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Ask an Expert is a free question-and-answer service about breast cancer and breast health that is available on weekends. If you'd like to ask a question or comment, please visit us again on Saturday or Sunday. In the meantime, please search the existing topics using the search tool at the top of the page. It's quite possible that one of our many existing topics already addresses your question.

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AskedPublicly Submitted Question
8/24/2017I am a 65 year old JH patient and have recently been diagnosed with HER2+, Stage 1A, Grade 2, ER/PR+ breast cancer. I've already had my lumpectomy and am awaiting my appointment with my MO which is scheduled for 9/18.

I also have peripheral neuropathy and am concerned about the effect of chemo on my condition. I emailed my assigned MO to ask if there are treatments that won't exacerbate my PN or if I will have to refuse treatment. I specifically said that I was not asking for any details of treatment but just rather a sense of what I am facing. Her answer that "these are all good questions" and that she will discuss it with me at my appointment has left me even more concerned.

In reading about the NCCN guidelines for treatment of HER2+ breast cancer there aren't any real possibilities for chemo that don't cause PN and the few that are either are more old-school with really strong side effects and/or are not as effective as taxanes.

I don't mean to put you on the spot but I really have nowhere else to turn so my question to you is this: Does JH ever create individualized treatment plans that fall outside the NCCN guidelines? Again, I am not looking for promises or specifics, but instead just some general information.
RepliedJHU's Breast Center Reply
8/25/2017Medical oncology will create treatment plans based on the characteristics of the cancer as well as individualized needs. However chemotherapy agents used must be appropriate for the type of cancer being treated.

Please note: This service is not intended to provide primary medical advice concerning specific medical care or treatment. Ask an Expert is a free service operated by health care professionals at the Johns Hopkins Avon Foundation Breast Center. Due to the volume of questions and their complexity, there are times when medical oncologists, surgeons, radiation oncologists or oncology nurses are consulted for their input. These individuals volunteer their time for this service and will respond as soon as they are able. Please do not post or send the same question to us in multiple locations or categories.

The contents of this portion of the website cannot be used as a substitute for a consultation with your doctor or other healthcare provider. It also may not represent the opinions of other Johns Hopkins professionals. It is a free service performed on volunteer time and intended to provide feedback to questions posted by consumers however should not be used as a directive or instructions to now follow. Seeing your own medical provider is always important in getting your needs and questions addressed. In the majority of cases, a clinical examination, review of pathology slides and xrays, along with other medical information is needed to truly provide a consultative service. If you wish to receive a formal consultation with our physicians please call 443-997-8282 for surgical appointments and 410-955-8964 for medical or radiation oncology appts. For breast imaging, call 410-955-4100.


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