I had a single mastectectomy with a .5 cm tumor that was positive, but borderline by IHC and FISH tests. No positive nodes. My Oncotype score came back at 31 of 100.
There were some studies that came out last November that recommend considering chemo in this situation. I chose chemo and had taxotere, carboplatin and herceptin to cut my chances of recurrance. It was not pleasant, but I am nearly back to my normal self since the end of the taxotere and carboplatin part of the treatment in early March. I worked throughout and have enough hair back to go without a scarf or wig. I am continuing herceptin for a full year and taking tamoxifen for 5 years. I am also part of a drug study with the osteoporosis drug, Zometa, which I am taking for 3 years to try to prevent recurrent cancer from coming back in the bones.
When I was deciding on my treatment, all my doctors told me that because my tumor was so small, whatever I decided would be fine. I had to do a lot of research to find any study information about small Her2 positive tumors and treatment. The trends that I found in the literature and confirmed with my surgeon and 2 oncologists were that over the last 10 years or so, smaller and smaller tumors were being treated more aggressively. In other words, 10 years ago, chemo was recommended for 2 cm tumors. More recently, 1 cm tumors. More recently yet, .6 cm tumors. Herceptin has been used in conjunction with other chemo drugs, such as the TCH regimen that I took and proven to be effective. There has been no study of the effectiveness of Herceptin alone, but it is being prescribed that way also.
Based on this information and the 31 score on the Oncotype test, I chose to treat my cancer with chemo. It was a hard decision, because there was no clear path. Discuss yout treatment options with your physicians and do what is best for you. I am 10 months into my treatment and feeling really good again. I am thinking of you. Please keep in touch and let us know how you're doing.
I agree that the more information you can obtain the better the situation and eventually the results. Best wishes with whatever treatment plan is chosen for you. Regards ....