HER-2 Positive Early Stage Breast Cancer

Juan Luna, Una Bulaquena, 1895
It used to be that when certain non-metastatic breast cancers were found to be markedly her-2 positive, they went into my "hope for the best, but expect the worst" category.

Overexpression of human epidermal growth factor receptor-2 (her-2) occurs in a third of breast cancers, and is a marker of an aggressive tumor. A gene mutation causes an excess production of this cancer growth promoter, conferring a clinical "profile" that science has begun to characterize. Myself, I obsess about occult metastases and drug resistance in these instances. When presented with her-2+(IHC+3 and/or FISH+) malignancies, the oncologist knows that certain chemo drugs are preferable, that hormonal agents aren't likely to suffice, & that the use of biologicals is optimal.

Anti-her2 monoclonal antibody surfaced years ago. As a biological "targeted therapy", it specifically seeks out the cancer promoter protein. Whether given alone or in combination with other drugs like chemotherapy, trastuzumab (Herceptin) is still finding all its indications. Its fabulous that we can now use this agent in early stage breast cancers. Did you know that herceptin use after potentially curative surgery decreases recurrence rates by half in high risk cases? I can afford to be more optimistic these days.

Not all breast cancers would benefit from the incorporation of Herceptin into a postoperative regimen, possibly not even all her-2 FISH+ cases if the risks are not sufficiently high. Discuss these points ad nauseum with your oncologist.

Previous Comments

After two years doing well on Herceptin and Zometa, the tumor in my sternum was growing again, so I had radiation, the results of which you can see in the photo. Subsequent scans showed that the radiation worked on the bone tumor, but that it’s now in my liver. So on to regular chemo.

Posted by Breast Cancer Stages at March 9, 2010, 6:16 pm  

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