Confusion with pathology waiting for oncotype

livin-on-a-prayer

Hi, I was diagnosed with IDC Oct. 17, 2016. I found a lump a week prior even though my June 22 2016 mammogram was clear. I had a lumpectomy on Oct. 21 so felt so blessed to get through all the appointments so quickly. The good news is that I was staged at a 1A as the margins of the 1.8 tumor were clear and the sentinel node was also clear. I was celebrating that I would only need radiation and anti-hormonal therapy. Here is where it seems to get tricky - I am ER Positive - but weak only 23%. I am PR and HER2 negative. My tumor grade was a level 3 which was scary from the on-set. When I met with my oncologist for the first time, she recommended chemo therapy before radiation and then anti-hormone therapy. I became very distraught as I didn't understand that the ER positive being weak was a problem or that the other 2 were negative. My oncologist stated we can wait for oncotype test, but she is pretty sure it will be in the medium to high range. Just wondering if there is anyone out there with similar pathology; or if I am more like a triple negative profile. Thanks for sharing your journe

juneping

the ER being 23% is weak, it only means that your cancer was not fed by the hormone. so hormonal therapy might not work as effective as for someone who's ER is being 90%.

sorry to meet you here but don't worry too much.....your team will help you along the way.

LeslieMemsicMD

Hi. So glad you have moved so quickly since diagnosis. With a weakly positive estrogen receptor you are NOT triple negative. Weak is absolutely better than negative and allows you to be treated with an antihormone medication which is great. I agree with your oncologist that the oncotype will be helpful. I would have recommended this even if you were strongly ER positive because you tumor was over 1 cm. As we gather more data, we find that the biology of the tumor is more important than the size and other traditional measures of aggressiveness. Advances in chemotherapy have been instrumental in prolonging and saving lives in breast cancer patients. Hopefully your oncotype score with be low enough to avoid chemo; however the fact that your tumor is 1.8 cm (still stage 1), progesterone receptor negative and only weakly estrogen receptor positive suggests it may be more aggressive than you want and chemo may minimize recurrence or metastasis. Hang in there but do remember that we have lots of tricks to offset the side effects of chemo now and it may be a short term investment for a long term good result. Good luck and take care.