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Topic: PCR after neoadjuvant for HER2+

Forum: HER2+ (Positive) Breast Cancer —

Testing, treatment, side effects, and more.

Posted on: Apr 12, 2021 11:09AM

Vee36 wrote:

To all mu Her2 positive sisters, i was wondering did you receive a complete pathological response to chemo and still feel the tumor?

I finished chemo and did an ultrasound today which showed a significant reduction in size and shape of the mass but it is not completely gone; i was kind of hoping to hear out your experiences

Thanks a million💗

Dx 10/4/2020, IDC, Right, 2cm, Stage IIB, Grade 3, ER-/PR-, HER2+ (IHC)
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Apr 12, 2021 11:50AM Aram wrote:

Vee36, I have not completed the chemo yet so I don't have an answer for you but I wanted to know what kind of chemo did you have if you don't mind sharing?

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Apr 12, 2021 11:58AM Vee36 wrote:

Hi Aram, i did the AC Dose dense and then weekly taxol with herceptin perjeta every three weeks

Dx 10/4/2020, IDC, Right, 2cm, Stage IIB, Grade 3, ER-/PR-, HER2+ (IHC)
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Apr 12, 2021 02:42PM Aram wrote:

Our plan is very similar, I just have 16 weekly taxol. By the way have you seen this thread? It might be related to your question:

https://community.breastcancer.org/forum/80/topics/874047

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Apr 12, 2021 03:17PM Melbo wrote:

Vee you also PM’d me, but I will respond here too. I had a PCR to TCHP — I couldn’t feel my tumor anymore after the 4th round of chemo or so and the post chemo ultrasound showed no evidence of a mass.

Diagnosed right before my 42nd birthday. One husband, two dogs, one cat and no kids. Dx 7/16/2020, IDC, Left, 2cm, Stage IIA, Grade 3, 1/7 nodes, ER-/PR-, HER2+ Targeted Therapy 8/7/2020 Herceptin (trastuzumab) Targeted Therapy 8/7/2020 Perjeta (pertuzumab) Chemotherapy 8/7/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/20/2020 Lumpectomy: Left; Lymph node removal: Sentinel; Reconstruction (left); Reconstruction (right) Radiation Therapy 1/31/2021 Whole-breast: Breast, Lymph nodes
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Apr 12, 2021 05:20PM Beesy_The_Other_One wrote:

Vee, I've read and heard that tumors don't necessarily shrink as we might think--they can shrink in a way that makes them look like swiss cheese. That gave me some comfort, when after six rounds of chemo, I could still feel something. They'd done ultrasounds and said it was shrinking, but it was still very much there. My final pathology after surgery found no live cancer cells and only a "tumor bed." I remember thinking as I drove to surgery at zero dark thirty that what I was still feeling had to be the tumor, but it wasn't. Until that point, no one had explained to me that there is something left there, even if there are no live cells at the site. Here's hoping for a pCR for you!

1997: Phyllodes, R breast. 2018: IDC, L breast. TCHP, BMX, Radiation, Nerlynx. Dx 8/20/2018, IDC, Left, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
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May 29, 2021 02:19AM DeniseML wrote:

Vee, I did still feel something after completing 6 rounds of TCHP. Had a breast MRI immediately following last treatment & no cancer was detected . I, too had pCR in breast & lymph nodes.

Dx 8/3/2020, IDC/IBC, Left, 3cm, Stage IIIC, Grade 3, 0/7 nodes, ER-/PR-, HER2+ (FISH) Chemotherapy 8/25/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 1/15/2021 Lymph node removal: Underarm/Axillary; Mastectomy: Left Immunotherapy 2/24/2021 Radiation Therapy 2/24/2021 Whole-breast: Lymph nodes, Chest wall
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Aug 17, 2021 07:18PM Jammicoo wrote:

I had a PCR to TCHP. I could not feel the tumor after the second round and completed four rounds and then stopped, mostly because of my concern about potential long-term damage being done by the TCHP, But also because I felt the tumor had disappeared. MRI showed complete clinical response. At surgery the pathology showed that I had had a PCR and no positive nodes.

Dx 2/1/2021, IDC, Left, 2cm, Stage IIB, Grade 3, 0/4 nodes, ER-/PR-, HER2+ (FISH) Chemotherapy 2/25/2021 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 6/23/2021 Mastectomy: Left; Reconstruction (left): Silicone implant Targeted Therapy Herceptin (trastuzumab)
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Aug 27, 2021 05:50PM AlwaysMeC wrote:


Bumping this.

I just came from speaking with my breast surgeon about my post chemo ultrasound. Although the tumor shrank to less than half its size, they couldn't say if it was still cancerous, and the radiologist didn't want to commit to saying that the one positive node resolved. The results says it shrank as well. My breast surgeon said that he was probably trying to avoid blame if he was too positive about the results, hence the vagueness in the report. My breast surgeon said not to worry too much because I could still achieve a complete response.

Did any one of you have a similar experience prior to surgery? He says for my subtype, there is a good chance it will just be scarring left over. I hate that I am worrying all over again like before I was diagnosed.

I am trying to remain positive. Additional chemo would really be frustrating because I had issues with my port and picc, and finally got approved for Phesgo shots instead. It would be a huge setback for me and a logistical problem.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Aug 27, 2021 09:49PM MinusTwo wrote:

I had a BMX for DCIS & reconstruction - and I'll add with totally clear margins. Two years later I discovered a lump at my collar bone that turned out to be recurrent cancer, but now IDC & HER2+. I had neoadjuvant TCHP without PCR and then ALND surgery. So then I had AC chemo even though they got clean margins again!!!. Then back to Herceptin for a year along with 5 weeks of radiation. I loved my port and it served me well. All that was 7 years ago and I am still NED. Sometimes it's hard to believe it's been that long.

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
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Aug 28, 2021 12:51AM AlwaysMeC wrote:

Thanks for the input Minus Two. I am just a little frustrated because of the port issues. I actually didn't mind having it in. It made it so much easier for infusions. I am really clinging onto what my breast surgeon says, not only because it's a better outcome, but because I seem to be that unicorn where everybody says, well I haven't really seen that! On top of being in the 4 percent that are ER/PR neg HER+, I am done being a unicorn! I wanna be in the majority this time, since outcomes for HER2+ have been a lot better than in the past. Grrr.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Aug 28, 2021 04:36PM WC3 wrote:

This thread is a few months old but I'll chime in since I had a pCR. The tumor had soften significantly after my third infusion and the MRI I had after my 4th infusion showed a spot where the tumor had been but the report stated no signs of cancer. I'm not sure if it was missed or just no longer had characteristics of malignancy.

The surgical pathology report stated a small bit of DCIS had remained but it is still considered a pCR because no residual IDC was found.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 5/31/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/14/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Aug 28, 2021 04:41PM AlwaysMeC wrote:

Thanks WC3. My biopsy pathology says there is also comedo DCIS present as well as the IDC. It's interesting that could still be left over.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Aug 29, 2021 12:06PM LGR239 wrote:

Hi AlwaysMe,

Some context, I'm triple positive with multiple chonkers and lymph node spread but they started shrinking after first round and now the only thing I feel in my breast is my actual boob so have also been holding on to unicorn hopes.

I can't speak to final result (i.e. a complete pathologic response) since my surgery is scheduled for next month, but I had my post-chemo (6 TCHP) MRI and mammogram last Friday and when I read the results posted on my chart midweek, it showed the lymph node tumor was completely resolved but there was a 2.1 cm residual viable tumor for one breast tumor and 5 cm distribution of micro calcifications where the other was so obviously I was bummed about that.

Fast forward to Friday when I had an appointment with my surgeon who comes in smiling and is like I have great news for you and proceeds to tell me that the test results show a complete clinical response. Apparently those masses were just residue/scarring and necrotic tumor cells - but obviously have to wait till surgery to confirm plus a cCR doesn't guarantee cPR, so I think its definitely possible radiologist was just being cautious.

Tl;dr: Have a bunch of stuff left in my boob per my post-chemo scans but still considered a complete clinical response per my doctors

Dx 3/17/2021, IDC, Left, 6cm+, Stage IIIB, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 4/18/2021 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 4/18/2021 Perjeta (pertuzumab) Targeted Therapy 4/18/2021 Herceptin (trastuzumab)
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Aug 29, 2021 01:16PM AlwaysMeC wrote:

Hi LGR239, I hope your surgery and path results turn out well. Mine is scheduled next month also. Thanks for sharing your experience with me.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Aug 30, 2021 02:59PM LGR239 wrote:

Same to you! The waiting game is tough, I need to stop googling so much haha....when is yours scheduled?

Dx 3/17/2021, IDC, Left, 6cm+, Stage IIIB, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 4/18/2021 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 4/18/2021 Perjeta (pertuzumab) Targeted Therapy 4/18/2021 Herceptin (trastuzumab)
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Aug 30, 2021 03:05PM - edited Aug 30, 2021 03:06PM by AlwaysMeC

Mine is scheduled the third week of September, I forgot the actual date. I'm glad they were able to schedule it, since I heard that some breast cancer surgeries were being postponed. The doctor said they could reserve the operating room because it was a surgery after chemo. I really feel for the women/men who don't get chemo, but do surgery first, especially if they don't know yet what they are dealing with.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Aug 31, 2021 11:38AM LGR239 wrote:

Mine is September 21 so same…I know its not that far off but also it feels like forever when waiting to find out if there’s still anything left.

That’s so crazy that they are postponing cancer surgeries, I’m glad you were able to get a date! Is it due to COVID?

Dx 3/17/2021, IDC, Left, 6cm+, Stage IIIB, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 4/18/2021 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 4/18/2021 Perjeta (pertuzumab) Targeted Therapy 4/18/2021 Herceptin (trastuzumab)
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Aug 31, 2021 11:58AM Aram wrote:

I will be having BMX some time in October. The tumors are not palpable anymore which made my oncologist and surgeon very happy. I am anxiously waiting for the surgery and crossing my fingers for PCR.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Aug 31, 2021 06:58PM AlwaysMeC wrote:

LGR239, yes it's because of Covid. The main reason is oxygen conservation, followed by saving bed space, then limiting exposure.

Aram, best to you that you get a pcr. We're the same sub type and started at around the same time, so I have been following your posts as well. I hope your surgery goes smoothly.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Sep 2, 2021 04:46AM WC3 wrote:

I forgot to answer the original question. I was no longer able to feel the tumor after chemotherapy but the area felt thicker/denser than the surrounding tissue to me.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 5/31/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/14/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Sep 23, 2021 06:25PM Kimm992 wrote:

I had an ALMOST complete response. The large tumor that I could feel very obviously started to hurt and throb after my 2nd round of chemo. By the 5th round I could no longer feel it. At the time of surgery it had gone from 1.7cm to being just a tiny "spatter" of cancer cells. My oncologist said that this was a very good indication that the cancer responded well to the treatment.

I will be 6 years out from diagnosis next month!

Dx 10/14/2015, IDC, Right, 1cm, Grade 3, 0/3 nodes, ER-/PR-, HER2+ Chemotherapy 11/3/2015 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil) Targeted Therapy 1/6/2016 Herceptin (trastuzumab) Chemotherapy 1/7/2016 Taxotere (docetaxel) Surgery 3/24/2016 Mastectomy: Right Radiation Therapy 4/30/2016 Lymph nodes, Chest wall
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Oct 15, 2021 02:20AM AlwaysMeC wrote:

Kimm992, congratulations on 6 years. I hope you have many more decades ahead!

For anyone reading this thread, the chemo resolved the invasive tumor in the breast, but there was DCIS left over, which was removed as well. So the lump I could feel at the tumor bed was that DCIS left over.

Dx 4/2/2021, IDC, Left, 1cm, Stage IIA, Grade 2, ER-/PR-, HER2+ (FISH)
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Oct 15, 2021 10:18AM Aram wrote:

AlwaysMeC, that is good news :)

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Oct 15, 2021 11:25AM LGR239 wrote:

Wahooo congrats AlwaysMeC!

Dx 3/17/2021, IDC, Left, 6cm+, Stage IIIB, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 4/18/2021 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 4/18/2021 Perjeta (pertuzumab) Targeted Therapy 4/18/2021 Herceptin (trastuzumab)

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