Treatment Options for HER2+ Breast Cancer: A Comprehensive Guide

[@BL-f4b]

I am a first time commenter but faithful follower on my two year triple positive sentinel node positive BC journey. I am grateful to have tolerated my year's treatment with Phesgo (Herceptin and Perjeta) well and am currently having no issues with Letrozole. Nerlynx was my nemesis as I had severe GI issues along with muscle spasms and deep fissures in my fingers. At 74, I chose to stop the kinase inhibitor to preserve my quality of life and ability to take care of an elderly spouse. My oncologist was supportive and is great ( but time stretched). This 40 year retired RN appreciates your kindness and thorough explanations Dr. Griggs. You obviously have the heart for your work.

[@yerbba]

Thank you for sharing your journey and for your kind words. It sounds like you've made some thoughtful decisions to balance treatment and quality of life, especially given the challenges with Nerlynx (for our other viewers, this is neratinib, an oral small molecule directed at the HER2 protein). Your experience as a retired RN gives you unique insight, and it’s wonderful to hear that your oncologist is supportive of your choices. We're glad to hear you're doing well on letrozole, and wish you continued health and strength as you move forward.

[@juanitagee9511]

Dr. Griggs ~ thank you for all the knowledge that you share with us. You're the BEST!♡♡

[@yerbba]

You're the best! Thank you for being part of our community.

[@ShitalNG]

Thank you Dr. Griggs! Your videos are always very informative.

[@yerbba]

Thank you for the positive feedback! We appreciate your support.

[@naththomas9946]

Thank you, Dr. Griggs, for your informative advice.

[@yerbba]

Thank you for being part of the Yerbba community!

[@ergwinn]

Dr Griggs…. I have triple positive BC and I’m on cycle 2 with TCHP. I’ve seen improvement in my nipple and the tumor is softer and seems to be smaller. However, I feel pain at the tumor. Is this unusual or typical? Thank you for all the help you are giving us!

[@payalpandey875]

mam can we take tucatinib or neratinib after the progression on lapatinib ? because my mom is 4 th stage mbc patient and whats the best option after progressions on lapatinib? pls help

[@samanthaesra4035]

Thank you Doctor for teaching us.

[@yerbba]

Thank you for watching!

[@samanthaesra4035]

Dear Doctor. I have been diagnosed with HER2 positive in my left breast with an aggressive tumor. Plus I have HER2 neg in my right breast. How is it even possible ? How will my oncologist treatt me ? I'm on the Red Devil at the moment. I am confused. I'm under state care in South Africa.

[@yerbba]

Thanks for sharing your story. It's important to differentiate a tumor that is "aggressive" in the pathology report from prognosis. Chemotherapy is highly effective along with anti-HER2 therapy (e.g., trastuzuamb) in tumors that are called "aggressive" by physicians. It is possible indeed to have two tumors, one in each breast, and they can be similar or completely different from one another. The "red devil" has a terrible name, doesn't it? It's also extremely effective in treating breast cancer. Keep coming back here for our videos and for the Yerbba community. We are wishing you the best as you progress on your treatment.

[@samanthaesra4035]

@@yerbba thank you Dr.

[@SlotstheMetaphysicalwa]

I am the same😢😢😢

[@iconic1758]

Is there any alternative treatment available for her2 positive tumors. I'm asking this because phyllodes tumor is highly resistant to conventional chemotherapies so doctors have just operated my mother

[@yerbba]

Phyllodes tumors are indeed relatively resistant to conventional chemotherapy, but the prognosis is generally excellent even without systemic treatment. It’s always a good idea to discuss with your oncologist if there are clinical trials or emerging treatments that could be worth exploring in your mother’s case.

[@This.is.amnaaa]

I am on kadcyla currently. Only last cycle 13/14 left. Cant wait for treatment to end so i can plan a family. I have a question to cover for your next video. (Sorry for spamming as ive asked this before). The biggest purpose of the breasts are to feed a baby but no video covers in detail about women breastfeeding after cancer treatment. I am a 31yo stage 2, grade 3 her2+ hr- survivor and i had lumpectomy with chemo and radiation on my right breast. Currently on kadcyla. My surgeon told me if i have a baby now, i would have to "dry out" both my breasts so i dont get mastitis and yet the research says to breastfeed after treatment to reduce chances of recurrance. Please can you highlight complications of breastfeeding in detail in your next video? Thanks.

[@yerbba]

Thank you for your question, and congratulations on nearing the end of your Kadcyla treatment! Breastfeeding after cancer treatment is an important topic, and we appreciate you bringing it up again. While our videos are already recorded, we’ll definitely add this topic to our list for an updated version. In the meantime, feel free to check out our existing video for more insights: kzbin.info/www/bejne/h57EooWdp519jKs. Thanks for your thoughtful question, and we wish you the best as you plan for the future!

[@Chakri-bc2jd]

Hi doctor , There is said to be a tablet from India called ' r+cu' Which is "resveratrol and copper" and is said to decrease reccurance chance by 40 % and eliminate side effects of chemo, Please please can you tell about it 🙏

[@yerbba]

It's important to approach claims like these with caution. There's no strong scientific evidence to support that "r+cu" or similar supplements can reduce recurrence by 40% or eliminate side effects of chemotherapy.

[@mariaesterdeleonguerrero9971]

This is my first time to comment. I just finished my 3rd cycle out of 6 cycles. Just recently I stumbled and I am very happy to subscribe to your channel. It really helped me how you explained things step by step. Thank you for making this video. 🙏🏼❤️‍🩹❤️

[@yerbba]

Thank you so much for taking the time to comment, and welcome to the Yerbba community! We’re glad our videos have been helpful to you as you go through treatment. We’re here to support you every step of the way.

[@edenetorne6987]

I am HER2 positive and will have my last 2 trastuzumab treatments to complete 18 cycles. After these Are there other treatments I will have to undergo? Based on my recent breast lungs and whole abdomen ct scan/ultrasound the results are all very good. Thank you so much for all your very informative videos.

[@yerbba]

Congratulations on nearing the completion of your trastuzumab treatments! After finishing trastuzumab, your oncologist will guide you on whether any additional treatments are necessary, but it sounds like you’re on a good path.

[@SlotstheMetaphysicalwa]

What is 18 cycles mean? Is this 18 months of treatments?😢😢😢🙏🙏🙏

[@ergwinn]

Generally a cycle of trastuzumab is 3 weeks. So 3 x 18 or 54 weeks.

[@SofiaAhmad-rp8sm]

I diagnosed breast cancer stage 3 Her2 positive.

[@neshatkoly7501]

me too treatment is going on

[@ASH-T786]

I just finished my treatment for stage 3 her2 positive breast cancer 🤞 just had my last infusion of tragerted therapy hopefully my next oncologist appt they say I am in next stage and my cancer is in remission. Good luck with your treatment ❤ praying for you all

[@yerbba]

We hope you found the video helpful. The Yerbba community is here for you every step of the way.

[@mezhini]

You are posting lastest updated videos. Great information sharing. Please arrange to provide your personalised report for Indian patients also. India , the most populated country in the world with substantial Breast cancer patients. Or please open an Indian branch in India

[@yerbba]

Thank you for your feedback! While we’re glad you find the videos helpful. Unfortunately, we currently cannot offer personalized Yerbba reports beyond the U.S. However, we hope to continue expanding in the future to reach more people globally.

[@elsatravisano]

What are treatment alternatives for HER2 positive if one was unable to tolerate Herceptin and Perjeta (heart ejection fraction issues)?

[@yerbba]

Options may include different targeted therapies, potentially in combination with other treatments like chemotherapy or hormonal therapy, depending on your specific situation. If you're in the U.S., we encourage you to visit Yerbba.com to learn more about your treatment options. Your Yerbba Report provides a comprehensive view of your diagnosis, ensuring you're aware of all possible treatments, including those that may not have been mentioned by your doctor, and explains why each treatment option was personalized to your health needs.

[@sand3882]

I'm a new commentor today, too...I think. I certainly do have chemo brain. Sadly, I felt I was slipping considerably even before my surgery. I'm in my mid 60s. I don't know where to put my question. I hope you will read and can address it. I have chemo fog...did I say that earlier...🙄? I have a dandy case of neuropathy, mostly in my hands and feet up to right above my knees. Btw, I have HER2+...or, hopefully, had. Two trips by ambulance with multiple days in the hospital at treatments 4 and 6. Dr. told me at 4, I may not be strong enough to finish. Wasn't a super fan of my Doc. She is from another country, and I have difficulty understanding her sometimes. When I ask her to repeat something, she often gets frustrated. Awkward! Anyway, in a real Hallmark moment, with tears in my eyes, I said to her...Don't give up on me. She looked at me like a deer in the headlights for a moment, then gave me an awkward couple of pats on my shoulder and said...I won't give up on you. Sheesh. I'm so sorry I'm rambling. MY question is after losing about 50 lbs from 190...everything tasted like burnt metal so I couldn't eat, they told me to eat anything I wanted...pizza, ice cream, etc. I didn't ask them to repeat that as I was already out the door to pick up a pizza. Now I have gained about 20 lbs back and it seems I have one huge "chemo belly". They don't tell us about that either. If this thing doesn't get smaller soon, someone is going to throw me a baby shower! Help! Btw...I understand kind of what it is and what caused it but can't figure out how to get rid of it. Hope you see this. Love your style of teaching. Very conversational. Keep it up!

[@yerbba]

Thanks for coming here to share your experiences. We followed you completely. Sounds like you've had quite the ride. We'll pop a link to our video on chemobrain here: kzbin.info/www/bejne/m4bRiqWPqNWJhZo If you're interested in learning another language, now's the time. Learning another language (even if you don't achieve fluency) has been shown to improve cognitive function. Hang in there, you're doing great.

[@swetaasinhaa]

My mom was diagnosed with Breast cancer 3 years ago Her2 positive with positive lymphatic node,she has undergone 6 cycle Chemotherapy, 17 target therapy, surgery and radiation. After 3 years now she found a lump in one of her lymph nodes and the same lymph node 1 cm in the neck was positive earlier as well. We are getting her biopsy done today. Could you suggest best line of treatment for her. How does people respond in such cases?

[@yerbba]

We're sorry to hear about your mom’s recurrence. In cases like this, the next steps depend on the biopsy results. If this is a recurrence of the cancer and if the cancer is still HER2-positive, further targeted therapies, such as trastuzumab (Herceptin) or pertuzumab, may be recommended. Chemotherapy or radiation might also be considered depending on the extent of the spread. Every case is different, but many people continue responding well to treatment even after recurrence. If you're in the U.S., we encourage her to visit Yerbba.com to learn more about her personalized treatment options. Each Yerbba Report provides a comprehensive view of the diagnosis, ensuring that she's aware of all possible treatments, including those that may not have been mentioned by her doctor, and explains why each treatment option was personalized to her specific tumor characteristics and health needs.

[@manishaingle-hf1ol]

How's she?

[@jjp897]

Hi Doctor i just diagnosed lobular cancer lymph node not involved. Tumor lessthan 4 cm , scheduled me for surgery . Whats your recommendation please let me know Thanks

[@yerbba]

Surgery is often a mainstay of treatment, and in some cases, no additional radiation is required. After surgery, your oncologist may consider hormone therapy if appropriate, given the nature of lobular cancer. Be sure to follow up on any pathology results after surgery to confirm the next steps.

[@nand4121]

I have Her2+ it was small they said they got it all and my nodes were clear I have had chemo and am on trzumabab and anastrozone therapy now they want me to have radiation therapy when I was told i didn’t need it originally should I have radiation. now 6 months later

[@yerbba]

It’s understandably confusing when treatment recommendations change. Radiation is often added to reduce the risk of recurrence especially if there’s new evidence or reevaluation of your case. Make sure to ask your doctor about the reasons behind this recommendation and how it will impact your prognosis. If you’re in the U.S., the Yerbba Report at www.yerbba.com can provide a personalized view of all potential treatment options including those your doctor may not have mentioned, and explains how each aligns with your unique situation while detailing the pros and cons.

[@JackiePorter-Smith]

Are HER2 Positive and HER2 Enriched the same? Do you have content related to HER2 Enriched breast cancer? Thank you.

[@yerbba]

HER2-positive refers to breast cancers overexpressing HER2 protein or gene, diagnosed by standard tests. HER2-enriched is a molecular subtype identified by gene expression profiling. Not all HER2-positive cancers are HER2-enriched. HER2-positive guides treatment, while HER2-enriched is mainly used in research and may indicate better response to HER2-targeted therapies.

[@bhanumathikalyanasundaram.4930]

Please clarify whether cancer patients can go for keto diet. I've been seeing videos being promoted by a certain Dr.Is it safe??Thanks a lot for all your informative videos. 👌 👍🙏🙏

[@yerbba]

We don’t recommend the keto diet in general unless you're under the supervision of a physician or dietician. We cover some of this in our video here: [kzbin.info/www/bejne/faCukqKNfcyki5I].

[@kathyspencer3292]

It's been 3 years since I had a tram flap surgery for my breast cancer. I had radiation, chemotherapy and now on 8 years of hormone therapy. Two months ago, I noticed a sore spot on my back. Jumping ahead to today, I now have nerve pain over 60 percent of my body. Gabapenten is not working. No one seems to know why. It is debilitating. Has anyone else had or heard of this? Does anyone have any idea what could be causing this?

[@yerbba]

This sounds incredibly challenging. While we haven’t heard of this exact situation, it might be related to nerve damage from surgery or treatment. It’s important to keep pushing for answers-maybe see a neurologist or pain or palliative care specialist for more insight. It's also possible that others here in the Yerbba community may have heard of this phenomenon. We hope you find relief soon.

[@stitchywiggles]

Thank Doctor.

[@yerbba]

Thank you for watching!

[@JackiePorter-Smith]

My biopsy is 2cm lesion infiltrating duct carcinoma grade 3 no lymphovascular invasion detected. I have been informed by oncologist it is HER2 enriched breast cancer stage 3. My lymph nodes were not biopsied but described on mammogram report as muliple hypoechoic left axillary lymph nodes measuring 7 and 9mm. Can they be sure without a biopsy of the lymph nodes just by looking at mammo and ultrasound images? I am to get chemo every 3 weeks for 6 months, then lumpectomy and lymph node removal, radiation for 3 weeks, then estrogen suppression meds. I was hoping lymph nodes not involved and could have a mastectomy and avoid radiation. If I have mastectomy instead of lumpectomy will this reduce the amount of radiation I get, even if lymph nodes are involved? I appreciate any clarity you could bring as I consider having mastectomy instead.

[@yerbba]

Thanks for writing. In people with Stage III (3) breast cancer, radiation therapy will be indicated even after mastectomy. Mastectomy may reduce the amount of radiation needed, but if lymph nodes are involved, radiation is often still recommended. It’s important to discuss all options with your oncologist to make the best decision for your situation. If you're in the U.S., we encourage you to visit Yerbba.com to access personalized treatment options and learn more about diagnosis. Your Yerbba Report provides a comprehensive view of all possible treatments, including those that may not have been mentioned by your doctor, and explains why each treatment option was personalized to your health needs.

[@zenetcenojas5279]

I was diagnosed stage1a, her2 negative.

[@yerbba]

Thank you for sharing. You might find our video about HER2-negative breast cancer helpful. You can watch it here: [kzbin.info/www/bejne/jJavqYSwgNp6npI].

[@randombySana]

Hello doc, My mom was diagnosed with stage 4 HER2 positive Breast cancer in 2022 and has been on Lapatinib and capecitabine but later was shifted to Lapatinib and Anastrozole. However her treatment doesn’t seem to be responding well. Her MRI report of brain shows ill defined lesion iso to hypointense on T1 and hyperintense on T2 in left hemicerebellum extending into vermis and left medial temporal lobe with inner areas of bleed with patchy diffusion with appearance of new enhancing lesions in right temporal lobe. We’re asked to give her T-DM1 but it’s very costly here in India. Will she be on T-DM1 forever or will the dose decrease accordingly? She is 43.

[@yerbba]

We're so sorry to hear about your mom’s situation-it’s clear how much you care for her. T-DM1 (Kadcyla) is often used for HER2-positive metastatic breast cancer that hasn’t responded to other treatments. Typically, patients stay on T-DM1 as long as it’s effective and well-tolerated, though dose adjustments can depend on side effects. Financial barriers are so challenging-have you asked about patient assistance programs through the drug manufacturer or local cancer support organizations in India? They may be able to help reduce costs. Sending strength to you and your family.

[@payalpandey875]

ab apki mom kaisi hai or kya treatment chal raha hai because same situation meri mom ki hai lapatinib kam nhi kar rahi ab kya karna chaiy

[@randombySana]

@@yerbba thankyou for clearing my doubt doc. We have discussed our condition with the doctors here and they’ve suggested for surgery. Hope it works out for her.

[@randombySana]

@@payalpandey875 mom ko neurosurgery refer kia h for further treatment along with PET CT since T-DM1 kam karega ya nahi uska koi guarantee nahi h . I hope apki mammi ki condition manage ho jaye🤞🏻

[@brendaillig-cg9xw]

AFTER traztuzmab is finished after 1 year, then what? What keeps HER2 from growing again

[@yerbba]

After completing a year of trastuzumab, your medical team will closely monitor your health with regular physical examinations and a careful history of any symptoms you may have. The main goal of trastuzumab is to reduce the risk of recurrence. If your tumor was hormone receptor-positive, you are likely to be offered endocrine therapy (also called hormonal therapy). Also, in a large clinical trial, one year of traztuzumab was as effective as two years of treatment, and of course, avoiding overtreatment is important. If you're in the U.S., we encourage you to visit Yerbba.com to learn more about your treatment options. Your Yerbba Report provides a comprehensive view of your diagnosis, ensuring you're aware of all possible treatments, including those that may not have been mentioned by your doctor, and explains why each treatment option was personalized to your health needs. You may also find our video on why scans are not done to be helpful: kzbin.info/www/bejne/iZSqcoiEo5KBZ6M

[@Barbara-ex3ge]

Thanks for another easily understood and empathic video. A question - I have been successfully treated for HER 2 breast cancer (chemotherapy and surgery followed by transtuzamab) and the sentinel node biopsy was negative. As I have had a double mastectomy (the first in 2015 for wide spread DCIS) can cancer reoccur in my breast (or elsewhere)?

[@yerbba]

Thank you for your question and your positive feedback. After a double mastectomy and successful treatment, the risk of recurrence in the area where your breast tissue was is extremely low. Even after treatment, it is possible that cancer can recur in other parts of the body. The risk of recurrence with HER2-positive breast cancer decreases over time, however.

[@iconic1758]

Are you an oncologist?

[@yerbba]

Yes, Dr. Jennifer Griggs is a renowned breast cancer oncologist with extensive experience in helping patients navigate their journeys and treatment decisions.