HER2/neu 3+ Chances of Recurrence and Survival

[odengp]

Dear Sir,

My sister in Manila was diagnosed with Breast Cancer (Invasive Ductal Carcinoma-IDC) in February of this year. She is 51 yrs.old. She had Modified Radical Mastectomy (on one of her breasts), the tumor size was 1.8 cm and all the 19 lymph nodes they removed were free from cancer. Her ERPR is positive (ERA +3/PRA +2). Unfortunately the HER2/neu results were positive Grade +3. Her treatments are 3 sessions FAC (she has done 2), followed by 3 sessions of Taxane, followed by 12 sessions of herceptin monthly for a year. She will take Tamoxifen for 5 years and monitoring for 2D echo, vaginal ultasound, bone scan and mammography of the other breast every year. This scares me a lot because as far as I know HER2/neu +3 result could mean it could recur. Also, I read that Tamoxifen can cause uterine cancer. I know that no one can tell for sure if cancer can recur. But given this information, what are the chances of breast cancer recurrence and survivial for my sister? Thank you Rodelia

[bluebutterfly2222]

You are very welcome.

I understand much of what you are going through, because I joined this community for the same reason about 10 months ago.

Your love and emotional support will be a big help to your sister, though calls, e-mails, cards, etc., when you cannot be with her in person.

My thoughts and prayers will be with you both.

Warm regards,
bluebutterfly

[odeng]

Thank you so very much for your posts Zouzi and Bluebutterly. It is so painful to even imagine my life without my sister. It took quite some time before I had the courage to write because I was afraid of the answers. But I have to be brave because she is brave. One thing that makes me really sad is I am here in Switzerland and she is in Manila. I am happy that I am at least financially able to fly back 2x a year to vist.

[zouzi]

Hi,
Chemotherapy reduces the chance of recurrence by one third.To determine the exact benefit to your sister, she should discuss with her doctor her risk for recurrence.  Her2/neu positive tumors tend to be more aggressive but respond well to chemotherapy..No one knows or can predict how an individual will respond to Chemo treatments.If your sister responds well and follows all the required scheduled tests, she'll have a very good chance not to have a recurrence.
I am afraid that she has to continue taking Tamoxifen as prescribed by her doctor to block the estrogen in her body, thus preventing breast cancer cell growth.Your sister should also discuss with her oncologist about her fear that this medication could cause uterine cancer and I am sure that she will get the best advice possible.
I am sorry that your sister has been diagnosed with breast cancer,but treatments  have progressed tremendously and she has a very good chance to win her battle and live a long and happy life.
Good luck and best wishes to both of you... .

[bluebutterfly2222]

HER2 and Grade 3 indicate, as you obviously know, that this is a highly agressive cancer, while more favorable circumstances in her case are that the tumor did not exceed 2 cm, and that her nodes were negative. However, no one can predict the future in regard to an individual case.  

There are various published tables of  5-year and 10-year average survival rates, but these of necessity are based on past periods of time when treatment methods were not necessarily the same as today's, and still don't tell you anything about what may happen in regard to a particular person.

The best anyone can do is to receive all the standard treatments known to be helpful in cases such as hers, as she apparently is doing (although you did not mention if radiation tx was considered?) and hope and pray for the best possible outcome.

Another point that might be worth looking into is that at the 32nd Annual San Antonio BC Symposium in December  2009, it was recommended that giving trastuzumab (Herceptin),  concurrently — as opposed to sequentially — with adjuvant chemotherapy should be the standard of care, due to improved outcome found with that approach in a portion of a trial that involved 1903 women with HER2-positive early breast cancer.(Trastuzumab is approved for both concurrent and sequential therapy by the US Food and Drug Administration, but concurrent is used by most clinicians in the United States.  However, in other parts of the world, only sequential therapy is generally practiced.)  This of course would be up to your sister's oncologist.
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Best wishes to both you and your sister...