her2 breast cancer

What is the standard of care for stage 1 breast cancer with a tumor .2ml. I was er and pr negative, and her2 postitive.
I had a mastecomy last year, and doctor recommended no further treatment just follow up.


This discussion is related to Lumpectomy vs Bilateral Mastectomy.

[bluebutterfly2222]

Hi,

Do you mean a 2 mm tumor?  ( 2 mm is very small, but .2 would nearly  be unable to be detected or measured...)

In either  case, there is not a universal accepted standard of care for very small HER+ tumors at this time.

In the past, chemo and Herception was the standard of care for HER2+ tumors over 1 cm.

Most small breast cancers have a good prognosis and adjuvant chemotherapy is not routinely recommended. However, retrospective data suggest that some small HER2-positive cancers might have a worse clinical outcome than others. This notion raises the key clinical question of whether patients with small HER2-positive cancers should be offered adjuvant trastuzumab and chemotherapy.

From the San Antonio Breast Conference in December, new data shows a higher than predicted rate of breast cancer recurrence even with very small breast cancers that are HER2 positive. The data is from the first large study to analyze early-stage breast cancer patients with HER2 positive tumors one centimeter or smaller. It suggested that all of these women would benefit from adjuvant trastuzumab, also known as Herceptin, (for one year, the standard in America) -- along with adjuvant chemotherapy. This represents a shift in the way women with early-stage HER2 positive breast cancer should be assessed for risk of recurrence and considered for treatment, according to the study's author.

HER2 positivity will likely change the recommendation regarding adjuvant chemotherapy/Trastuzumab -- even for smaller node negative cancers, but clinicians face the dilemma of whether the potential reduction in risk of recurrence in this patient group warrants the toxic effects and risks of adjuvant chemotherapy and trastuzumab.

On the basis of present evidence, it is  recommended  that the benefits and risks of adjuvant trastuzumab should be discussed with patients with small, HER2-positive breast cancer.

In regard to your specific case, since no futher  treatment after your mastectomy was recommended, you will just need to maintain followup as recommended by your doctor.

Best wishes...