d******g
发帖数: 2 | 1 左乳全切，前哨淋巴只切了一个，有isolated tumor cell, 但医生说按现在的标准算
Negative，不需radiation。
biospy时左乳发现的两个tumor：
乳头处的tumor HER2是negative (IHC score 2+，FISH negative) ；
12点的tumor HER2是positive (IHC score 3+)。
手术病理显示有两块 specimen, 因为有re-excision。
但是只发现一个 tumor(乳头处)，1.5cm, HER2结果和biopsy时乳头处的tumor一样，
IHC score 2+, FISH negative，另一个(12点)不仅tumor没找到，biopsy时放到那的
clip也找不到。后来作过X-RAY， US， MRI，没有发现体内有什么残留。
本来医生说chemo会采用 TCH*6 with HERCEPTIN for 1 year based on the fact that
ONCOTYPE SCORE for the tumor at nipple is 20 (intermediate) and there is
another 12:00 tumor which is HER2 positive, 结果second-opinion pathology
review发现biopsy时12点的tumor HER2居然是negative (IHC score 2+， FISH
negative) , 所以他要取消Herceptin, 让我只做TC*4。
感觉医生的想法是只要没法证明HER2 肯定是positive,就不用HERCEPTIN, 而我的想法
是只要没法证明HER2 肯定是negative, 不用HERCEPTIN就有很大风险。万一其实是
positive, 我却没用herceptin, 不是很惨吗？我这个case从一开始就挺复杂，感觉医
生已经烦了，不愿意再order第三方作her2 test了, 没有医生order, 我也没法找人作
吧？
想请问一下这里的专业人士，我这种情况只TC*4行吗？
感谢大家花时间读我的贴子，any suggestions will be highly appreciated. | g******1
发帖数: 45 | 2 Ask the doctor to order Her2 FISH for the biopsy from 12:00. If FISH is
positive, you need Herceptin. If negative, then you don't need Herceptin. | g******1
发帖数: 45 | 3 I am I did not read carefully. They did FISH on the biopsy specimen taken
from 12:00. It was negative. You most likely don't need Herceptin. I am
sorry about this. | I****a
发帖数: 407 | 4 From existing information, the her2 status is negative, therefore
Trastuzumab is not indicated. Adujuvant TC is reasonable choice although
benefit of chemotherapy is not going to be high with the intermediate
OncotypeDx score. |
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