Topic: TRIPLE POSITIVE GROUP

Forum: HER2+ (Positive) Breast Cancer — Testing, treatment, side effects, and more.

Posted on: Jan 31, 2011 07:30AM - edited Dec 10, 2012 08:55AM by TonLee

Posted on: Jan 31, 2011 07:30AM - edited Dec 10, 2012 08:55AM 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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Dec 15, 2012 01:22PM dancetrancer wrote:

I don't think I've seen this posted here yet - sharing some good news:

Trastuzumab Survival Benefit Still Significant 10 Years Later

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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Dec 15, 2012 04:20PM suzieq60 wrote:

Pbrain - I'm so glad you are tolertaing the new tx so much better.

LeeA - a port sounds like a plan for you - you've still got lots of treatments to go - it will make it a LOT easier.

2nd diagnosis October 2010 - IDC 5.8mm node negative - missed on mammogram in October 2009 Dx 10/13/2009, ILC, 1cm, Stage I, Grade 3, 0/5 nodes, ER+/PR+, HER2+
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Dec 15, 2012 05:02PM Bellanan wrote:

Lee, after my second treatment I decided to get a port! I had a similar experience and it is so unpleasant! Black and blue all over my hand and arm. The port is so easy. If you are going to continue with Herceptin I think it is really worth it- without it would amount to a year of poking. I figured I had so many other things to deal with that was one thing out of the way. SE alone are enough to deal with.
I asked before but didn't get a response - has anyone ever heard of IP-6? Vitamin.

Dx 9/19/2012, 2cm, Stage IB, Grade 2, 0/0 nodes, ER+/PR+, HER2+ Chemotherapy 10/3/2012 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Dec 15, 2012 06:39PM LeeA wrote:

Hi everyone - 

My MO (Relda's MO as well) is setting up a consult with a thoracic surgeon.  My left side used to be my "good" side for blood draws.  Since that was the cancer side - it can no longer be used.  

I have three more Vancomycin infusions/doses which = an 11 day course.  The breast surgeon said the culture came back negative for MRSA.  Actually, they said "the culture came back negative" so I don't know exactly what they were testing for but it was definitely negative for MRSA.  

The PS said the Alloderm didn't seem like it had adhered (?) correctly when he reopened everything (right side) last Friday.  I got the impression he removed it completely (right side).  I don't really understand Alloderm so I may not be wording that correctly.

Hopefully, the IV in my hand right now will stand up to these three last doses - then I'm to start Clindamycin (oral) and am now changing the dressing (right side only) three times per day using antibacterial ointment (prescription).  I still have the right drain but that will hopefully come out Thursday.  

The idea of all these antibiotics prior to chemo makes me kind of nervous but fortunately, a probiotic I purchased when my husband was sick back in 2007 was on sale 2 for 1 (I was shocked - it's typically $49 a bottle) so I'm taking that right now.  In case anyone is interested in this particular probiotic it's called Healthy Trinity by Natren.  Back in 2007 it had great online reviews but I see a few people have given it just one star on Amazon since then.  One thing I noticed when I took it back in 2007 was that my skin really cleared up.  

===

cypher, yes, I had the first dose of Herceptin this past Wednesday.  I didn't have any problems with it.  1.5 hour infusion.  I was really tired when I got home and the next morning I had a slightly elevated temperature (99.2) and my blood pressure was slightly elevated (also the next a.m.) but my blood pressure is all over the place anyway.  I had some very slight achiness in the area right above my knees and a bit of a runny nose but that was it.  I have no idea if any of this was related to the Herceptin but the slight thigh achiness was gone by the following morning (after the infusion). 



God is with you in all that you do. Dx 10/9/2012, IDC, 2cm, Stage IIB, Grade 3, 1/3 nodes, ER+/PR+, HER2+ Chemotherapy 1/2/2013 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 7/30/2013 3DCRT: Breast, Lymph nodes Hormonal Therapy 10/10/2013 Arimidex (anastrozole)
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Dec 15, 2012 07:24PM cypher wrote:

SpecialK, they haven’t checked my thyroid and I’m not on bone building stuff.  They are checking my ejection fraction—next muga is early jan.  I’m on a clinical trial and I think they checked the phosphorus because of that. 

Dance, encouraging study, but I can’t read much of it – is there a way to see the rest of it or can you cut and paste?  Also I see it studied anthracyclines, I wonder if the article says anything about taxanes?  It’s a little hard for me to get too excited about a 10 year survival given that I’m in my 40s.  I know they haven’t had herceptin all that long so that’s all they can say.

LeeA, I have no idea what MRSA is?  I’ve been taking probiotics since june and I do believe that they really helped me deal with GI issues during chemo.  But again – why no port? 

Dx 4/2012, IDC, 4cm, Stage II, Grade 2, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/14/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel Targeted Therapy 7/26/2012 Herceptin (trastuzumab) Chemotherapy 7/26/2012 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/17/2012 Breast Hormonal Therapy 1/31/2013
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Dec 15, 2012 07:55PM dancetrancer wrote:

cypher, here is the article: 

Trastuzumab Survival Benefit Still Significant 10 Years Later

IMNG Medical Media. 2012 Dec 12, MG Sullivan



SAN ANTONIO (IMNG) - Women who received paclitaxel and trastuzumab after anthracycline chemotherapy for HER2-positive breast cancer were almost 40% less likely to die by 10 years than were those given only paclitaxel in a pair of landmark clinical trials.

"This means that 80% of these patients - most of whom had node-positive disease - were alive at 10 years after their diagnosis of breast cancer." said Dr. Edward H. Romond, reporting long-term findings at the annual San Antonio Breast Cancer Symposium.

The regimen also reduced the risk of a 10-year disease-free survival event by 40% in the definitive survival analysis of the two pivotal trastuzumab (Herceptin) studies - the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31 protocol and the North Central Cancer Treatment Group (NCCTG) N9831 trial.

Both studies compared the paclitaxel/trastuzumab combination with paclitaxel alone in women with invasive HER2-positive breast cancers. All patients had undergone a lumpectomy or mastectomy with pathologically clear margins, and had axillary nodes that were initially pathologically involved.

Outcomes of both trials have been separately reported. However, because of their similar structure, treatment regimens, and patient populations, the Food and Drug Administration agreed to combine them to allow for a definite survival analysis, said Dr. Romond of the University of Kentucky, Lexington.

The combined analysis comprised 4,046 patients, 2,028 of whom took the paclitaxel/trastuzumab combination and 2,018 of whom took paclitaxel alone. The median follow-up in the combined analysis was 8.4 years, with data available for up to 10 years.

About half of the patients were younger than 50 years. Most had node positive disease; slightly more than half had hormone receptor positive-breast cancer. The tumor was T1 in 40%, T2 in 50%, and T3 in 10%.

By the end of the follow-up period, 680 disease-free survival events had occurred in the paclitaxel-only group vs. 473 in the combination therapy group (hazard ratio, 0.60; P less than .0001).

The disease-free survival curve began to separate shortly before year 2. The difference became significant around year 5; by year 6, 81% of the combination group and 69% of the single-therapy group were without an event. By year 10, the rates of disease-free survival were 74% and 62% - an absolute difference of 11.5%.

Most events in each group were distant recurrences (227 with the combination and 391 with single-therapy). Local or regional recurrence was seen in 84 and 124, respectively, and contralateral breast disease in 46 and 40. About 4% of women in each group developed a second primary cancer, and about 2% in each group died without a recurrence of their breast cancer.

There were 286 deaths in the combination group and 418 in the paclitaxel-only group. Women in the combination-therapy group were 37% less likely to die than were those who took paclitaxel alone - a significant difference (HR, 0.63; P less than .0001)

The survival curves began to diverge around year 2 and continued to separate throughout the follow-up period. By year 10, 84% of those in the combination group and 75% of those in the single therapy group were still alive, an absolute difference of 9%.

The survival advantage was apparent whether women had hormone receptor positive or negative disease, Dr. Romond noted (HR, 0.61 and 0.64, respectively).

Most deaths in both groups were due to the original breast cancer (209 in the combination group and 340 in the paclitaxel-only group). Other causes of death were a second primary cancer (25 and 41, respectively), or other or unknown causes.

The combination treatment was especially helpful for women with high risk factors, conferring a significant survival advantage over paclitaxel alone to women aged 60 years and older (14%), women with 10 more positive nodes (16%), and women with tumors larger than 5 cm (12%).

Dr. Romond had no financial disclosures.

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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Dec 15, 2012 08:04PM cypher wrote:

Thanks.  I'm confused that at the  beginning it says paclitaxels + herceptin after anthracyclines, and then later it doesn't talk about anthracyclines.  This is basically talkign about the benefit of adding herceptin to the mix, right?  Also, it looks like we're still at only a 74% survival rate at 10 years -- but it looks like the study mixed stages so that would include stages 1-3? 4? 

Dx 4/2012, IDC, 4cm, Stage II, Grade 2, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/14/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel Targeted Therapy 7/26/2012 Herceptin (trastuzumab) Chemotherapy 7/26/2012 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/17/2012 Breast Hormonal Therapy 1/31/2013
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Dec 15, 2012 09:01PM - edited Dec 15, 2012 09:02PM by TonLee

Cypher,

The study used node positive women...so yes, that would likely mean 1B,2, and 3.  Especially since it included data on women with 10+ positive nodes.

I don't see any new information here.  This is pretty much the stats I had two years ago when I started Herceptin.

Maybe it's the length of follow-up?  I dunno.  But as far as I can tell, no real news here.

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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Dec 15, 2012 11:26PM specialk wrote:

cypher - MRSA is methicillin-resistantStaphylococcus aureus, two types - community acquired and hospital acquired.  It is a mean infection that can kill you if not treated in time.  On the phosphorous I also was reading about an anemia connection, so I guess that could be a possibility too.

BMX w/ TE 11/1/10, ALND 12/6/10. 16 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 2013-2018. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+, IHC
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Dec 16, 2012 01:11AM fluffqueen01 wrote:

Lee, I highly recommend a port. Mine was removed after I finished my treatments.

Then I started a trial where they have to draw six units of blood every six weeks. They had a hard time getting one vial, much less six. The record for stabs was five, and they were freaked out at that. I was wishing I had left my port in, and so were they.

BMX 2/10 w/TE Taxol 12 wkly/herceptin- 1 yr/ Tamoxifen now. TE’s fail/TE’s back in.  Implants 11/11- perky!" tatoo touchup remains. Be kind, for everyone you meet is fighting a hard battle. Plato Targeted Therapy 3/12/2011 Herceptin (trastuzumab)

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