Triple Positive DCIS?

tinkerkell

Hi, I am newly diagnosed with DCIS - surgery is scheduled for 6/2. I was just looking over the pathology report (again) from my biopsy. I originally didn't think they'd tested for HER2 status, because it doesn't mention it at all, but now I'm thinking that it is there after all and I just didn't understand what I was looking at:

IMMUNOHISTOCHEMICAL STAINS FOR DUCTAL CARCINOMA IN SITU (DCIS):

MARKERS RESULTS

Estrogen Receptor (ER): POSITIVE (>95%, 3+)

Progesterone Receptor (PR): POSITIVE (80%, 3+)

Am I right that the 3+ is HER2 status? No one so far has mentioned that to me, but from the research I've done, it seems like that is an indicator of aggressiveness. Up until now, everyone has been assuring me that this is low risk, possibly even no need for RT etc. I haven't been able to find too much on triple positive status specifically related to DCIS though. It would be great to hear from anyone with experience with this.

Beesie

No, that definitely is not the HER2 status.

ER and PR often are presented with both the '% of cells with positivity' and the 'average intensity of staining'.

In your results, you have over 95% of cells that are positive for ER and 80% that are positive for PR. The intensity of staining is often stated as weak, moderate or strong but may also be reported as 1, 2 or 3. Your 3+ for both ER and PR means that the intensity of staining is very strong.

You will not read much about triple positive DCIS because HER2 status is currently not known to impact DCIS prognosis, and there are no treatment differences for HER2+ DCIS. This is why HER2 status is often not determined for DCIS, as seems to be the case with your pathology.

ctmbsikia

Hi. So sorry you had to find your way here. The 3+ is the intensity score of the estrogen and progesterone. 3 being the highest. If you don't see Her2 on the report it probably wasn't tested. I hope that helps you.

ctmbsikia

Oh and thanks Beesie. We must have been typing at the same time.

Beesie

ctmbsikia, typing at the same time and thinking the same thing.
Consistency in replies is good!

tinkerkell, are you having a mastectomy or lumpectomy? It's pretty unusual for rads to not be recommended after a lumpectomy for DCIS, unless the DCIS is low grade and very tiny and the surgical margins are large, or the patient is elderly. Of course, the decision on every course of treatment is up to you.

tinkerkell

Oh thank you both so much - I was really stressing myself out!

Beesie, I am having a lumpectomy (assuming my genetics come back clean). I didn't mean to imply that they were recommending no rads - just that my surgeon had mentioned it as a possibility when we were discussing the DCISionRT test - and depending on the results from that as well as margins, etc. and because the area appears to be very small.

My point was only that they were making it seem pretty positive and if that WAS the HER2 status on my report then I was wondering why they hadn't made a bigger deal about that.

Thanks again so much for your replies!

LivinLife

Want to welcome you tinkerkell! Sorry you find yourself here! Wishing you well as you proceed in working out your plan.... Keep us posted on new developments. We're here for you!

tinkerkell

Thank you so much!