can someone please explain what diagnosis I have received

rabbit

I was originally told I had a 1.2 cm tumor and some microcalcifications in the right breast, the MRI showed it to be a 4-5 cm tumor, somewhat close to the skin (what are the pros and cons for that) and that a few lymph nodes looked "slightly inflamed", we decided to start chemo first then do the surgery, I had the port put in yesterday.

I do know that I am ER+ and HER2- can someone please explain a bit more what that means exactly and anything else to put my mind at ease on what to expect with the diagnosis I have so far? 

AnnNYC

Hi rabbit, first of all I'm so sorry you've had to join this club that nobody wants to be a member of!

The one thing (or is it two?) about your diagnosis ("dx") that I know a little about are the receptors: ER+ means your cancer cells have estrogen receptors on the cell surface -- little proteins that latch onto estrogen, so that estrogen "feeds" the growth of the cancer.  The good thing about this is that there are other treatments for ER+ cancer besides chemo.  Probably after chemo your oncologist will prescribe tamoxifen (if you are premenopausal) or maybe an aromatase inhibitor (Femara, Arimidex or Aromasin) if you are postmenopausal (though your picture certainly doesn't look like you would be!). 

HER2 is another kind of receptor on a cancer cell -- if you were HER2+, you would have these receptors, which would mean the cancer cells could be targeted by a drug called Herceptin.  But HER2+ cancers are very aggressive, so (to quite MY oncologist when I first saw her): "even though there's a treatment for HER2+, you're much better off being HER2-negative."

Others will be along soon who know more, I'm sure -- just want to wish you the very best of luck with your treatment --

hugs,

Ann

rabbit

Ann thanks so much for the info..I am 45 yrs old and am starting to go through premenopause, heavier periods, much more moodier and a few hot flashes off and on. 

xoxo 

jennyboog

I'm so sorry you've had to join us here.  This is a wonderful site that has loads of info and support from good people.  You're in the worse spot right now...the unknown, once you get all testing done and get a treatment plan in place you'll feel more in control again.  I'll just try to add to what Ann has said.  I'm not sure if there is a pro or con to the skin thing, I had IBC (inflammatory breast cancer) along with IDC so I had a spot of redness and warmth.  I'm not sure if you have this going on or not if so, I saw mine go away once chemo started.  Doing chemo first is called neoadjuant chemo and they use that to shrink a large tumor and that helps them in getting clean margins during surgery also.  Since you have lymph nodes (LN) affected they most likely will remove those with surgery but chemo could help remove the cancer there.  I had only 5+ out of 16 with residual cancer.  They use all this info to stage you and help decide what is the best tx plan for you.  I was stage 3C, I finished chemo in Dec, had BMX (bilateral masectomy) in Jan., finished rads (radiation) in Apr and had my ooph (ovaries removed) 2 weeks ago.  It can be a long scary road at the beginning but it does get better and we're here with you because we understand and we've been there.  Hugs going your way and feel free to message me if you need to.

Artemis

Hi, rabbit ~
My mammogram, ultrasound and MRI all measured my tumor as different sizes; I don't *think* this is anything that should trouble you as it probably won't make a difference for your treatment plan.

My tumor was also very close to the skin, and apart from having an itchy patch and a nipple that pulled toward the tumor, I don't think I've ever heard of any pros or cons about it.  Maybe it would make it easier to have just a lumpectomy, maybe?  I don't know; maybe someone else can chime in about that.

I can't speak about the nodes since mine showed clear before surgery.

As Ann said, you'll probably be put on Tamoxifen due to being ER+.  I also agree with her that while HER2+ isn't the terrible thing that it used to be, being HER2- is a good thing!

*hugs*
Artemis

rabbit

Thanks everyone I think the surgeon mentioned that it being close to the skin is worse, that is spreads to other areas easier that way, but I could of misunderstood....

pp729

Hi rabbit,  my mom has IDC that had some involvement of the dermal lymphatics and it had spread into the skin, so they felt this was a sign that it "could be" an aggressive form of IDC.  They also did a Ki67 test and that value was high (you will see this when you have surgery and get your pathology report back).  So they decided to do the Oncotype DX test -- has your onc mentioned doing this?  It's a test that can give you a feel for the likelihood of recurrence with your particular type of cancer, so it tells you how aggressive the cancer is and what the impact of chemotherapy can be.  My mom's Oncotype score was high, so that coupled with the skin involvement and the high Ki67 score made them say that she does have an aggressive form, and they gave her a treatment plan that reflected that (surgery, chemo, rads).

Enjoyful

Hi, rabbit!

Sorry that you have to join us. :-(

My primary tumor was also close to the skin (I had five others in the same breast that weren't) and the only problem I had with it was that they couldn't get clean margins; the cancer had just invaded the skin.  After the bilateral mastectomy and lymph node resection, I followed up with chemo and radiation.  That was in 2004 and no local recurrence though I did have metastasis in a distant lymph node.  Doubtful that it was related to the skin invasion, though.

A lot of us felt much less anxious once we had a complete diagnosis and started treatment.  I agree with all of the other ER+, HER2- comments.  I started on tamoxifen after the initial chemo/radiation blast and am now on arimidex.  After the last chemo treatment in 2009-2010 (for the distant lymph node), I have "no evidence of disease" (or NED) and remain there as of today. 

Best of luck to you!  

E

rabbit

pp729, the onco said we would get that oncoDX test but I'm thinking after surgery, which would be end of the year after chemo. 

enjoyful, I am so glad you are here with us today and here's to all of us being here over many decades to come!!

xoxo to everyone 

Anonymous

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pp729

Rabbit, good that you are planning to get the Oncotype test.  I'd ask my onc about whether to get it before or after surgery -- not sure which is preferred.  In my mom's case, they did it before surgery.  In addition to a score, it does tell you the likelihood of recurrence both with and without chemo.  So for example, my mom's score is 36 -- considered high AND she had a recurrence percentage of 26% without chemo (so 1 in 4) and 6% with chemo (so 1 in 17).  It's really great information to have when considering a treatment plan. 

rabbit

Well some good news in all of this. I got the bone scan and CT scan results and there is no sign of any growth anywhere else in my body, woohoo for that. But I'm also sure it won't see the tiny cells just starting out, but hopefully the chemo will take care of that, I start chemo Wednesday. 

 I will get the brca gene test results back then as well, holding my breath on that one!  

AnnNYC

Great news on the scans, Robin!