Diagnosis and Treatment

June 12, Surgery: left mastectonomy

Pathology report:  4.9cm Ductal Carcinoma In-Situ (DCIS, the kind that does not spread); among which is found multifocal invasive ductal carcinoma, largest focus is 2.5mm and is rated as Grade III. Lymph node 0 positive out of 2 (meaning the cancer has not spread to any neighboring lymph node). Estrogen Receptor – negative (meaning that it does not need any hormone therapy).

Progeterone Receptor – negative.

HER2- strongly positive +++. HER2 is a non-inherited genetic abnormality occurring in some breast cancers that makes the cancer susceptible to Herceptin. The HER2 gene produces a protein receptor on the surface of the cell that can stimulate growth and multiplication when a growth protein attaches to it. Normally only a few receptors are formed and the cell grows and divides only occasionally. Herceptin is a targeted monoclonal antibody that binds to the growth receptors on the surface of the cancer cell and blocks growth protein factors from attaching from attaching to it. This prevents the cancer cell from growing and dividing.

Doctor’s recommendations: though the invasive part is quite small, but considering the extensive micro-invasion within the DCIS, doctors recommend a more aggressive treatment: Chemotherapy (Docetaxel + Cyclophosphamide) x 4 cycles + 1 year of Herceptin injection. Herceptin injection is the main theropy targeting HER2 but extensive research finds that Herceptin injection combined with 4 cycles of chemo is more effective than Herceptin injection alone – that is why I still have to go through chemo even after the mastectonomy operation. Please pray for me!

First Chemo: July 30, 2008 – done!

Second Chemo: August 20, 2008.

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