Her2 and estrogen positive?

ruthiema36 · New User Joined: 08 Jul 2006 Posts: 7

- Age 60
- time since diagnosis 6 months
- menopausal at diagnosis
- Specific type of cancer invasive ductal carcinoma grade 2
Ductal carsinoma in Situ solid type intermediate grade
- Treatments: mastectomy followed by Arimidex
I am both estrogen and Her2 positive. Is this common? I was under the impression that Her2 positive (I am
7.2 amplified on the FISH test} usually means estrogen -. I am
between 71 and 100% positive for estrogen. Progesterone is between 1
and 11%. I am also T2N0, grade 2 out of 3. I am puzzled by my
oncologist's reaction to my Her2 status, which we just found out last
week, three months after the mastectomy. He is quite insistent on the
Arimidex in case those estrogen loving little beasties have some how
managed to travel from my parafin inbeded, carefully preserved right
breast into my blood stream, but sees no reason to treat the Her2
aspect of the little beasties. Soooo if those cells somehow got past
the nodes without our knowledge wouldn't the fact they are Her2+ make
them more aggressive and shouldn't I be treated for both? Just
thinking out loud. Would appreciate any and all comments. Thanks.
Ruth

AlaskaAngel · Posted: Tue Jul 25, 2006 9:31 pm Post subject: HER2

Ruthie,

Waste no time, go to HER2support.org and hang out there, do a few searches there in the past posts by others, ask a few questions there.

Because early testing for HER2 was erratically done until the results of the Herceptin trials came out, there was a lot of confusion about HER2's. However, basically it now is believed that around 35-40% are hormone receptor positive.

AlaskaAngel
_________________
Dx Dec 2001 at age 50
Lumpectomy Jan 2002, 1.6 cm IDC plus some DCIS
Node neg
ER+, PR+, HER2+++
CAF x 6, 35 rads+boost
NED
Tamoxfen 1 3/4 yrs
In 2 clinical trials
bc for mom and 1 sis and 1 aunt and 1 granny
ovarian cancer for 1 aunt

ruthiema36 · New User Joined: 08 Jul 2006 Posts: 7

AAAHHHHH, one of my own, Alaska Angel. Shall do as you suggested. Any info on the trials you were in? I am node - which is why the oncologist doesn't want to treat for the Her2+. I am taking a break from the Arimidex to see if that is what is causing my "moodiness" I am getting a second opinion tomorrow.
Ruth

AlaskaAngel · Posted: Tue Jul 25, 2006 11:17 pm Post subject: Re: Her2 and estrogen positive?

Have you looked through the NCCN site that explains staging and treatment to see where you "fit in", so that you have a clearer idea what it is about for you when you are talking with the oncs?

http://www.nccn.org/patients/patient_gls/_english/_breast/3_work-up.asp

You are diagnosed at a time of greater progress as well as greater confusion... and more genuinely less-invasive choices... at a time when there is more recognition that targeted therapies look better for some hormone-responsive patients than chemotherapy... Some women have a tendency to think they want to "throw the book at it" but do not realize that less than 20% who get chemotherapy actually benefit from "throwing the book at it". I was node-negative also, but grade 3 and the HER2 was why I got blasted with chemo. I asked about the alternative of having the ovaries out and doing hormonal therapy but back in 2002 my onc was far from thinking more progressively about anything that didn't favor chemotherapy. Some oncs back then were giving Herceptin off-label to women like me, who weren't eligible for the clinical trial. Now the same women as me get Herceptin with chemo.

Were you given an educated guess using Adjuvant! ?

Be very picky about your treatment and especially consider having your tumor block analyzed in more detail... (many past posts about this at her2support.org website that are worth reading).

A.A.
_________________
Dx Dec 2001 at age 50
Lumpectomy Jan 2002, 1.6 cm IDC plus some DCIS
Node neg
ER+, PR+, HER2+++
CAF x 6, 35 rads+boost
NED
Tamoxfen 1 3/4 yrs
In 2 clinical trials
bc for mom and 1 sis and 1 aunt and 1 granny
ovarian cancer for 1 aunt

ruthiema36 · New User Joined: 08 Jul 2006 Posts: 7

My onc immediately suggested AC cheno, I declined. He then told me that given the size of the tumor 2.4 cm chemo would be appropriate. (I am stage 2 node negative) Again I declined. He then used the adjuvent shared decision making model and given my stats chemo ewould give me a 10 year disease free survial rate of only 2% where as the aromatase inhibitors raised that to 17%. I decided to go with the aromatase inhibitor. My Her2 was not done at the time of mastectomy. Wouldn't you know I had it at the only hospital in the area that doesn't do it routenely. I finally had my surgeon request it in May. By IHC it was a weak positive so I insisted my onc have a FISH done. He was not happy about it. Now I know I am definitely Her2 positive but he is not recommending a change in treatment so am going for a second opinion. I am not willing to throw everything at it, only that which might be helpful and it has to be more than a 2% helpful. Thanks for your input. I have joined the forum you suggested.
Ruth

dizzybuff38 · Posted: Fri Aug 04, 2006 2:23 pm Post subject: Er+ and HER2

I don't know how old your information is on ER+ and HER2 status is, but I have recently been tested for HER2 (which thankfully was negative) and my Oncologist told me only some 10-20% of ER+ tumours will have an HER2+ result. Where did you get the 30% figure from?

ruthiema36 · New User Joined: 08 Jul 2006 Posts: 7

My Her 2 status was verified via FISH the end of May O6. Research has sugested that Her2 positive comprises about 30 % of all breast cancers. The figure for both Her2 + and estrogen + is a bout 25% according to the oncologist I saw for the second opinion.
Ruth

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