her2 breast cancer

[chezzy44]

I recently had a lumpectomy which was grade 3, Er & Pr negative but Her2 positive.  DCIS was very close to the surgical margins and so I have the option of further lumpectomy or mastectomy.

My question is: Does the presence of Her2 + make any remaining DCIS more likely to change into invasive cancer at a later date? Would mastectomy be safer due to the presence of Her2 +?

I will be given Herceptin and Chemotherapy regardless of the surgery I choose.

[Ray515]

Hi-
I was diagnosed with invasive ductal cancer last March.  Mine was also ER/PR neg and Her2 positive, both indicating unfavorable markers.  I choose to go ahead and have the mastectomy because I knew that I would be taking chemo and Herceptin and didn't want to have to do radiation on top of all that due to a lumpectomy.  I had no lymph node involvement so I was relatively sure that I wouldn't have to have radiation with a mastectomy.  Also, it is my understanding that DCIS will always eventually lead to invasive breast cancer regardless of HER2 status.

My main reason for choosing the mastectomy was because of the HER2 positive status and to avoid radiation.  Good luck on whichever you decide.

[PaulMD]

Hi there.

Her2 postivity is a negative prognostic marker, meaning that cancer cells with this marker tend to be more aggressive and has more tendency to recur and spread.  It will not matter much if you have another lumpectomy or a mastectomy, but make sure you receive adjuvant radiation treatment after the lumpectomy.

The drug Herceptin, which targets specifically the Her2 receptor, has been a very remarkable drug and has been shown to lower the incidence of the cancer coming back.

I wish you all the best in your treatment, and I hope everything will be as uneventful as possible.  Regards and God bless.