Hormone therapy and ER status

Septmom

I am a bit confused about ER status. I have a Allred score of 7/8. Score 4 in proportion + 3 for staining (Total 7 out of 8). If you aren't 100% ER positive how much benefit does tamoxyfin really have? If you are 80% ER positive then how do you take care of the 20% that's not ER positive? I am stage 1, grade 3, had a lumpectomy with clear margins. ER positive (allred score 7/8), PR neg, and Her2 neg. Lymph nodes are clean. Oncotype was 26. I am starting chemo on Thursday DD AC followed by taxol. I will have radiation after chemo. I will be on tamoxyfin after treatment and my MO says I will probably be on Arimidix soon after. I am premenopausal - 44 years old. Trying to understand how they define ER positive and what it really means if you are not 100% ER positive.

NancyHB

Septmom: My understanding from all my research, reading here, and talking with my doctor is that positive is positive - regardless of whether it's 100% or 1%. The benefit of being ER+ is that you can take medication such as Tamoxifen; if you're ER- there is nothing to take. So there is nothing to "take care of the 20% that's not ER positive" - you simply do nothing. In my case I am barely ER+ (I mean barely, by a smidge) but my doctor suggested (and I tried, twice), Tamoxifen.

Good luck with your treatment - will be thinking of you!

ruthbru

It's like being a little bit pregnant.....you are, or you aren't.

dlb823

Septmom, don't think of it as some of your bc being ER positive and some not (which it sounds like you might be). Think of it as a percentage of the whole, or the strength of the ER. In other words, whether you're 60% or 70% or 80% or 100%, the fact is that, to one degree or another, estrogen possibly fuels your bc.

You will probably find that your onc will not be able to adequately explain the whole estrogen-progesterone-breast cancer relationship to you, and that's because most docs don't have an indepth understanding of hormones. I finally went to a naturopathic doctor to get a better grasp on what was going on with my hormones, although excessive ER is just one component of bc risk.

Good luck with chemo. Have you joined the November 2013 chemo group here? You'll probably find one in the Chemotherapy section (under All Topics, to the left). Many of us found that core group (one usually starts each month) invaluable support for getting through chemo. (((Hugs))) Deanna

Septmom

Thanks dlb823

I have been thinking of seeing a naturopath after chemo/radiation. Are there any supplements that you set taking? I have been reading a lot about iodine, and possibly avoiding milk. I have eliminated processed foods/refined sugar. Trying very hard to stay positive. I want to be around to see my 9 year old son grow up. Until all this I was a very active, healthy working mom. Now I feel just useless and very overwhelmed.

dlb823

Septmom, you're going to be fine! I know how overwhelming it all is in the beginning, but you will get through treatment and go on with your life.

To answer your question, I have always taken a lot of supplements, but I did add several upon the advice of the integrative specialist at UCLA (who I also waited to see until after I finished chemo & rads), then a brilliant local naturopathic doctor who has since become my and my husband's primary care doc. Some of the things I've added post-bc include iodine (Iodoral), D3 (really important), curcumin, I3C, various mushroom extracts (although I now just try to eat a lot of different mushrooms), as well as stuff specifically RX'd, like a natural thyroid med and other hormones.

As far as foods, I've also cut out milk in favor of almond milk. I've also cut way back on butter (rarely ever use it) and cheese, and try to buy only European made ones now (a tip I got from another BCO member), because their milk isn't as chemical-laden. I do eat a little organic Greek yogurt. I don't eat processed foods, buy as much organic now as I can justify re. cost, and eat mostly a plant-based diet, plus some fish. But it's such an individual thing. I think both genetics and environmental toxins, are big factors for many of us, so we just each have to do the best we can in deciding what feels like a healthy change, as well as not blame ourselves for things we didn't know about in the past.

One question for you... Since you had a lumpectomy, did you have an MRI prior to your surgery? It's something I have a special concern about based on my own experience (detailed on my bio page). Deanna

Septmom

Deanna - thanks so much for all this info. I did have an MRI prior to my lumpectomy. I haven't read your bio page . Will try to find It. Did you have a MRI?