What does her2 mean negative. Consultations
31.05.2018
QUESTION: Vitaly Alexandrovich, what does her 2 mean in immunohistochemistry and what does it affect?
ANSWER: The her 2 neu receptor is a protein molecule and indicates the content of the her 2 neu protein in tumor cells. This is an important prognostic factor on which the prognosis and treatment depend. Approximately 25% of patients have overexpression or amplification of her 2 neu, that is, a positive status, which predetermines more frequent relapses and progressions, resulting in reduced survival in patients with breast cancer. The treatment of such tumors is indicated by targeted therapy with trastuzumab. active substance, which is part of Herceptin and our domestic Herticade.
31.05.2018
QUESTION: Vitaly Alexandrovich, please tell me what her 2 0 means?
ANSWER : This is a receptor that shows the content of the her 2 neu protein in tumor cells. If overexpression or amplification of her 2 neu is detected, then this means that the status is positive. If it is absent, then the status is negative, that is, her 2 0 is the absence of the her 2 neu protein in tumor cells.
17.06.2018
QUESTION: Vitaly Alexandrovich, amplification of the her2 gene was not detected, what does this mean? Thank you.
ANSWER: Hello! This means that you do not have HER2NEU breast cancer and this cancer does not need to be treated with targeted therapy with Trastuzumab in the future, you also have a less aggressive cancer and a long-term remission is expected, but many factors are taken into account: stage, grade, age!
07.08.2018
QUESTION: Vitaly Alexandrovich, hello! In the immunohistochemical study, it is written that her2 +1 overexpression is negative. What does this mean? Thank you.
ANSWER: Hello! This means that your cancer is not as aggressive and you are not eligible for targeted therapy with trastuzumab!! If you had her2 positive breast cancer, you would be treated with trastuzumab!
03.12.2018
QUESTION: Good afternoon. Can her 2 on IHC before biopsy and after surgery be her2/neu-negative first? And then on the same operating units in another laboratory her2 - 2+ ? And what is the treatment for such differences in IHC? I take tamoxifen after surgery. Chemistry and rays were not prescribed.
ANSWER: Hello! Treatment varies greatly and such cases may occur because tumors are heterogeneous in composition. You have her 2neu +2, but this does not mean that the tumor is positive for this receptor. Did you do Fish research? If the her2neu tumor is positive in the fish test, then targeted treatment with trastuzumab is prescribed; if it is negative, then it is not prescribed. Not only the Her2neu receptor is also important for prescribing chemotherapy, but also other indicators, such as ki 67, stage of the disease and age! In the first stage, trastuzumab is not prescribed, even if her2neu positive cancer. We must look at each case individually!
21.07.2019
QUESTION: Hello! Analysis of ki 67-12% and her 2- +2, sent to Fish for determinations of her2. Does it happen with ki67-12% , what are the chances of her 2 positive results?
ANSWER: Z hello! Of course, this happens with ki 67 -12% positive fish test. Wait for an answer!
17.09.2019
QUESTION: We have HER2 denied... What does it mean.
ANSWER: Hello! This indicator is determined in breast cancer, and it determines the need for targeted therapy with trastuzumab, in this case this indicator is negative and targeted therapy is not indicated.
06.11.2019
QUESTION: Breast cancer, HER tests were negative before surgery, became positive after surgery, is this possible? And what treatment is required?
ANSWER: Hello! It also happens because breast cancer is heterogeneous. In this case, I cannot recommend treatment, because many factors are not enough for recommendations. We need age, stage, complete immunohistochemistry, etc.
21.11.2019
QUESTION: Good day. My wife is 53 years old, stage 3c, 3 axillary, 3 supraclavicular L.s. are affected. IHC er 6 b, pgr 6 b, her2/neu +3, ki 67 30%. What is the prognosis for such an aggressive cancer?
ANSWER: Hello! Due to the fact that cancer is aggressive in this case, it is necessary to undergo long-term treatment and only after complete treatment a good prognosis can be expected. The prognosis may depend on the treatment received - chemotherapy, targeted therapy and radiation therapy followed by long-term endocrine therapy.
Below is information about testing for HER2 and breast cancer. HER2 is a protein that can influence the growth of cancer cells. This information should be read with knowledge of breast cancer and trastuzumab (Herceptin®). We hope you find answers to your questions about HER2 testing and breast cancer here.
- Breast cancer with HER2
- Herceptin and early breast cancer
- Herceptin and secondary breast cancer
- HER2 and hormone therapy
- HER2 tests
- Availability of HER2 tests
Receptors are specific proteins found on or inside cells. Other proteins or chemicals found in the body can attach to these receptors to effect a change within the cell (for example, cause it to repair or reproduce).
Growth factors are chemical compounds that attach to receptors and stimulate cell growth.
HER2 is a protein found on the lining of some cancer cells. It is created by a special gene called the HER2/neu gene. HER2 is the receptor for a specific growth factor called human epidermal growth factor that exists naturally in humans. When human epidermal growth factor attaches to HER2 receptors on breast cancer cells, it can stimulate the growth and division of these cells.
Some cancer cells breasts may have many more HER2 receptors than others. In this case, the tumor is defined as HER2 positive. It is estimated that one in five women with breast cancer is HER2 positive.
HER2 positive breast cancer
HER2-positive tumors grow faster than other types of breast cancer. Knowing that a cancer is HER2 positive can influence the choice of treatment. A drug called trastuzumab (also known as Herceptin®) was developed to treat HER2-positive breast cancer. It is a type of monoclonal antibody. Monoclonal antibodies target specific proteins in the body.
Herceptin attaches to the HER2 protein and prevents human epidermal growth factor from reaching breast cancer cells and stimulating their growth. Herceptin is only effective if a person has high levels of the HER2 protein.
Herceptin and early breast cancer
A recent study suggests that Herceptin is indicated for women with early cancer breasts to reduce the risk of cancer coming back. It is known that chemotherapy and/or hormonal therapy can reduce this risk. A number of research trials involved the use of Herceptin along with chemotherapy (and comparing results with chemotherapy alone) to determine subsequent reduction in the risk of cancer recurrence. The test results are promising; cancer recurred in half as many women when Herceptin was used with chemotherapy.
Herceptin was licensed for use in early breast cancer in 2006 in the UK. National Institute of Clinical Excellence, which provides courses in prevention and treatment, published guidelines for the use of Herceptin in women with HER2-positive early breast cancer in July 2006. According to the guidelines, Herceptin should be considered possible method treatment after surgery and additional chemical and radiotherapy. The guidelines recommend using Herceptin every three weeks for a year.
HER2 and hormone therapy
Hormone therapy can slow or stop the growth of breast cancer cells. This happens by changing the level of certain female hormones that are naturally produced by the body, or preventing the absorption of hormones by cancer cells.
Hormone therapy is effective when a woman's cancer cells have estrogen and/or progesterone receptors. They are defined as estrogen or progesterone positive. There are many various types hormone therapy and they function only slightly differently from each other.
It was assumed that the status of HER2 in a woman can affect the effectiveness of a particular type of hormone therapy. However, further research is required to draw definitive results.
HER2 test
Tests may be done to determine if a woman has HER2-positive breast cancer. Tests may be performed at the same time as the first stage of surgery. Cancer tissue samples from previous biopsies or surgery may be used.
The two main methods used for HER2 testing are immunohistochemistry and fluorescence in situ hybridization (FISH):
Immunohistochemistry
Immunohistochemistry can show how much HER2 protein is in a tumor sample. HER2 level is rated from 0 to 3+
- 0 - 1+ means that HER2 protein is present in normal amounts and the result is HER2 negative
- 2+ means that the HER2 protein is present in an average amount
- 3+ means that the HER2 protein level is higher than normal, and the result is HER2 positive.
Fluorescent in-situ hybridization (FISH)
While immunohistochemistry measures the level of the HER2 protein in a tumor sample, the FISH test measures the level of the HER2/neu gene in each cell. This gene is responsible for overproduction of the HER2 protein.
There is no numerical scale for measuring the result of a FISH test. Possible result:
- FISH-negative - normal level gene, or
- FISH-positive - excessive level of the gene. This is sometimes called gene amplification.
16.01.2018
QUESTION: Dear Vitaly Aleksandrovich, please comment on the results of immunohistochemistry: ER 0 points, PR 6 points, ki 67 30%, her2neu+. Stage 2c, G3. I understand that the tumor is aggressive. Right? Is it very bad when estrogens are 0 points? And what treatment would you recommend? Right Madden mastectomy 4 weeks ago. Thanks a lot.
ANSWER: Hello! Yes, it is considered that she is aggressive and she needs to be treated with chemotherapy 4 AS (doxorubicin and cyclophosphamide) + 4T (docetaxel), then prescribe tamoxifen 20 mg, since progesterone is 6 points - this is also considered sensitivity to endocrine therapy.
16.01.2018
QUESTION: Vitaly Alexandrovich, according to the results of immunohistochemistry, her2neu=0. What does this mean? Is it good or bad? Thank you.
ANSWER: Hello! This means that you are not eligible for targeted trastuzumab therapy, which is good!
18.01.2018
QUESTION: Vitaly Alexandrovich, hello! Based on the results of the trephine biopsy, the conclusion was obtained: Invasive cancer non-specific type(ductal) G3, luminal type B, HER2 negative. Immunohistochemistry: ER=PS5+IS2=7 PR=PS1+IS1=2 by Allred. Ki67 6%, HER2 neo 0. 68 years old. Stage t2n1m0. Only hormone therapy and surgery? What can be the forecast?
ANSWER: Hello! You don't have luminal type B, you have type A, which is usually treated with surgery and tamoxifen, but you have G3 and lymph node metastases, so you need surgery, chemo, and tamoxifen.
18.01.2018
QUESTION: Vitaly Alexandrovich, why, with more high rates ki 67 Does the tumor respond better to chemotherapy treatment?
ANSWER: Hello! Yes, there is such a statement, but it is not always correct and the tumor does not always respond to treatment!
20.01.2018
QUESTION: Vitaly Alexandrovich, good evening! IHC result: PR 0 points, ER 0 points, her2neu +, ki67=50%. Is it triple negative cancer?
ANSWER: Hello! Yes, it is, chemotherapy with taxanes is indicated!
22.01.2018
QUESTION: Vitaly Aleksandrovich, what are Allred points?
ANSWER: Hello! For you, in simple terms, this is a scale of scores for the expression of estrogen and progesterone receptors, or rather, a gradation of low-expressing receptors, medium and high-expressing. It serves to determine the purpose of endocrine therapy for breast cancer.
22.01.2018
QUESTION: Vitaly Aleksandrovich, what studies determine the presence of ER/PR receptors in breast cancer?
ANSWER: Hello! In our arsenal there is a standard study - immunohistochemistry, it is with the help of it that we can determine the expression of estrogen and progesterone, as well as other indicators.
24.01.2018
QUESTION: Vitaly Alexandrovich, what are the chances for a long remission with a cell proliferation index ki 67=90%? Thank you.
ANSWER: Hello! What are the chances? Why think about it, I will tell you that not only Ki 67 determines remission here, but also the subsequent treatment! The chances of remission are good, you just need to heal well after the operation!
27.01.2018
QUESTION: Hello, Vitaly Alexandrovich! I have a question: is a tumor considered hormone-positive if IHC values are: ER 3 b, PR 0, HER2 0 ki 67 = 12%. Can this be treated with aromatase inhibitors? Or just chemistry? T2N0M0 G2
ANSWER: Hello! Yes, it is considered a hormone-dependent tumor and it is luminal type A. Aromatase inhibitors are prescribed in this case, but other factors must be taken into account, for example, whether there is menopause or not!
01.02.2018
QUESTION: Good afternoon! Mom has breast cancer, T2N1M0. Help decipher morphology - PR: 5 (PS) + 2 (IS) = 7 points, (TS) ER: 5 (PS) + 3 (IS) = 8 points, Ki-67 = 45%.
HER/2-neu=1+. What type of cancer is it, what does the Ki indicator mean, what does its value indicate? And what are the predictions, if it is possible to say. Thank you very much in advance!
ANSWER: Hello! This type of cancer is luminal B, it is necessary to carry out chemotherapy and then drink tamoxifen! The prognosis for this molecular type of cancer can be different and depend on many factors. The most important thing is a positive attitude, live and enjoy life!
Here you can read about ki 67 which is a proliferative index:
11.02.2018
QUESTION: Good afternoon! Vitaly Aleksandrovich, I handed over my glasses and blocks after the operation for breast cancer for re-checking at the urgent request of my girlfriend. And I don't know what to do now. Should I do another check? Because according to one immunohistochemistry, I have high hormone scores, and according to the other, they are completely absent. I don't understand how this is possible?
ANSWER: Hello! It makes sense to review it in the third place and ask your oncologist which analysis to believe, although it happens that the third analysis may be different, because the tumor itself is heterogeneous and the antibodies for determining IHC are different in different clinics, so the results are different!
13.02.2018
QUESTION: Hello Vitaly Aleksandrovich. I have breast cancer T2N1M0 undifferentiated. from 01/31/17-6 red chemistries, mastectomy, histology and IHC according to the material of the operation, 15 radiation therapy for non-removed lymph nodes. IHC was not performed before chemo. I'm interested in how inaccurate the IHC result is after chemo. I had a metastatic lymph node done. The swelling in my chest had completely dissipated. Her2/neu-(-); ER-(+++); PR-(-); Ki67<3%. Возможно что если бы ИГХ был до химии то Her2/ neu мог ли быть положительным??? Дело в том, что хирург к которому я обратилась на счёт операции мне отказал из-за того, что результаты ИГХ будут искажены, и он не сможет мне назначить правильно дальнейшее лечение.
ANSWER: Hello! In global practice, Her 2neu does not change before and after chemotherapy, so this result is considered correct for you and you can rely on it! You should be glad you don't have her positive cancer!
14.02.2018
QUESTION: Vitaly Alexandrovich, how right am I in my statement that the result ki 67=0 happens only at the zero stage of cancer? Thank you.
ANSWER: Hello! At the zero stage, you can not watch it at all! This happens (ki 67-0) very rarely, in any case it is very good for the patient!
17.02.2018
QUESTION: Good evening! Please help me decipher IGH research - er o,
pr o, her2+++ ki 67 50%. What does this mean and what will be the treatment. Thank you.
ANSWER: Hello! This tumor subtype says that it is aggressive and requires chemotherapy and targeted therapy: doxorubicin and tascans are most often prescribed, followed by trastuzumab!!!
05.03.2018
QUESTION: Vitaly Alexandrovich, what does her 2 negative status mean? Thank you.
ANSWER: This means that the tumor does not require targeted treatment and the tumor is less aggressive, unless, of course, it is triple-negative breast cancer.
05.03.2018
QUESTION: Vitaly Alexandrovich, hello! What does it mean when her 2 neu is not amplified? Thank you.
ANSWER: Hello! This means that this gene is not detected in you, and the tumor does not require targeted therapy!
05.03.2018
QUESTION: Vitaly Alexandrovich, what is the forecast for ki 67=90%? Have there been long-term remissions in your practice with such a high ki 67? Thanks!
ANSWER: Hello! This is a poor result in terms of prognosis, this Ki 67 definitely requires chemotherapy! Of course, there were long-term remissions with such ki 67 in my practice.
05.03.2018
QUESTION: Vitaly Alexandrovich, according to the results of immunohistochemistry, my mother has triple-negative breast cancer. Does it make sense to remake IGH in another laboratory? Do you often encounter mistakes in your practice? Thank you.
ANSWER: Hello, sometimes it makes sense, but in this case I think not, since all three receptors are negative!
Breast cancer is the leading cause of cancer death among women in the world. The HER-2 test is shown to every woman with an established diagnosis of breast cancer, its importance cannot be overestimated - it is the main fulcrum in the choice of further targeted therapy.
What is HER2?
To understand the nature of HER2, one must learn about receptors and growth factors.- Receptors- These are certain proteins that are on the membrane of cells or inside them. Other proteins or chemicals found in the body can attach to these receptors to effect a change within the cell (for example, cause it to repair or reproduce).
- growth factors are chemical compounds that attach to receptors and stimulate cell growth.
What is HER status?
The HER2 receptor is a protein molecule and is therefore also called the HER2 protein or HER2 protein. It shows the content of the HER2 gene and HER2 protein in tumor cells. HER2 status of breast cancer can be negative or positive.Why is HER-2 analysis necessary?
Determination of HER2 status is extremely important, because based on the result of the study, doctors in Israel make a decision on the tactics of treating the patient. Depending on the presence of biological tumor markers (estrogen and / or progesterone receptors, HER2 receptors), hormone-positive, HER2-positive and triple-negative breast cancer are isolated. There are currently drugs in Israel that target the HER2 receptor.What does a positive HER2 status mean?
In HER2-positive breast cancer, there is an excess of HER2 receptors on the surface of the tumor cells. This phenomenon is called “positive HER2 status. When overexpressed, HER2 receptors on the membrane disrupt the normal cell cycle and force cells to divide uncontrollably. A similar phenomenon was noticed by researchers in a quarter of patients with breast cancer. If the tumor is HER2 positive, the patient is indicated for targeted anti-HER2 therapy.What does HER negative status mean?
Some breast cancer cells may have many more HER2 receptors than others. In this case, the tumor is defined as HER2 positive. It is estimated that one in five women with breast cancer is HER2 positive.What is positive breast cancer?
Breast cancer with an increase in the content (amplification) of the HER 2 gene or accelerated production (overexpression) of the HER2 receptor is called HER 2-positive. He is considered especially aggressive. It is diagnosed in about 25% of breast cancer cases. Tumors of this type progress very quickly, but the glands can be treated with special drugs Herceptin and Lapatinib, as well as the new drug Beyodyme.It is important to note that over time, approximately 30% of HER2-positive breast cancers become HER2-negative.
What is Negative Breast Cancer?
Breast cancer with a normal HER2 gene and HER2 receptor is called HER 2 negative. This type of cancer is determined in approximately 75% of patients with breast cancer. In HER2-negative tumors, Herceptin therapy is not indicated due to its low efficacy.How is HER-2 breast cancer status determined in Israel?
To determine the HER2 status of breast cancer, namely to detect an increased level of the HER 2 gene in tumor cells, special tests are used from the tumor tissue taken during a biopsy. Tests can be carried out simultaneously with the initial stage of surgical intervention.The two main methods used for HER2 testing are immunohistochemistry and fluorescent in situ hybridization (FISH):
1. Immunohistochemical study(IHC)
2. FISH test(fluorescent hybridization) FISH is the most accurate test for detecting elevated levels of the HER 2 gene in breast tumor cells.
3. SPOT-LIGHT HER 2 CISH test
4. INFORM HER 2 DUAL ISH test
The latest US-approved Inform HER2 Dual ISH test has been used in Israel since 2010.
The results of the Inform HER2 Dual ISH test are similar to the tests above and are also categorized into positive and negative breast cancer.
HER2 and hormone therapy
Hormone therapy can slow or stop the growth of breast cancer cells. It does this by changing the levels of certain female hormones that are naturally produced by the body, or by preventing the hormones from being absorbed by cancer cells.Hormone therapy is effective when a woman's cancer cells have estrogen and/or progesterone receptors. They are defined as estrogen or progesterone positive. There are many different types of hormone therapy and they differ only slightly from each other.
HER2 test
Tests may be done to determine if a woman has HER2-positive breast cancer. Tests may be performed at the same time as the first stage of surgery. Cancer tissue samples from previous biopsies or surgery may be used.Who needs a HER2 status test?
Modern treatment of breast cancer is unthinkable without determining the HER2 status. All women diagnosed with breast cancer should be tested to determine the HER2 status in tumor cells, since this status is extremely important both for prognosis and for the selection of adequate treatment.Determination of HER2 status allows you to purposefully prescribe drugs, Lapatanib, or in cases where they will be effective, i.e. only in HER2 positive breast cancer.
Can HER2 status change over time?
Yes maybe. Studies show that in 30 percent of cases, HER2-positive breast cancer eventually transforms into HER2-negative.There are currently effective drugs in Israel that target the HER2 receptor. In the group of patients with IHC 3+, IHC 2+/ISH-positive tumors, targeted HER2 therapy is used.
New in breast cancer treatment
Currently, several types of chemotherapy drugs, targeted therapy drugs and hormone therapy are used to treat breast cancer - Tamoxifen, Herceptin, Bayodayme and others. The optimal treatment is selected by Israeli doctors after a thorough study of the histological findings and medical history.Predicting and assessing the need for chemotherapy before it starts
A unique diagnostic technique for patients with early stage breast cancer
When diagnosed in the early stages of estrogen receptor-containing breast cancer, the diagnostic will help you and your doctor choose the most suitable chemotherapy drugs for you in addition to your treatment plan. In addition, this test can help predict the risk of future recurrences of the disease. And most importantly: it will help you avoid unnecessary, unnecessary treatment and get the necessary targeted therapy, not calculated on the statistics of your disease, but selected for you individually.Call us for free
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Galina asks:
Hello! I would like to know how to understand this "final clinic. dz at discharge: Ca mammae sin pT1pNOMO G2 st I Er-100% Pr-60% HER2\neu-0 Ki-67-42% p53-0%". Have attributed to drink aksastrol.
Responsible Filonenko Andrey Grigorievich:
Good afternoon, Galina. This should be understood as "a malignant tumor of the left breast of small size without changes in the lymph nodes." It also says that the operation was performed and the tumor was completely removed. It also says here that tumor cells have receptors. Estrogen (100% of all cells), progesterone (60% of all cells), Ki-67 (42%). And they do not have receptors like HER2-new and p-53. The presence of receptors on tumor cells makes it possible to additionally influence the tumor. In particular, the presence of receptors for female hormones (estrogen and progesterone) allows the use of hormone therapy. Axastrol (anastrozole), which was attributed, this is such a treatment. Axatrol should be taken for 5 years.
Oksana asks:
Hello, Doctor. I am 43, breast cancer 2B on ultrasound before biopsy 35x15mm, lu without changes, on mamography after biopsy 65x30mm accumulation of microcalcifications, CT up to 45mm in diameter, multiple LUs 5-10mm, signs of distant metastasis are not visible. 1 lu is palpated. Constant aching pain and not much swelling of the chest.
Biopsy showed G-2,
HER 2new is not harmonically dependent. Treatment suggest: 2 or more chemotherapy before surgery Doxorubicin, Docetaxel. Herceptin after surgery.
I'd like to know your opinion about the treatment.
Is Heptral needed right away, and what are the forecasts in my situation.
Responsible Filonenko Andrey Grigorievich:
Good afternoon, Oksana.
Quite a large tumor with the presence of lymph nodes in the armpit. HER 2new is positive. The age is young.
All these points negatively affect the prognosis. Nevertheless, successful treatment and lasting recovery are possible. Treatment will be long and rather complicated. You only need to carefully follow the recommendations of the attending physician.
In such a situation, it really makes sense to conduct several courses of chemotherapy before the operation. Subsequently - surgery, after surgery - Herceptin and continued chemotherapy. So everything is correct.
Heptral is a hepatoprotector. As far as it is shown now, I cannot determine without an examination, you will have to rely on the attending physician in this matter.
Hope asks:
Hello. My mother was diagnosed with T4 N1M1 breast cancer, they said that metastases went to the lungs and to the cervical vertebrae. She has a wound on her chest and it does not heal, tell me what can be done. Doctors in Tashkent said that nothing could be done, but at the last stage they don’t go, as far as I know, but she walks. The truth is that he coughs a lot (cough is wet) and I don’t know what to do, how to help, where to take? Tell me please. Thanks waiting for an answer.
Responsible Filonenko Andrey Grigorievich:
Good day, Nadiya. I have no doubts that the diagnosis was made correctly, and I can effectively have the remaining stage. To confirm this, there is a wound that that constant cough does not drag on. With whom, it doesn’t matter what your mother is doing on her own. Sorry, spent more than an hour. The plumpness is already large, rozpovsyudzhen, and anti-puffy exuberance is effectively impossibly. Necessary watch over the wound (dressing, fight against bleeding, fight against infection and odor), symptomatic relief of cough and reduced breathing (like in the empty pleura, the rіdina - puncture), obov'yazykovo nebolyuche kolіvannya (tablets tramadol, plasticine) . To take your mother anywhere is not the next thing, all the next thing is to work at home.
Xenia asks:
My mother has adnexal cancer....the tumor under the armpit is very dense...she has already had 4 chemotherapy...the tumor has not decreased..now they have prescribed radiation..2 months...is it not harmful for so long??? ?and another question, can metastases appear after chemistry? when we went to the doctor .. there was no metastasis
Responsible Heavenly Evgeny Vasilievich:
Hello! Maybe you mean cancer of the accessory lobe of the breast? Refine your question. Actually, if I understood you correctly, the mother should have felt better. Just now the views on the treatment of breast cancer have changed. The survival rate (sorry for the rude word) of patients after surgical treatment and after conservative treatment is almost the same. Therefore, it is now not customary to operate on breast cancer widely. Sometimes chemotherapy and radiation are used as the initial treatment before surgery. Metastases can also occur after chemotherapy. But sometimes the increase and swelling of the tissue around the tumor is just the body's reaction to treatment. If I explained something wrong, please repeat the question more specifically.
Anastasia asks:
Good evening! On 30,07,13 I had an operation. Radical resection of the lion, of the mammary gland with plastic surgery with an oncoming flap. Infiltrative ductal cancer of the 2nd stage, there is no malignancy, no tumor growth, and there is no cancer in the mts. Final diagnosis C50.2 C-h of the upper inner quadrant of the left mammary gland,
pT1 N0 M0 G2.1st.
Histological examination: ER-negative, HER-negative, PR-70% weak expression, KI-95%.
After the operation, I underwent 2 courses of chemotherapy (cyclophosphamide, fluorouracil, doxorubicin), now I am finishing the irradiation on a linear accelerator.
I have a few questions
1) what is the percentage of survival, can a relapse develop, do I have a chance for a full recovery?
2) At first, my chemotherapist said that he would do a course of 4 chemo, and then he said that 6, to the question why at the first stage there are so many courses and such strong drugs are dripping on me, he says so? Is it possible to change to other more generous ones and take only 4 courses, I am only 27 years old and I would like to give birth again !!!
3) Do I need hormonal treatment according to the results of histology?
Responsible Filonenko Andrey Grigorievich:
good day
1) The survival rate in your case is quite high. More than 90% of these patients live longer than 5 years. Of course, most likely you will be completely cured with proper treatment. Unfortunately, it is impossible to insure against relapse.
2) The FAC regimen is standard in this tumor. The doctor insists on 6 courses, most likely due to the fact that the tumor turned out to be very aggressive (KI-95%) and does not have estrogen receptors. I recommend that you agree to 6 courses.
3) Indications for hormone therapy in the case of the presence of receptors only for progesterone (your case) are not clearly defined. Perhaps it makes sense to redo the immunohistochemical study. I would prescribe hormone therapy.
Yana asks:
Please decipher the diagnosis: "Cr of the right mammary gland st III b. Mts in the bones (T4N1M1), lungs (Th 12), 2cl.gr"
Responsible Filonenko Andrey Grigorievich:
Good afternoon Yana. I decipher: There is a malignant neoplasm (cancer) of the right breast with metastases to the bones and lungs. Th 12 is the thoracic 12th vertebra. Obviously, it was there that a manifestation of tumor metastasis was found. You can read more about breast cancer here: http://www.cancer.ic.ck.ua/index_4_3.htm st III b and T4N1M1 - this is a characteristic of the prevalence of the process. You can read in detail about the classification of TNM and in general about the stages here: http://www.cancer.ic.ck.ua/index_2_8.htm 2 cells gr (clinical group) - means that a special antitumor treatment is indicated. More details about clinical groups can be found here: http://alloncology.com/enciclopedia/0/12/.
Natalia asks:
Good day! Tell me please. In the city of Lutsk, my mother was diagnosed with breast cancer, grade 2 B, and uterine fibroids were found. They prescribed at least 4 or 6 chemotherapy and then surgery (the doctor said that the breast would be removed completely). They said they would prepare for chemotherapy for 4 days, pierce some injections. Why I didn’t understand for 4 days, I know that chemistry in Kiev is done for 1 day. Maybe the doctor is missing something? Tell me, please, with such a degree, how much is the probability of curing my mother? What is the treatment method? Can I come to Kiev for a consultation and treatment? Mom is 66 years old.
Thank you.
Responsible Titenko Eduard Vasilievich:
Good afternoon. Most likely, 4 days of preparation for chemotherapy, given the age of the mother, will include drugs to maintain the cardiovascular system and liver function, antiestrogen therapy can also be carried out, given the presence of uterine fibroids. Grade 2B gives a high percentage of cure. The treatment method at this stage is : 4 courses of preoperative chemotherapy (neoadjuvant), then surgery (unfortunately, complete removal of the breast is impossible to avoid, in order to avoid recurrence), then 6 courses of postoperative chemotherapy, treatment can be supplemented with radiation therapy, but this is all decided after surgery. Treatment standards are the same in all oncology dispensaries , so it's up to you to decide whether to go to Kiev.
Nina asks:
Hello! Thank you very much for your useful site.
I would be grateful if you help me understand the problem more deeply.
I'm 55 years old.
An operation was performed a month ago to remove the right breast and lymph nodes.
Invasive lobular, partly ductal carcinoma (M8522/3)
solid structure G3 with metastasis in 1 lymph node.
ER - "+++" expressed positive reaction
PR - " - " backlash
С-erbB2(HER2/new) - "+" negative reaction
Ki67 - 40%
20 sessions of radiation therapy
but there are doubts about chemotherapy due to its toxicity
what treatment is usually indicated in such cases and what drugs can facilitate its passage (nausea, etc.)
are there any dietary recommendations?
Thank you for your reply.
Responsible Filonenko Andrey Grigorievich:
Nina, good afternoon. As for special (antitumor) treatment: if lymph nodes affected by a tumor (like yours) are detected during surgery, chemotherapy significantly improves the chances of a complete cure (about twice). In other words, the probability of continued tumor growth without chemotherapy in your case is twice as high as if chemotherapy was given. You decide. In your case, 4-6 courses of chemotherapy with anthracyclines are indicated. In the future - hormone therapy for five years. To reduce side effects, so-called accompanying drugs are used. The doctor who will treat you during the chemotherapy period will definitely prescribe them and tell you everything.
Svetlana asks:
In June 2011 I had an operation for ductal breast cancer (left),
RE-5%, RP-60%, HER2\Neu 1+. Before the operation, there were two red chemo, after - six yellow ones. I am currently taking tamoxifen. I don't feel bad, I'm examined every 3 months.
Questions: 1. Do I need to change to another medicine.
2. Why is HER2\Neu 1+ (weakly aggressive) worse than 3+.
2. What is the prognosis for survival. I read that even with a three-time negative after 3 years, the percentage of survival increases. Thank you
Responsible Filonenko Andrey Grigorievich:
Good afternoon, Svetlana.
1. The choice of medication for hormone therapy depends on the age (more precisely, on the presence of menopause) at the time of the start of treatment. Tamoxifen is used in cases where menopause has not occurred at the start of treatment. I think that your appointments took this moment into account, so there is no need to change anything. The best results of treatment are obtained when taking tamoxifen for 5 years.
2. With HER2\Neu 1+, the prognosis is not worse than 3+. At least I do not know such data.
3. Indeed, the more time has passed without a relapse since the end of treatment, the more likely it is that there will be no relapse at all. So your prognosis is good.
Elena asks:
My mother has stage 3 B left breast cancer, what does this mean and is there any hope for recovery after surgery or how can I support the body after surgery
Responsible Filonenko Andrey Grigorievich:
Good day, Elena. Stage 3B means that the tumor has existed in your mother for at least 10 years (most likely, in reality, much longer), and at the time of treatment it has reached a large size and / or spreads to structures adjacent to the mammary gland. Therefore, most likely, treatment will be started not with surgery, but with drug treatment (chemotherapy). The next task is to reduce the size of the tumor. The distant task is to facilitate (and perhaps even make possible) the operation. Recently, the concept of treating advanced breast cancer has been changing. Instead of the desire for a cure, the desire to prolong life and improve the quality of life for a patient with a tumor comes to the fore.
Nick asks:
Hello. Mom has RM. Complete mastectomy of the right breast was performed. The tumor is hormone dependent. Tamoxifen was prescribed, but after 3 months of taking the drug, endometrial hyperplasia of the uterus was determined. The doctor suggests replacing tamoxifen with farestan. But farestan has a contraindication - endometrial hyperplasia.
The following questions arise:
1. Is farestan prescribed correctly?
2. Is it possible to get rid of endometrial hyperplasia without curettage?
I would be very grateful for an answer, since my mother lives in a small town and it is not always possible to go to the region to consult a doctor all the time, and it is not so easy to find a farestan.
Responsible Babik Andrey Ivanovich:
Good afternoon. 1) fareston was prescribed correctly 2) in this case, you need to switch to the next line of hormone therapy - aromatase inhibitors 3) why don't you ask your doctor all these questions? In the offices, everyone is silent, as if they have taken water in their mouths, and then at home, at the computer keyboards, inspiration dawns on everyone, and they begin to write to "Internet" doctors!
Natalia asks:
Is there a disability for breast cancer if the breast is cut off?
Responsible Medical consultant of the portal "site":
Hello, Natalia! Disability is established not by a medical diagnosis, but by the changes that the disease has caused in the patient's body. You can count on disability if, as a result of an illness, surgery or subsequent treatment, you have partially or completely lost your ability to work, the ability to take care of yourself. Women after surgery for breast cancer are often given disability group 2 for 1 year - for the period of chemotherapy or radiation therapy (since these types of treatment seriously affect the patient's ability to work). At the end of this period, the group is removed (again, in the absence of indications for extension). Take care of your health!
Svetlana asks:
Please tell me if treatment with another aromatase inhibitor - axostrol - is not contraindicated if I have metastases in the bone after treatment in 2006-2007 of ductal carcinoma (mastectomy of the left breast)? After all, axo strol destroys the bone tissue itself, and I already have severe problems with the bones - a compression fracture of the 3rd vertebra and osteolytic metastases in the hip joint. Metastases were discovered in 2012. She underwent chemo and radiation. The pain syndrome has decreased significantly. But about hormonal therapy, I asked the doctor myself recently and she wrote to you on the page. The tumor was extra gene dependent. For 4 years she drank Femara and, when the cycle was resumed, she was injected with Diphereline. Now I am 41 years old
Responsible Filonenko Andrey Grigorievich: Mariana :
Hello! It would be desirable to learn or find out your opinion in occasion of spent treatment.
In December, I was diagnosed with a lump in my chest,
On January 21, they operated on - Dz: moderately differential. ductal carcinoma with lymphoid infiltration of the stroma.
Т1N0М0, G2
IHC: triple negative (EP, PR, Her2 - negative), ki67-50%.
February 5 - quadrantectomy with removal of tissue and LU, histology-sections and LU are clean.
The glasses were reviewed in the regional clinic, the DZ was slightly clarified: medullary carcinoma
To date, 3 weeks have passed since the operation, our city doctor suggests starting Radiation therapy - 6 courses, then CT - doxorubicin + paclitastel - 6 courses.
In the regional antitumor center - another treatment option:
4 courses in 21 days CT: paclitastel 300m + carboplatin 450m, after that Radiation on the operated breast
in the first variant, it is embarrassing that radiation is prescribed before chemistry,
in the second option - the fact that the drug regimen is not the same as in many cases read on the Internet.
What is your opinion - what treatment will be the most effective and correct?
Thank you in advance for your advice and explanations, I really look forward to your answer, I need to start treatment, I want to make the right choice.
Responsible Filonenko Andrey Grigorievich:
Good afternoon Mariana. I believe that it is necessary to irradiate immediately. The ideal is a combination of radiation and chemotherapy, but this combination is usually poorly tolerated by patients.
As for the choice of chemotherapy regimens, the problem is that there is no single approach to the postoperative treatment of triple-negative breast cancer. The first option (taxane + anthracycline) is actually better known, because actively used in all types of breast cancer. The second option (the use of platinum + taxane preparations) is used only in the case of a triple-negative variant, but is also well known. Currently, research is ongoing, and it is not yet possible to say which option is better.
Lily asks:
Hello, 39 years old, on 10/17/12 I underwent Madden surgery, please decipher my diagnosis pT2N1M0, 2B st., in 3 out of 8 l. nodes mts c-r. ER-90%, PR-40%, HER +1, KT67- 40%. After the operation, a month later, l. therapy was prescribed for 18 sessions, after it, after 2 weeks. - 6 courses of "red" chemistry. After 9 days of irradiation, a ball similar to an inflammatory lymph node appeared on the neck closer to the collarbone, then two days later a similar "ball" appeared under the armpit. I show doctors, they touch and are silent ..... Thank you in advance for your answer. Children are small, they really want to live ....
Responsible Filonenko Andrey Grigorievich:
Good afternoon Lily. The "balls" you are talking about could be tumor foci. This means that even before the operation, there could be microscopic tumors in these areas, which are now growing. This information is just a guess. To clarify, a histological examination of the "balls" may be needed. Doctors are silent, because they are afraid that such “balls” may also be in other places, in other organs. I think for now the treatment should continue as planned. Changes will be made later. I recommend that you follow the instructions of your doctors as accurately as possible, this is the only way for you to do everything in your power so that your children have a mother.