Suggest Treatment For Fibroadenoma Of Breast

Respected Sir,

I am a 30 years old lady from Chennai.

I had a hardness on my left breast upper left portion since my 18th year. Consulted many doctors and all of them told me it can only be a fibroadenoma. In August 2010, again I consulted a breast surgeon and she told me to have an ultrasound. I had them Ultrasound for both the breasts and found out a hypoechoic lesion measuring 2.0 x 1.5 cmc in the left UOQ. Right breast is normal.

So my surgeon advised me to have an excision biopsy and the same was performed in the last week of August on my left breast. The lumpectomy specimen reported positive for breast cancer. The below are the details:

Macroscopic Description: Received a single nodule measuring 3x2.6x2.3 cm. Cut surface is tan white, fleshy with tiny specks of calcification ==2 bits

Microscopic Description: Sections show breast parenchyma with foci of invasive malignant tumour composed of cells arranged in cords and groups with scant tubular differentiation. The cells are large with moderate to abundant cytoplasm and large pleomorphic vesicular nuclei with prominent nucleoli. Mitotic activity is high (16-18/10HPF). Surrounding desmoplasia and extensive foci of high grade ductal carcinoma in situ are seen. The tumour reaches very close to the inked resection margin.

IMPRESSION: Poorly differentiated infiltrating duct carcinoma, Grade II to III: Nottingham Modification of Bloom and Richardson's Grading System; Along with Extensive high grade ductal carcinoma in situ. The tumour reaches very close to the inked resection margin.

ER/PR/Her2 Neu Status:
Estrogen Receptor - Positive
Progesterone Receptor - Positive
Her2 Neu - Positive 3+

My Bone Scan, Ultrasound Abdomen and Pelvis, and Mammogram Right Breast reported Negative for Malignancy or any other abnormality other than tiny follicular cyst (~16 x 13 mm) in the left ovary and a tiny gall bladder polyp (~4 x 4mm) on the fundus of gall bladder. wall thickness appears normal..

I have undergone Left Modified Radical Mastectomy on September 8th, 2010 at Apollo First Med Hospital in Chennai and the mastectomy sample reported negative for Malignancy. Here are the details:

* Nipple Tissue and Deep Margin - Free of Tumour
* 26 Left Axillary Lymphnodes identified - All Free of Tumour
* Separately sent infraclavicular lymphnode shows adipose tissue - Free of Tumour
* Breast Tissue Showing Defect with Chronic Inflammation and Granulation tissue with focal histiocystic reaction with no residual tumour. (Post Lumpectomy)

I was sent to a Medical Oncologist and he advised me to have

* Adjuvant chemotherapy 6 cycles (TAC regimen)
* Herceptin Treatment
* Hormone Treatment for 5 years

I have undergone 2 cycles of TAC chemotherapy now.

I would like to get an expert opinion on the Herceptin Treatment as it is very costly. My Oncologist tells me he is just advising me to have it because of my Her 2 neu status (3+) and he tells me 9 weeks is the minimum. I would be greatly obliged if you could give me more clarification on this treatment.

Also, can you please give me your valued opinion on how can i reduce my chances of any recurrence. I have no family history of breast cancer or any other form of cancer till now.

Hope I am not disturbing you and also hopes you will give me your kind reply. I am very anxious.

Thanking You in Advance