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Her2 Positive Score 3 Ki-67 45%25 Eco- 1cm Pet 1.3cm
Question: Her2 positive
score 3
Ki-67 45%25
eco- 1cm
pet 1.3cm
medication - trastuzumab - Cyclophosphamide - Docetaxel
cancer is not getting smaller ? another option
The Cancer has not gotten smaller, we think this medication is not working. We are worried that after the surgery the same medication will not work and cancer will come back. What are our options?
score 3
Ki-67 45%25
eco- 1cm
pet 1.3cm
medication - trastuzumab - Cyclophosphamide - Docetaxel
cancer is not getting smaller ? another option
The Cancer has not gotten smaller, we think this medication is not working. We are worried that after the surgery the same medication will not work and cancer will come back. What are our options?
Brief Answer:
Pertuzumab based chemo
Detailed Answer:
Hi
Thanks for reaching out to healthcaremagic.
The tumor size is really small. So we prefer upfront surgery in this situation. Were there any enlarged lymph nodes on USG or PET scans?
If at all we choose upfront chemo then we prefer docetaxel carboplatin trastuzumab plus pertuzumab. This combination gives the best response rates.
Now, even if she continues with the current regime, at the time of surgery, if the cancer cells vanish then outcome is good. If they don't, we can give trastuzumab emtansine (TDM1) after surgery, which improves the outcome to a great extent.
Hope this helps,
Regards
Pertuzumab based chemo
Detailed Answer:
Hi
Thanks for reaching out to healthcaremagic.
The tumor size is really small. So we prefer upfront surgery in this situation. Were there any enlarged lymph nodes on USG or PET scans?
If at all we choose upfront chemo then we prefer docetaxel carboplatin trastuzumab plus pertuzumab. This combination gives the best response rates.
Now, even if she continues with the current regime, at the time of surgery, if the cancer cells vanish then outcome is good. If they don't, we can give trastuzumab emtansine (TDM1) after surgery, which improves the outcome to a great extent.
Hope this helps,
Regards
Above answer was peer-reviewed by :
Dr. Kampana
This tumor has not spread, when we pet scan.
Total 4 treatments and we checked ECO after 2nd treatment- it did not get smaller- same size
You mentioned it was small , when tumor is surgically removed what percentage or chance that cancer will return?
Should she remove the whole breast or just the cancer and surrounding area? What are her surgery options?
If trastuzumab and chemo is not working now and TDM1 is trastuzumab and chemo combined ……this seems to be the same medication…why do you this this will work? Is there a difference between these medications?
Total 4 treatments and we checked ECO after 2nd treatment- it did not get smaller- same size
You mentioned it was small , when tumor is surgically removed what percentage or chance that cancer will return?
Should she remove the whole breast or just the cancer and surrounding area? What are her surgery options?
If trastuzumab and chemo is not working now and TDM1 is trastuzumab and chemo combined ……this seems to be the same medication…why do you this this will work? Is there a difference between these medications?
Brief Answer:
Small tumors recur less
Detailed Answer:
Less than 2 cm node negative tumors do well in 95% or more cases after upfront surgey followed by chemo plus trastuzumab. Hence surgery upfront preferred.
In her case without knowing about all details can't say which surgery is possible, but mostly small tumors are treated by removing tumor with surrounding tissue with axillary sentinel node biopsy.
Tdm1 is completely different. It delivers chemo directly into tumor cells. In patients with residual tumor after chemo plus targeted therapy, tdm1 after surgery leads to vastly improved outcomes.
Regards
Small tumors recur less
Detailed Answer:
Less than 2 cm node negative tumors do well in 95% or more cases after upfront surgey followed by chemo plus trastuzumab. Hence surgery upfront preferred.
In her case without knowing about all details can't say which surgery is possible, but mostly small tumors are treated by removing tumor with surrounding tissue with axillary sentinel node biopsy.
Tdm1 is completely different. It delivers chemo directly into tumor cells. In patients with residual tumor after chemo plus targeted therapy, tdm1 after surgery leads to vastly improved outcomes.
Regards
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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