• My sister was diagnosed with HER2 breast cancer last week after a biopsy. What next??

    Asked by Erika on Monday, January 21, 2013

    My sister was diagnosed with HER2 breast cancer last week after a biopsy. What next??

    She went to two different surgeons this week and found that they have two very different approaches... She is now seeking a third opinion. Should she see an oncologist before she has the surgery? I thought that the Oncologist would have a say in the matter but my sister feels that she will find an Oncologist after the surgery.... Please advise

    18 Answers from the Community

    18 answers
    • nancyjac's Avatar
      nancyjac

      Absolutely. She will need more treatment than just surgery. A medical oncologist should be driving the train here. She is eliminating many of her options by having surgery before seeing an oncologist. Surgery many not even be the primary treatment indicated.

      almost 5 years ago
    • TinaJacques' Avatar
      TinaJacques

      Absolutely, if the two opinions are very different, get a third. HER2, as I am sure you know, is a very aggressive breast cancer. It is imperative that she gets the best treatment for her type of cancer. She should seek out a third opinion immediately so she can move forward with a treatment plan ASAP.

      almost 5 years ago
    • SueRae1's Avatar
      SueRae1

      Yes your sister should get another opinion and see an oncologist as well. She needs to get a team in place that can work collaboratively on her treatment plan. In fact when I got my original stage 1 diagnosis, I saw the breast oncologist first, he recommended my surgeon. After that I got a "2nd" opinion on my treatment plan.

      almost 5 years ago
    • gwendolyn's Avatar
      gwendolyn

      Ideally, a surgeon and a medical oncologist would be collaborating and discussing her case right from the start. Even better is the option at many hospitals where a board of doctors all review the new cases and giving treatment recommendations. The board at my hospital included the radiologist, pathologist, surgeon, plastic surgeon, medical oncologist, and radiation oncologist. I had the option to have some chemo before surgery to shrink the tumor. I was able to discuss that option with both the medical oncologist and the surgeon before making my decision.

      almost 5 years ago
    • JennyMiller's Avatar
      JennyMiller

      My daughter arranged my appointment with the Surgeon within a couple of days of diagnosis and the Surgeon agreed to come in the following Saturday morning to do my surgery so I did not have a chance to see an Oncologist prior to surgery. However, my Oncologist and Surgeon have a great relationship in working together to prescribe the best course of treatment for the individual patient -- in fact, there is one day per week that the Surgeon is at the Oncology Center so I saw both of them at my first appointment following surgery so that when I left there, we were all in agreement as to what treatment was best for me. They knew I wanted to be aggressive in my battle -- so the plan following Bilateral Mastectomy included 8 sessions of Chemo followed by 35 sessions of Radiation followed by 5 years of Arimidex. Some ladies that I know who have HER2 had to have Herceptin treatments following chemo (for about a year). If your sister can see an Oncologist before surgery, she definitely should -- Often, they will do chemo before surgery, etc. -- and the Oncologist is the principal Navigator on this Journey. Best of Luck to her!

      almost 5 years ago
    • Tania's Avatar
      Tania

      Erika, I am a breast cancer survivor of 4 years. I went to two doctors and they had different approaches that I did not like and went to a third one and that is the one I stayed with. There are many approaches out there but you have to talk to your Oncologist and do what is best for you. I had surgery then radiation and now I am taking a medication for 5 years. Good luck and keep me posted. Hugs Tania from Miami Florida. stay positive it will all work out..

      almost 5 years ago
    • lwell's Avatar
      lwell

      My breast surgeon highly recommended chemo before surgery with HER2 type cancer. She wanted to make sure that my cancer responded to treatment. If surgery is performed first, you don't know if the tumor responded to the chemo. If they find after chemo, that it did not respond, then they can change the chemo and try something else. I also read in Cure Magazine that chemo first is used as a curative measure as well.

      almost 5 years ago
    • lwell's Avatar
      lwell

      My breast surgeon highly recommended chemo before surgery with HER2 type cancer. She wanted to make sure that my cancer responded to treatment. If surgery is performed first, you don't know if the tumor responded to the chemo. If they find after chemo, that it did not respond, then they can change the chemo and try something else. I also read in Cure Magazine that chemo first is used as a curative measure as well.

      almost 5 years ago
    • Steph921's Avatar
      Steph921

      I had HER2 cancer and due to the size of the tumor we opted for chemo first to shrink the tumor, then surgery. Before I did anything, I met with the surgeon, medical oncologist and the radiation dr and everyone was in agreement on the course of action. As it turned out, I had an excellant reaction to chemo, had the surgery last month and will start on radiation next month. I will also be on Herceptin every three weeks for a year. If it's one thing I've learned through this it's that everyone is different but I would definitely see the oncologist before surgery if at all possible. Good luck to you and your sister!

      almost 5 years ago
    • Lindy's Avatar
      Lindy

      See the oncologist first!! Then the decision as to which procedure will be easier, proper sequence of care critical to seeing the oncologist first.

      almost 5 years ago
    • Risa's Avatar
      Risa

      I would definitely see the oncologist first! I have HER2 and had chemo first to shrink the tumor and provide a systematic approach for my entire body as well!

      I can't imagine waiting until after surgery, recuperation from the surgery, and radiation to have chemo. HER2 is so aggressive! I wish your sister lots of luck with her treatment

      almost 5 years ago
    • princess123's Avatar
      princess123

      After seeing my oncologist she went over the pet scan and explained each part. She did not recomend surgery but went directly to Chemo treatments due to it's spreading to too many places. She should see an oncologist to find a plan that best suits her.
      It does seem a lot better after you know all the facts. Seek someone who will share everything with you and talk over the plan untill you understand it.

      almost 5 years ago
    • Beverly60's Avatar
      Beverly60

      Please strongly encourage her to see an Oncologist FIRST! Very often Chemo and/or Radiation can shrink a tumor to the point surgery may not be required, or could be way less invasive.
      Her Oncologist will co-ordinate her care, not the Surgeon.
      Sometimes Chemo can kill the cancer cells and give a defined edge for a tumor that did not exist before.

      almost 5 years ago
    • Ydnar2xer's Avatar
      Ydnar2xer

      Information is crucial at this point, so I agree, see the oncologist right away. I was diagnosed with HER2 Positive on August 3. Because it was my second breast cancer, I already was working with a wonderful oncologist. He recommended mastectomy (I chose bilateral) and then 6 "cycles" of Taxol, Carboplatin and Herceptin. I had my double mastectomy on August 21 and was relieved to get it over with. The GOOD thing about HER2-pos is that Herceptin is like a smart bomb for it. Supposedly, it bonds to the Her2-pos cells and kills them--doesn't mess around with other (healthy) cells like some drugs do. I finished my 18 weeks of chemo today and am heartily looking forward to a every 3-week schedule with Herceptin now. (I can't do radiation because I had it (and lumpectomy) the first time around) Please contact me if you have other questions. Your sis is lucky to have you as her advocate. good luck!

      over 4 years ago
    • SMeridith's Avatar
      SMeridith

      I got a second opinion before deciding on a breast surgeon. He recommended surgery first before chemo. He wasn't positive I was going to need chemo until he absolutely had my diagnosis after surgery path reports. As it turned out, I had stage 1a triple negative/HER2 positive cancer. It was not in my lymph nodes or lymph canals so I didn't have radiation but did have six doses
      of Carboplatin, Taxol and Herceptin. I was scheduled to have 12 months of Herceptin every three weeks but had heart problems (Ejection Fraction) after 8 months so treatments were stopped.
      My surgeon, oncologist and cardiologist have worked closely together and I feel I have been in good hands and gotten the appropriate treatment.
      Good luck to you as you seek answers and as you continue this journey.

      over 4 years ago
    • KimG's Avatar
      KimG

      Wow you are very close to me! I grew up in Glendale Hts. and now live in Lake Villa.(northern IL)I can only tell you what I did and I saw my surgeon that I think came from the mammo place. First she or he takes a biopsy(ouch!)so be prepared. Then depending on that you decide on your treatment. You go with whatever you head tells you to. I just had a lumpectomy, then chemo(which is when I found my oncologist),then radiation, then oral meds for 5 years. Some women elect to have a mastectomy first round so they don't have to deal with the possibility of another occurrence even if stage 1. If your cancer is malignant and depending on the stage and the grade that may help you to decide, and whether the lymph nodes have become involved. They usually find out about the lymph nodes during surgery. I was stage 1(a lump about the size of a marble or grape)but a grade 3, which is a most aggressive. I figured it was stage 1 and that it wasn't necessary to remove the breast or both, then do reconstructive surgery. I figured I was relatively young and didn't have time for all that when maybe it wouldn't be back for quite a while. I still had to raise my 11 year old son so I wanted to get back on my feet ASAP. Turns out, for me anyway, that there were many issues that I never thought of came up like emotions, the kinda fog when trying to start a new job or going back to your regular job, menopause, depression ect. it was just really hard for me over these past few years. The best advise I can give your sister is take the time to recover, don't rush it-I went back to work too soon and that caused a lot of other problems. Also the only ones who truly understand what your sister is going through is people who have gone through it. So staying at this site is another wise decision already. At the time my oncologist kinda made the decision based on the surgery, my positives and negatives, your percentages, age, ect, . I trusted his decision and all I knew was if I woke up with drainage lines that wasn't as good. It probably would have made the difference in the treatment and if the lymph nodes are involved it's easier to spread. I was 49 when diagnosed and 52 now. I'm still struggling now because I'm again unemployed and had to file bankruptcy. I say it's because I rushed going back to work when I was so emotional and still getting my radiation. I would stop quick on the way to work, get radiation, then continue on to work which was a new job-so that didn't help either. Everyone's case is a little different but I hope some of this helps and prepares your sister for a not as easy as she thinks recovery. Please just be there for her and listen really listen not trying to push your views onto her. All my best to your sister and you. Praying together to God too. I don't think your sister needs to be more confused with a 3rd doc in the picture, but maybe she's looking for the tie breaker. At least she's on the right track about the oncologist. I'm positive she'll do just fine
      because she's made some good decisions already and has a sister like you! Take care, kimg

      over 4 years ago
    • mrsstevie's Avatar
      mrsstevie

      Erika, it's been awhile since I read this and you posted; but hope your sister has seen an oncologist. I'm also Her2 and also live in Glen Ellyn, I would be more than willing to answer any questions. I've had lumpectomy, mastectomy, chemo and am now ready to finish my last infusion of Herceptin. It's been a long year but your sister can do it. Thoughts and prayers for her.

      over 4 years ago
    • Lindy's Avatar
      Lindy

      Oncologist first, become an her2 expert as you traverse this new journey. So much happening now with great promise particularly for her2. I wish you every good and appropriate decision.

      over 4 years ago

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