My mother is diagnosed with breast cancer stage 2 after surgery doctor started chemotherapy with herhope 440 mg injection can you describe her condition and how many chemo necessary for her and is their any other bttr process of treatment.

Dr. Nikhilesh BorkarOncologist14yrs exp

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Herhope is Transtuzumab, which is an anti Her 2 receptor antibody. If the tumor is Her 2 receptor positive, then it is recommended to give 3 weekly Transtuzumab for a year. It is a costly drug (Herceptin, the original brand by rosche costs 55k to 75k per vial of 440 mg) hence biosimilars are used which cost anywhere between 20K to 45K per vial. There are various schedules of chemotherapy which are used. The most common being 4 cycles of dose dense (2weekly) Adriamycin + cyclophosphamide followed by Taxanes (4 cycles of 3 weekly Docetaxel or 12x weekly paclitaxel). Transtuzumab is usually started with the Taxane chemotherapy and continued for a year. If radiation therapy is indicated (all Breast conservation or mastectomies for large tumour or node positives) The it is given after completion of the chemotherapy. Also, after completing the chemotherapy if your tumor was hormone receptor positive (ER/PR), then hormonal therapy would be started. It may be in the form of Tamoxifen or Aromatase inhibitor, for 5 -10 years. Sometimes we consider Adjuvant Bisphosphonate or Denosumab in postmenopausal women (6 monthly for 2 years, but kidney function must be normal and after dental prophylaxis. I would be able to guide you better if you could send the details of the surgery and the histopathology report. If you have any doubts or if you want to discuss this further, feel free to contact me directly.  

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