Need information about cost and survival rate for HER 2 positive breast cancer (ER/PR both negative)

[Zahid100]

My mother had infiltrating ductal carcinoma. Her ER and PR both are negative. But HER2 positive. She had right breast lumpectomy on 5th August,2017. She also had Mastectomy with axillary clearance (8lymph nodes removed) after the biopsy of lumpectomy showed invasive ductal carcinoma. Mastectomy was done 13th August, 2017. After the mastectomy I got the ER/PR report yesterday. My financial condition is not that much well. I live in Bangladesh. How is the survival rate of Grade 2 infiltrating ductal carcinoma having ER/PR negative with HER2 positive (3+)?? What is the cost o the treatment? how long the treatment will last?? how many days my mother can live having treatment??? In normal eye my mother seems fit enough. She walks and moves around and talks like a normal person. I want to take her to India. In india how much is the cost of this treatment??? please answer.. In Bangladesh it is now holiday period and hospitals are shut. Will there be any problem if the treatment starts on next week????

[sumeet_shah Administrator]

ER / PR and HER2 do not determine the stage of breast cancer or the outcome. It's the nodal status which is the most important determinant for that.

My suggestion is, please go ahead and treat your mother, she will be fine. Just be in touch with your Oncologist there. Do whatever they say. If need be, take an opinion. But continue the treatment as per their advice.

[Zahid100 in reply to sumeet_shah]

Thank you very much sumit sir. But I don't know what is the nodal status? Can you clarify about nodal status?

[sumeet_shah Administrator in reply to Zahid100]

Nodal status means if the nodes are positive or negative and other characters. Sit with your Oncologist, the one who operated upon her and discuss. I am sure he will elaborate.

[Zahid100 in reply to sumeet_shah]

Thank you very much.

[kaarenorgaard]

Here are some important questions regarding survival:

* 8 nodes were removed, but how many had cancer of those (if any?)

* How big is (was) the cancer in diameter?

* Did the cancer infiltrate other than the surrounding tissue (i.e. bones or skin)?

Being ER-, PR-, HER2+, she would need 2 types of medications now:

(1) Chemo therapy for some 20 weeks (+/-) (the oncologists have their preferred combinations, which can have many reasons, some of which relate to the patient, some just to their own preferences and relationship with drug companies).

(2) Herceptin (or one of its equivalents - in India there are some: but they must contain Trastuzumab. E.g. Hertraz and CANMAb) for a year. This is potentially the expensive component of the treatment. It is Rs 57,500 per 440 mg injection, which you must have every 3 weeks for a year, i.e. 17 times. See timesofindia.indiatimes.com...

It is important, that if the doctor chooses a certain chemo therapy combination containing a drug from the "anthracycline" class, that the Trastuzumab treatment must wait for the anthracycline to be completed.

See herceptin.com/hcp/treatment... - under AC -> TH.

If there were any positive nodes (infected with cancer) among the 8 lymph nodes removed, then she would benefit from radiation of the axilla, where the nodes were. This is called radiation therapy. It must await the completion of chemo therapy.

A few weeks do not matter ... it's better to get it right.

Feel free to follow up with more information and questions. Good luck. I think she has a good survival chance, given she is HER2 positive and receives Trastuzumab.

Kind regards

- Kaare (from Denmark)

[Zahid100 in reply to kaarenorgaard]

Thank you sir for your kind suggestion and I am very very grateful to you. After the mastectomy a histopathology was done with the specimen of the right breast. That showed follicular hyperplasia in the lymph nodes. I will send you the report if it is possible to send the photo here. Before the first operation my mother's blood report was normal. I think that might be a good indication for not spreading to other organs but I don't know. If it is possible I will post the photo of the blood report here.

[kaarenorgaard]

"Follicular hyperplasia in the lymph nodes" doesn't mean that they are cancerous, necessarily. You can send the report to my email: [e-mail].

But the key is to get Herceptin or one of its substitutes as well as chemo therapy.

And if at least one lymph node was cancerous, then to get radiotherapy.

Kind regards,

- Kaare

[Zahid100 in reply to kaarenorgaard]

I have sent a mail to your e-mail address. Waiting for your kind response.

Thank you sir.