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Topic: Please help - Kadcyla vs Herceptin for residual disease

Forum: HER2+ (Positive) Breast Cancer —

Testing, treatment, side effects, and more.

Posted on: Jun 18, 2021 07:39PM

SJH15 wrote:

Hello breast cancer community :)

I recently had surgery after receiving neoadjuvant treatment (chemo/Herceptin/Perjeta) for my T3N1 diagnosis of estrogen and HER2 positive ductal carcinoma. My path report came in showing less than 1mm of residual disease in the breast, with lymph nodes coming in clear.

After discussing with my oncologist, he is recommending I stick with Herceptin and not go on Kadcyla. His rationale is that <1mm of residual is very close to a PCR, so they will treat it as such. He mentioned there is no research that shows Kadcyla is effective on less than 1mm of residual plus the risks of the drug outweigh the potential benefits for my specific case.


My oncologist is very good, definitely a leader in the breast cancerspace in Canada. However, to me residual disease means there was still active cancer after treatment and I am questioning if I should push him on this. Curious to know if anyone in this group had a similar amount of residual disease and was put on kadcyla.


many thanks 🙏

Dx 12/10/2020, IDC, Right, 4cm, ER+/PR-, HER2+ Chemotherapy 1/8/2021 AC + T (Taxol) Targeted Therapy Herceptin (trastuzumab)
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Jun 18, 2021 10:48PM Docy wrote:

Hi SJH

I hade complete resolution of breast tumor, however had 0.3 mm micrometastasis in one lymph node.

My case some what complicated because I had positive lymph node on PET scan that was never biopsied and tagged and had lumpectomy and sentinel node removal.

Sine I decided not go for Axillary node dissection and not knowing if I have any other lymph nodes positive, I got a second opinion.

Both MOs recommenced Kadcyla and Iwill be also getting radiation to whole breast and axilla.

Docy Dx 12/2/2020, IDC, Left, 1cm, Stage IIB, Grade 2, ER-/PR-, HER2+ (FISH) Chemotherapy 12/21/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 5/13/2021 Lumpectomy: Left Targeted Therapy 6/17/2021 Kadcyla (T-DM1, ado-trastuzumab) Radiation Therapy 6/22/2021 Whole-breast: Breast, Lymph nodes
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Jun 19, 2021 08:33AM SJH15 wrote:

Thank you Warrior73. Reading your story makes me want a second opinion. All the best to you on your journey

Dx 12/10/2020, IDC, Right, 4cm, ER+/PR-, HER2+ Chemotherapy 1/8/2021 AC + T (Taxol) Targeted Therapy Herceptin (trastuzumab)
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Jun 25, 2021 08:39PM Imani wrote:

0.4mm residual in one node and I am doing kadcyla

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