ER+/PR-

CAMommy

I just looked at my final path report. My biopsy was ER 95% PR 70% but my lump path report is ER 70% PR 0%. Why do different? And what does this mean if anything for me

redsox

The biopsy takes samples from a small area of the tumor but the characteristics may vary considerably throughout the whole area of cancer. The lumpectomy takes out the whole area of cancer so it should give a more complete picture. Even with the lumpectomy the pathologist looks at a series of slices but not at every bit of tumor. The final path report should be accurate but still not 100% fixed.

The difference in ER is not unusual but still clearly positive. The PR difference is dramatic but the significance of PR status is not well understood for DCIS. Neither should make a difference for treatment recommendations

ballet12

Thanks for jumping in and responding, Red Sox. I was going to respond, but didn't have a lot of data about PR and DCIS. I just knew that MSKCC, where I had the last two of three lumpectomies for the DCIS, didn't even assess PR response. They only use ER. My PR was found to be negative in the first lumpectomy (and not measured in the last two). The ER changed from 30 percent in the large sample (first lumpectomy), to 95 percent in the re-excision.

calidancer

This is very interesting. My er went down from biopsy to excision (40 to 25). From what I've read there may be two things at work: heterogeneity of the lesion such that different slides stain differntly and as the dcis progresses it can lose er receptors. As far as hormonal treatments effectiveness though any positivity seems to be almost as good as super high positivity.

Why does some dcis turn invasive so soon and some grows so large without that switch? That is the million dollar question.

I worry a bit about an invasive recurrence being negative but am trying to remember that the chance of not recurring is like in the 90s. And I'll be trying my Tamoxifen starting today.

Best to all! I'm off to enjoy a day at the water park. Viva la summer!