Im in same boat - triple positive .diagnosed June 2020. I’m 63 years of age so post menopausal. Stage 1 . I was told from day 1 , I had 90% chance of beating breast cancer .( status of lymph nodes were not known then altho looked clear ). Oncologist and surgeon both reinterated that statistic as it meant they thought I was a good candidate for lumpectomy surgery if I wished to retain breast .I could have opted for a mastectomy ( if I personally wanted to remove the offending boob completely which is both a understandable reaction and approach ).
I’ve since had two rounds neoadjuvant chemo (AC and taxcel ) plus herceptin (immunotherapy) before lumpectomy surgery in jan . No cancer in 5 lymph nodes .tumour totally removed at surgery . Had radiation post surgery and am now on femara tablets. Will have bone infusion every 6 months as well .
I’d read about HER2 + and I had realised it’s potential with recurrences . It’s worrying I must admit .
I thought I was only having more herceptin infusions post surgery/radiation/hormone tablets BUT
Then my oncologist proposed further chemo . It sounds as though you had complete tumour regression at surgery ?
‘Turns out post chemo and surgery your pathology results important . Mine showed my tumour had not completely regressed , was still discernible to pathologist so my oncologist proposed T-DMI (kadcycla) chemo every 3 weeks for a further 14 sessions. This used to be a treatment for metastatic breast cancer only but recent KATHERINE clinical trial found it gave early breast cancer patients with HER2 + extra protection against recurrences, and better survival rates in cases without total regression when compared to,just herceptin.infusions . It’ went up April 2021 on EVIQ - noted a acceptable protocol for early breast cancer HER2+ cases without total tumour regression.
I was a bit shocked , As no one had ever discussed full importance of tumour regressing after neoadjuvant chemo by time of surgery in my case and what it may mean in regards to further treatment . I thought I was only having herceptin infusions which had been well tolerated although caused a few side effects with cardiac ejection fractions and I was on medication for that .
I realised that the T-DMI chemo for me was a cannon approach , whereas if I only had herceptin it was the peashooter approach. I’ve opted for the cannon approach as suggested by oncologist, so I won’t have any regrets down the track if I took all that was offered and there is a recurrence. I’ll know I took all treatments that were offered to me .
TDMI has potential,side effects and they are being monitored but to be honest I’ve found it’s easier to tolerate that other two,types of chemo so,far .
so I’m hopeful the HER2+ has been targeted well with the chemo/ immunotherapy options and it does play on my mind a bit as I’m really only 12 months since diagnosis. And now 6 months since surgery in particular . Everything crossed !
