER2+ (IHC)
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Feb 27, 2020 08:39PM rlmessy wrote:

vijiya - for me the plan was to be chemo/herceptin, then tamoxifen. Now that has changed to herceptin/tamoxifen. I am 52 and have been in pre-menopause for the last 3 years, I get to like 10 or 11 months with no period and then have one in the fall. First time that happened we did a biopsy, second time I refused the biopsy because it was on time, in the fall and felt like a regular period. The third year same thing - difference was my estradiol jumped super high (I had been in the teens and it went to the 40's) and I got my BC diagnosis.

My MO is taking the approach that we will do tamoxifen for two years and see where I am at with the whole menopause and from there decide when to do a hysterectomy but both he and I agree all the female pieces and parts are going to come out at some time.

I am meeting with a new Gynecologist who will help us keep track of what's going on down there and if need be we will do surgery sooner.

I do think sometimes in the rush we move so fast we don't stop to think, fear plays a big part in that. I am comfortable waiting and giving the meds time to settle in my system and for my body to heal from one surgery before I move into another.

My DX appears below but I am also a caregiver to my awesome Mom, a 13 year (2006) BC Survivor, IIIa IDC, ER/PR+, HER2+, R MX, Lymphedema R Arm Dx 10/10/2019, IDC: Papillary, Right, 2cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 12/17/2019 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Hormonal Therapy 2/21/2020 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Targeted Therapy Herceptin (trastuzumab)
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Feb 27, 2020 09:14PM Vijiya wrote:

thank you very much for all the quick responses. Guess I can wait till the 3 month chemo is done before thinking about removing my ovaries.

have a nice day everyone

BTW...I am from Malaysia, so my postings will be at odd hours :)

Dx 1/21/2020, IDC, Right, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2+ (IHC) Targeted Therapy 3/3/2020 Herceptin (trastuzumab) Chemotherapy 3/3/2020 Taxol (paclitaxel)
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Feb 27, 2020 09:24PM LaughingGull wrote:

Good morning then Vijiya! Going to bed. Take care.

ACx4, THPx4, HP (to complete 1y); Nerlynx (1y); AI (expected 10y), Surgery: BMX + ALND, Reconstruction, Oophorectomy. Radiation. Dx 10/26/2017, IDC, Right, 3cm, Stage IIB, Grade 3, 2/6 nodes, ER+/PR+, HER2+ (IHC)
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Feb 28, 2020 05:29AM morrigan_2575 wrote:

"I do think sometimes in the rush we move so fast we don't stop to think, fear plays a big part in that. I am comfortable waiting and giving the meds time to settle in my system and for my body to heal from one surgery before I move into another."

Yep. I read about Ovary suppression as part of my initial research and presented to my BS as a question (can/should we do this and, why not just rip them out rather than more drugs?). I never stopped to think about the long term results, just cut it out, cut everything out that could lead to cancer (Tamoxofin has a 1% chance of causing Uterine Cancer? - Let's take The Uterus out?).

I've started to calm down and focus on getting through Chemo and Primary Surgery before looking at the road ahead. It's not always easy, especially if I read something on the board that sends me down a rabbit hole.

Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Feb 28, 2020 06:08AM Kimmh012 wrote:

Re: Ovaries removal...

I was diagnosed almost a year ago at age 49 with 95% ER, 90%PR and Estradiol was 302 Ovulation ... I was like Wait, What ... I had the ablation done 2010 and partial hysterectomy 2015, kept my ovaries for health benefits, no periods since.

At first, I too wanted everything gone. chop off my breast and total hysterectomy!! Thank goodness my doctors new better. I kept my breast and no oophorectomy.

Chemo put me into menopause and I had my Estradiol checked again Jan 2020, last chemo Sept 2019, it is now at <5pg Postmenopausal (ChemoPause). I am not on AL yet, waiting til after my DEXA scan.

Meanwhile I take 20mg of melatonin at night as there have been studies showing it decreases your hormone levels. Hot Flashes are hard, going to try the SGB, stellate ganglion nerve block, to see if it helps, supposed to help with my migraines as well, fingers crossed.

Hang in there! Here are just a few links, hope they work.

https://www.hindawi.com/journals/ije/2018/3271948/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55036...

https://www.sciencedaily.com/releases/2016/08/1608...

https://www.naturalmedicinejournal.com/journal/201...


~ALWAYS AN ADVENTURE~ Dx 3/22/2019, IDC, Left, 2cm, Stage IIA, Grade 3, 1/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 4/3/2019 Lumpectomy: Left; Lymph node removal: Sentinel Dx 5/1/2019, DCIS, Left, 1cm, Stage 0, Grade 3, 1/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 5/1/2019 Lumpectomy: Left Chemotherapy 5/13/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Chemotherapy 6/24/2019 AC Chemotherapy 9/17/2019 Taxotere (docetaxel) Targeted Therapy 9/18/2019 Herceptin (trastuzumab) Surgery 11/6/2019 Lumpectomy Radiation Therapy 1/13/2020 Whole-breast: Breast, Lymph nodes
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Feb 28, 2020 05:12PM hapa wrote:

I keep getting confusing reading the soft and text trials. I am on AI + ovarian suppression. Is this the most effective option for triple positives? It looks to me like tamoxifen + ovarian suppression was more effective. But maybe not when you take overall survival into account? Can you even look at overall survival as an end point on an 8 year trial these days? I feel like our odds are so good as triple positives that you'd need a 10-20 year study to be finding difference in overall survival vs. disease free survival (which I guess is why they use DFS). Maybe it's time to quit reading studies. I see my MO again in June when I finish Nerlynx, I'll see what he has to say then. I certainly do not mind not having periods anymore. I can't believe I lived like that for almost 30 years!

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2+ (FISH) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 10/22/2018 Whole-breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Mar 2, 2020 03:50PM SuzieQ2019 wrote:

Hapa,

May I ask if you took Arimidex and Nerlynx at the same time? My MO started me on Kadcyla instead of Herceptin and Perjeta after completing 6 rounds of TCHP and DMX in November. I just learned about Nerlynx, and I’m curious if I would be a candidate.

Stage 1 IDC. Triple positive. TCHP and double nipple sparing mastectomy with implant reconstruction.
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Mar 2, 2020 05:12PM hapa wrote:

I have been taking Arimidex and Nerlynx concurrently. I doubt your MO would put you on Nerlynx after Kadcyla. Nerlynx was approved before Kadcyla on some dubious data and was nowhere near as effective in its phase III trial.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2+ (FISH) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 10/22/2018 Whole-breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Mar 2, 2020 07:51PM SuzieQ2019 wrote:

Hapa,

Thanks for the info!

Stage 1 IDC. Triple positive. TCHP and double nipple sparing mastectomy with implant reconstruction.
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Mar 5, 2020 07:21PM JP47 wrote:

Hi, new here and newly diagnosed. Starting chemo next week. Confused about a few things. 1. I really don’t know what stage I am because I have multiple tumors in the left breast and an area that showed non mass enhancement on MRI. One tumor was 1.8 cm and one was 1.2 Cm there “might be 2 more 1 cm“ ones and a larger area of the non mass enhancement. Maybe multi focal or multi centric. This worries me.

2. Lymph node involvement.... nothing shows up on CT, MRI or PET but don’t we have to wait for surgery to know? And if we do neo-adjuvant then how will we ever know?

3. One of the questions asked was if the cancer was in our vascular system? Is that just mean was our cancer markers high in the blood tests we got?


Dx 2/16/2020, IDC, Left, Stage IB, Grade 3, ER+/PR+, HER2+ Targeted Therapy 3/10/2020 Perjeta (pertuzumab) Targeted Therapy 3/10/2020 Herceptin (trastuzumab) Chemotherapy 3/10/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 5, 2020 07:52PM morrigan_2575 wrote:

Welcome to the board. Have you met with an MO yet? Most of these questions are probably best answered by your MO.

For #2 i asked an MO that and he basically said if there's no cancer post neoadjuvant therapy it counts as no lymph nodes involved (provided all others tests pre-chemo showed no involvement)

#3 should tell you on you biopsy. Mine was on the biopsy done for the microcalcifications.

Hopefully someone else can help you out with the rest. My doctor told me final staging is done during the surgery which is a little frustrating to me.

Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 5, 2020 10:41PM HeartShapedBox wrote:

JP47 There are two types of staging, clinical (based on what is known from biopsy and scans) and pathological (the final call, based on what is actually found surgically). If your MO staged you at 1b (as listed on your stats), then that would be your clinical stage. My understanding is even with (potentially) multiple tumors, sizing is based solely on the largest diameter of the largest tumor. Is it possible there are mets in lymph nodes not yet known/ too small to show in scans? Yes, and that's part of why pathological staging is the final call. Scans can prove murky in terms of actual dimensions/ #s of tumors, but that's the best we can know until surgery, which will further determine actual tumor size and status of lymphovascular invasion.

Diagnosed at age 43. Triple + luminal B regional spread to lymph nodes, pathological TNM stage llB after 6 sessions neoadjuvant TCHP (dropped perjeta after 4 doses), initial clinical stage lllA Dx 5/24/2019, IDC, Left, 5cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 8/1/2019 Perjeta (pertuzumab) Targeted Therapy 8/1/2019 Herceptin (trastuzumab) Chemotherapy 8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Dx 12/27/2019, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 2/8 nodes, ER+/PR+, HER2+ (IHC) Surgery 12/27/2019 Lymph node removal: Underarm/Axillary; Mastectomy: Left Radiation Therapy 3/4/2020 Whole-breast: Lymph nodes, Chest wall
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Mar 6, 2020 07:16AM JP47 wrote:

Ok thank you. So lymphovascular is the same thing? Not separate? So we really don’t know until the pathological surgery point then?
The surgeon told me that the PCR is no cancer remaining after the neoadjuvent, but not to worry if there was some because they would take it out with surgery.

I’m reading that if you are a PCR (60% of people are), and you follow the normal regimen of Herceptin follow up with the hormone blocking agents.... the chances of “cure” (at least for a 5year rate) are 92-95%. Is that what you guys understand too? I guess my question is.... do we know the stats of you are NOT a PCR? Assuming it depends on how much cancer was left and where. And what follow up drugs you took after.

This is so much to take in.

Dx 2/16/2020, IDC, Left, Stage IB, Grade 3, ER+/PR+, HER2+ Targeted Therapy 3/10/2020 Perjeta (pertuzumab) Targeted Therapy 3/10/2020 Herceptin (trastuzumab) Chemotherapy 3/10/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 6, 2020 08:25AM morrigan_2575 wrote:

"So lymphovascular is the same thing? Not separate?"

Not the same as Lymph Node Involvement

"Vascular or lymphatic system invasion happens when breast cancer cells break into the blood vessels or lymph channels. This increases the risk of the cancer traveling outside the breast or coming back in the future. Doctors can recommend treatments to help reduce this risk.

Your pathology report will say "present" if there is evidence of vascular or lymphatic system invasion. If there is no invasion, your report will say "absent." Lymphatic invasion is different from lymph node involvement. The lymph channels and lymph nodes are part of the same system, but they are looked at and reported separately.'

https://www.breastcancer.org/symptoms/diagnosis/va...

https://www.breastcancer.org/symptoms/diagnosis/ly...

" I'm reading that if you are a PCR (60% of people are), and you follow the normal regimen of Herceptin follow up with the hormone blocking agents.... the chances of "cure" (at least for a 5year rate) are 92-95%. Is that what you guys understand too? I guess my question is.... do we know the stats of you are NOT a PCR? Assuming it depends on how much cancer was left and where. And what follow up drugs you took after."

I was told my 5 year OS rate was 98% with TCHP but, my prognosis is different so I would ask your MO.

There's also post surgery treatments (14 Cycles of Kadcycla) if you don't have a PCR.

The only thing I know about PCR is that if you're in that bucket it reduces your recurance risk but, i don't know by how much for Triple+. Sadly, we are quite often left in limbo on these things.

https://ascopost.com/News/59546

  • Patients with breast cancer who had a pathologic complete response were 69% less likely to have disease recurrence compared with those who did not have a pathologic complete response. The relationship was strongest among patients with triple-negative or HER2-positive breast cancer with a pathologic complete response, where such patients were 82% and 68% less likely, respectively, to have a disease recurrence.
  • Patients with hormone receptor–positive breast cancer who had a pathologic complete response had a trend toward lower risk for recurrence compared with those without a pathologic complete response, but the data were not statistically significant.
Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 6, 2020 12:04PM HeartShapedBox wrote:

JP47 I know it's frustrating, but yes, besides any genetic testing, you won't know more than what you know now, until surgery (besides any future scans looking for changes from chemo response or disease progression, if applicable). Scans are limited in what they can "see" and often can't detect smaller tumors (of a few mm) and cannot detect lymohovascular micromets (the vessels of blood and or lymph), and all of these things determine accurate staging and thus statistical odds of recurrence and death.

Being stage 1 wiith small tumors and no lymph involvement gives you really good odds, even without PcR. If it helps you to compare and contrast, my clinical staging was an estimated 3a, with an almost 6 cm main tumor and multiple palpable lymph nodes (the exact # unknown but 1 confirmed during biopsy, and my largest lymph node was larger than your largest main tumor). Every scan gave me a different tumor size or node #, at one point they said I had a 5 cm tumor with smaller satellite tumors around it. We'll never know exactly what was going on at that point because I had neoadjuvant TCHP, which gave me a response my MO called "very good", but not PcR. There was lots of cancer left in my opinion- my main IDC tumor still measured 4cm (but "was positive for signs of response"), with areas of DCIS and 2 positive nodes, which makes me pathological stage 2b. My MO said without Kadcycla I had 23% chance of recurrence within 3 years (aka 77% chance of disease free survival in 3 years), but a year of Kadcyla would shave those odds of recurrence in half. So (if I'm able to finish treatment, which I'll start once I'm done with radiation) I'm looking at a 88% of disease free survival, with a large tumor and positive nodes with no PcR.

My MO also said that being HER2+ means it's more likely to come back within the next several years, but LESS likely than hormone positive HER2 negative cancer to come back after that, at say, the 10 or 15 year point. Note that there is NO "cure"; nothing will make even the smallest case of DCIS 100% likely to never come back, and all we have are statistics for what is likely but not guaranteed in each case.

Diagnosed at age 43. Triple + luminal B regional spread to lymph nodes, pathological TNM stage llB after 6 sessions neoadjuvant TCHP (dropped perjeta after 4 doses), initial clinical stage lllA Dx 5/24/2019, IDC, Left, 5cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 8/1/2019 Perjeta (pertuzumab) Targeted Therapy 8/1/2019 Herceptin (trastuzumab) Chemotherapy 8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Dx 12/27/2019, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 2/8 nodes, ER+/PR+, HER2+ (IHC) Surgery 12/27/2019 Lymph node removal: Underarm/Axillary; Mastectomy: Left Radiation Therapy 3/4/2020 Whole-breast: Lymph nodes, Chest wall
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Mar 6, 2020 12:29PM - edited Mar 6, 2020 12:30PM by morrigan_2575

"My MO also said that being HER2+ means it's more likely to come back within the next several years, but LESS likely than hormone positive HER2 negative cancer to come back after that, at say, the 10 or 15 year point."

This is on my list of questions to my MO next time I see him. Was supposed to be this week but, they switched me to the NP without telling me.swear we get lost in the discussion.

I think the clinical vs pathology/surgery staging is confusing to those of us doing Neoadjuvant. I know i asked both my BS and MO about it because it confused me.


Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 6, 2020 02:01PM - edited Mar 6, 2020 02:06PM by HeartShapedBox

Morrigan- staging status is definitely confusing and frustrating, esp when you're newly diagnosed. It gets more confusing when neoadjuvant chemo is in the picture- if a person has tumors and positive nodes but achieves PcR with no cancer found at surgery, what is pathological staging then?? It gets complex, but at the end of the day the PURPOSE of staging is what's really important (and different types of staging models can help with this). Here's a good article explaining that dynamic a little better

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC44417...

My first try wouldn't hyperlink, hope this one works!

Diagnosed at age 43. Triple + luminal B regional spread to lymph nodes, pathological TNM stage llB after 6 sessions neoadjuvant TCHP (dropped perjeta after 4 doses), initial clinical stage lllA Dx 5/24/2019, IDC, Left, 5cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 8/1/2019 Perjeta (pertuzumab) Targeted Therapy 8/1/2019 Herceptin (trastuzumab) Chemotherapy 8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Dx 12/27/2019, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 2/8 nodes, ER+/PR+, HER2+ (IHC) Surgery 12/27/2019 Lymph node removal: Underarm/Axillary; Mastectomy: Left Radiation Therapy 3/4/2020 Whole-breast: Lymph nodes, Chest wall
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Mar 6, 2020 03:25PM morrigan_2575 wrote:

thanks for the link, that was a very good read.

Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 6, 2020 04:55PM HeartShapedBox wrote:

Also, this Neoadjuvant therapy outcome calculator may be of help

http://www3.mdanderson.org/app/medcalc/index.cfm?p...


Diagnosed at age 43. Triple + luminal B regional spread to lymph nodes, pathological TNM stage llB after 6 sessions neoadjuvant TCHP (dropped perjeta after 4 doses), initial clinical stage lllA Dx 5/24/2019, IDC, Left, 5cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 8/1/2019 Perjeta (pertuzumab) Targeted Therapy 8/1/2019 Herceptin (trastuzumab) Chemotherapy 8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Dx 12/27/2019, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 2/8 nodes, ER+/PR+, HER2+ (IHC) Surgery 12/27/2019 Lymph node removal: Underarm/Axillary; Mastectomy: Left Radiation Therapy 3/4/2020 Whole-breast: Lymph nodes, Chest wall
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Mar 6, 2020 05:02PM morrigan_2575 wrote:

ohh, I love Calculators 😁. Will have to remember once I get the pathology staging post surgery

Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 7, 2020 08:43AM Cassandra6430 wrote:

Hi everyone, while reading a different thread I heard about the triple positive group. Well that’s me! Was diagnosed just about two weeks ago and I’m scheduled for my port placement Monday and TCHP infusion Tuesday. I’m so thankful I joined this community

Dx 2/24/2020, IDC, Right, Stage IB, Grade 2, ER+/PR+, HER2+ (FISH) Targeted Therapy 3/10/2020 Herceptin (trastuzumab) Chemotherapy 3/10/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 7, 2020 09:19AM YesIamaDragon wrote:

Hi Cassandra, and welcome to the club no one wanted to join!

For the port, I got a seatbelt cushion off amazon and am glad I did. Was (actually still is, since i have a bony chest and have another 9 months of Kadcyla infusions) great for both the port and coming home after surgery (though I was nie and numb and flying high for that!)

Get some Emla cream for the infusion Tuesday -- you will still be pretty darn sore after port placement and the Emla helps. At this point I usually forget it before infusions and the poke isn't bad enough to want lidocaine but when the port is new it is more tender.

Best of luck!

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Mar 7, 2020 01:10PM JP47 wrote:

Thank you for the info. My path report didn't say anything about "present" or "absent" so I guess I don't know. My left breast also had multiple tumors and a large area of DCIS...likely to be 5-6cm. We just dont know. But knowing this...maybe pending lymp nodes after surgery...I might ask for the Kadcyla. Lets hope both of us can get through the treatment protocol we are on (me just about to start).

Dx 2/16/2020, IDC, Left, Stage IB, Grade 3, ER+/PR+, HER2+ Targeted Therapy 3/10/2020 Perjeta (pertuzumab) Targeted Therapy 3/10/2020 Herceptin (trastuzumab) Chemotherapy 3/10/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 7, 2020 01:15PM JP47 wrote:

THanks!

Dx 2/16/2020, IDC, Left, Stage IB, Grade 3, ER+/PR+, HER2+ Targeted Therapy 3/10/2020 Perjeta (pertuzumab) Targeted Therapy 3/10/2020 Herceptin (trastuzumab) Chemotherapy 3/10/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 7, 2020 02:47PM HeartShapedBox wrote:

JP47 if you have any residual cancer at surgery I'm sure your MO will recommend Kadcyla- it's becoming the new standard of care in such cases since 2019.

Some people do pretty well on TCHP and others have a harder time- I was in the latter category! Perjeta gave me awful nonstop diarrhea despite immodium, so after 4 rounds my MO pulled that part, but said even that amount did a lot of good. I highly recommend using glutamine powder to prevent neuropathy and ease mouth pain- it's been proven in clinical trials to do so

https://clincancerres.aacrjournals.org/content/7/5...

I started to develop neuropathy after my first chemo, but taking 10g of glutamine 3x a day in some juice (for a week, starting the day before chemo) prevented it entirely for the most part (with a few days of tingles towards the end, when I was sometimes forgetting to take all 3 doses) I didn't ice anything except my mouth (sucked on ice chips during the taxotere and carboplatin portion), but some choose to ice hands and feet.

If you haven't already done so, join the March 2020 chemo group; it can be very helpful to have the support of people going thru it at the same time! Good luck, I hope TCHP is easy on you.

Diagnosed at age 43. Triple + luminal B regional spread to lymph nodes, pathological TNM stage llB after 6 sessions neoadjuvant TCHP (dropped perjeta after 4 doses), initial clinical stage lllA Dx 5/24/2019, IDC, Left, 5cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 8/1/2019 Perjeta (pertuzumab) Targeted Therapy 8/1/2019 Herceptin (trastuzumab) Chemotherapy 8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Dx 12/27/2019, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 2/8 nodes, ER+/PR+, HER2+ (IHC) Surgery 12/27/2019 Lymph node removal: Underarm/Axillary; Mastectomy: Left Radiation Therapy 3/4/2020 Whole-breast: Lymph nodes, Chest wall
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Mar 7, 2020 03:43PM AngieB92 wrote:

JP47, hi!

I did fine with TCHP. HeartShapedBox is right though, get out in front of the diarrhea and stay hydrated! I was able to work (desk job) through TCHP. The worst of my side effects was the loss of taste buds for about 10 days. It made wanting to eat and drink a challenge. Dasani bottled water was the only water that tasted good to me.

The port will be your best friend!

I wish you loads of luck

Dx 8/8/2019, IDC, Left, 2cm, Stage IB, Grade 2, ER+/PR+, HER2+ Targeted Therapy 9/17/2019 Perjeta (pertuzumab) Targeted Therapy 9/17/2019 Herceptin (trastuzumab) Surgery 3/3/2020 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy 4/10/2020 Kadcyla (T-DM1, ado-trastuzumab)
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Mar 7, 2020 03:58PM - edited Mar 7, 2020 04:05PM by morrigan_2575

I'm currently on TCHP (middle of round 2). Taste buds go wacky but, water still tastes good. Immodium doesn't do a lot for me I just living with it. I do ice hands/feet/mouth but, will add the glutamine powder didn't hear of it before. I haven't gotten mouth sores but, have had Thrush both times. They gave me a mouth rinse and now lozenges and they work.

For me the biggest issue is the Thrush and taste buds but, everything is manageable.

I agree with others join the March 2020 Chemo group, it really helps talking to people going through it same as you (even If they're on a different treatment)

Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 2/4/2020 Perjeta (pertuzumab) Targeted Therapy 2/4/2020 Herceptin (trastuzumab) Chemotherapy 2/4/2020 Carboplatin (Paraplatin), Taxotere (docetaxel)

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