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Topic: Her2 positive - lumpectomy or mastectomy?

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Mar 13, 2019 10:31PM

Gritty wrote:

hi, any advice, path, etc. you took would be helpful in making my decision. Recurrence seems high for HER2 but maybe not so much now with Herceptin? Thanks!

Just diagnosed.... 2cm lump. PR+, ER+, HER2

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Mar 13, 2019 10:38PM Salamandra wrote:

My understanding is that Herceptin has been such a big game changer that any statistics with data from before it came into common use are basically useless. Definitely speak with your doctor about expected recurrence rates with either form of treatment.

Also anyone facing this decision should read Beesie's awesome and epic post on it. She is such a treasure: Considerations: Lumpectomy w/Rads vs. UMX vs. BMX

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Radiation Therapy 12/3/2018 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 13, 2019 10:47PM Gritty wrote:

thank you

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Mar 14, 2019 08:16AM Ingerp wrote:

I was told early on that HER2+ tumors are more aggressive but have a better outcome, specifically because of Herceptin. Happy to be living at a time when it's available.

Dx 3/11/2016, DCIS, Left, 6cm+, Stage 0, Grade 3, ER-/PR- Surgery 3/23/2016 Lumpectomy Surgery 4/20/2016 Lumpectomy: Left Radiation Therapy 5/18/2016 Whole-breast: Breast Dx 3/2/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 3/13/2018 Lumpectomy: Right; Lymph node removal: Sentinel Targeted Therapy 5/18/2018 Herceptin (trastuzumab) Chemotherapy 5/18/2018 Taxol (paclitaxel) Radiation Therapy 8/20/2018 Whole-breast: Breast
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Mar 14, 2019 08:56AM Beesie wrote:

You need to separate the risk of a local/regional recurrence (in the breast or nodal area), which is affected by the type of surgery chosen, from the risk of a distant recurrence (i.e. metastasis), which for the most part is not affected by the type of surgery chosen.

From these two small studies, it appears that being node positive and not having radiation (necessary with a lumpectomy; not usually done with a MX unless node positive) are factors that may drive a higher local/regional recurrence rate.

Locoregional recurrence and survival outcomes by type of local therapy and trastuzumab use among women with node-negative, HER2-positive breast cancer.

Predictors of locoregional outcome in HER2-overexpressing breast cancer treated with neoadjuvant chemotherapy.
“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Mar 14, 2019 09:55AM BadLuck wrote:

Ingerp - I would go for a lumpectomy for sure & if you ever get cancer back in that same breast then have a mastectomy. A mastectomy is too risky for infection. And to go to the extreme of losing your whole breast would be even more devastating.

BadLuck Dx 6/15/2018, IDC: Mucinous, Left, 3cm, Stage IB, Grade 1, 0/2 nodes, ER+/PR+, HER2- Hormonal Therapy 8/31/2018 Arimidex (anastrozole) Radiation Therapy 9/3/2018 Whole-breast: Breast
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Mar 14, 2019 07:56PM Denise-G wrote:

I was only able to have 3 months of Herceptin due to heart issues, however, 7 years later, I am still here. When I got that news, I was grateful I had a Mastectomy. There are many issues to look at ... my sister was not Her 2 Pos, but her first mammogram post cancer treatment was too stressful for her to handle and had a double mastectomy as she did not want to go through screening as it was way to stressful for her.

Always, I recommend to get a second opinion at an National Cancer Institute Designated Cancer Center. They are the best of the best in the USA. https://www.cancer.gov/research/nci-role/cancer-centers/find

Sending all my best to you!

www.denise4health.wordpress.com my BC Blog with over 200 informative posts about all aspects of BC - stop by! Myself, my mom, and sister were all diagnosed with BC within 3 years. What a ride! Dx 10/10/2011, IDC, Left, 6cm+, Stage IIIA, Grade 2, 9/14 nodes, ER+/PR+, HER2+ (FISH) Surgery 11/22/2011 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Chemotherapy 12/26/2011 AC + T (Taxol) Targeted Therapy 2/27/2012 Herceptin (trastuzumab) Hormonal Therapy 10/10/2012 Arimidex (anastrozole)

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