ER+/PR+/HER-2- Means what?

Janina, sorry to have to welcome you to this club.  I am almost at my 1st cancerversary - finding my lump on Jan. 20, 2009 and dx with IDC, stage II, Grade II, ER/PR+ and HER2- on Feb. 14, 2009.  You may or may not need chemo - it will depend on how involved the margins are and if they can get clean margins the second time and your node status.  There is also the Oncotype testing which is only available to ER/PR+ women - and what it does is help determine the risk of reoccurence with and without chemo - the higher your score, the more likely you will need chemo.  I fell right into the middle.  My margins were clear as were my nodes, but we decided to go very agressive and do the chemo - I did 2 rounds, after having some severe se's, but then did rads and right now, at almost 1 year out, am completely clean.  Good luck and I hope you don't need chemo - but it is not the end of everything - it is doable. 

Janina,

ER stands for estrogen and PR stands for progesterone.  Both are hormones produced by your ovaries.  The fact that you are ER+ and PR+  means that your breast cancer is "fueled" by estrogen and progesterone.  This is a good thing because it means that you can be treated with an anti estrogen like Tamoxifen (if you're pre-menopausal) or with aromatase inhibitors like Femara or Arimidex (if you're post menopausal.) Her2 is a gene that controls how a cell grows.  If you are Her2 negative, you have a normal number of these genes in your cells and will not need to be treated with Herceptin.

However, this doesn't tell you whether or not you'll need chemo.  Doctors use tumor size, tumor grade, lymph node involvement, and oncotype scores to determine whether you'll need chemo.   The oncotype is a test that looks at 21 different genetic markers on the RNA of your tumor and gives you a  score which predicts the likelihood of you having a distant (metastatic) recurrance.  Those with low scores usually don't do chemo, those with high scores do, and those with intermediate scores may or may not depending on tumor size and other factors.

 I hope this helps to explain things.  If you go to the breastcancer.org home page and click on  Symptoms and Diagnosis, you'll get a more detailed explanation.  I'm sorry you've had to join us here, but please keep asking for help.  Good luck!

Janina! Sounds great to me!

Janina, congrats on your good news!! :-}  Southport & Mac gave awesome explanations, sounded like word for word what my Dr. said. You've been doing a lot of research I take it and have found all the good websites. Can you share a few good ones for me? I am new at this and it is still overwhelming for me. I found the lump myself and went for a mammo, it didn't even show up!! Only with the Ultrasound. The next day was the biopsy, then few days later the MRI. Then the dreaded call from the Dr. I was diagnosed in Dec. 09 with Infiltrating Carcinoma with Lobular features. +for all hormone receptors ER/PR and HER2. I chose breast sparing surgery. A lumpectomy and 2 nodes were removed at same time. My pathology came back IDC with "Lobular features", nodes were Neg-, ER/PR+ he was going to go back to take more tissue but went to the Lab to look at the slides himself and said he was happy with the margins. My Med Oncologist sent out a sample to some other lab for special test and the HER2 came back Neg-!!  I await another test think its Onco to decide if Chemo would be beneficial. Radiation is a definite for 33-38 rounds and also Tamoxifen. Everything is on hold while I do P.T. a vein under my arm got caught up in the scarring so I cant even straighten my arm or lift it above my shoulder. It looks like a guitar string when I try to stretch out my arm, it goes all the way to my wrist. I have been working on it all week and have made a lot of progress.

 Does anyone out there have implants? I had them done 3 years ago way before Breast cancer. The Dr said they can safely do Radiation with them in. If they get damaged a PS can fix them!! Everything I have read on this subject has said differently. I haven't heard anything good. Swollen, crispy, blistering, splitting, and shrinking the skin around it making it hard as a rock!! and unable to be fixed with another implant. I would have to go with a "flap" and that wont match my other breast. So why put myself through all the B.S. with Radiation then possibly reconstruction, why not have a mastectomy and reconstruction in the first place? And what if I decide to only take the Tamoxifen and thats it? Please help, my daughters & friends think I'm crazy, but what if it was them? you all have BC how do I decide?? Once you go with one treatment you cant change it after your done, you have make the right one in the first place............

Thanks, the reply. It's 1;30 and my eyes are swollen from being tired and looking at the comp. Last night I stayed up till after 2! I'm going to bed, I'll get back on in the am when I get up. I have all day to sit on this thing. LOL on your Boob comment, I like my Boobies too. Thats why I got the implants 3 years ago, I dont wana go messing them up now. Yes my life is more important but if there is an alternative IM GUNA FIND IT!!  I forgot all the sites I read about Rad. W implants but i'll find them and let you know. ;-}

Janina - I am confused from your post regarding them not removing any lymph nodes because none were positive.  How did they know none were positive if they didn't remove any?  I thought they had to be sent out to the pathologist? 

Sue

Good morning, or afternoon, I thought we were supposed to be getting a lot of rest and take care of our selves? Not staying on the damn computer all night researching this crap for ourselves, I thought that's what we pay our Dr's all that $$ for!! I haven't checked out the web site Macc gave, but I'm going there after I finish this post. Janina, you mentioned your income tax $, I hope your not paying for any reconstruction your self? It's a law, your ins Co. HAS to pay for any reconstruction of the cancerous breast. You may have to make your breast match your other breast, and if they can't they need to do them both over to make them the same. As for any Dr. bills left from your co-pay, ask to speak with the Social worker at the Cancer Center, and or the financial aide (or worker). I am already on disability from a work injury 5 years ago, and back surgery 2 years ago. I am ONLY 51 years Young, but am on Social Security Disability and Medicare. They pay crap. The financial worker had me fill out a lot of paperwork applying for aide  and grants where ever it may be, and the Hosp/Cancer Center has Grants and Charity organizations to help pay for or pay the rest of your medical bills. EVERYONE please don't be too proud to accept or ask for help. That is what it is there for, uninsured, under insured, low or no income, or just unable to make ends meet and still take care of yourself. You DID NOT ask for this Cancer, nor should you be burdened with worrying about bills piling up, & bill collectors calling, and ruining you credit, or totally draining you, and your finances, or have the bills/$$/cost of procedures be a factor in the type of procedure you choose!! I am the last one to ask for help, but at the beginning of this new "Cancer career" the first thing I thought about was, "OMG how am I guna pay for this, and make my bills at the same time? It is very liberating, soul, and stress relieving to know I can have the treatment I choose and still buy groceries, and a gift now and then for my 6 year old most precious gift in the world, my Granddaughter! Without her I would not be fighting and kicking this damn disease in the butt!! don't get me wrong I have a a lot of other reasons, My three grown Daughters, my family & friends, & my "(Soul mate,-life partner,-significant other,-best friend,-better half,-Lover,-my rock,-my chauffeur,-my nurse,-my chef,-my maid when I'm sick,-my appointment maker & reminder,-and BIG, Lovable, Hugable,-Big hearted,-Teddy bear,-Good kisser,-Mental counselor,-Big shoulder to cry on,-.............) "Boyfriend"... and my 3 little doggies Too. OH and my 4 Hens & Big Bad, Red the Rooster!! lol. Janina please don't worry about offending anyone. I didn't read the post you deleted but what you write is your own feelings and business, we are all tired and under a lot of stress you cant be polite to everyone and have them approve of everything you think and do. If you cant be honest and open about your feelings on this post to women that are going through the same or similar things you are you'll explode!! I have heard the same thing from several other women that are going through BC, as soon as we were diagnosed with this terrible disease it in some way has been a blessing to help us deal with and take care of ourself and our lives. I feel like a different person, everything counts, I have new appreciation for my life and others. Don't sweat the small stuff, and what you cant do or accept, change!! Either the issue or yourself. I am not afraid to speak up about anything, what you see is what you get....... take me or leave type of attitude. I am in no way rude or telling anyone else to be rude, but speak up for yourself. Support your cause it feels really good to inform or teach others what you have learned along the way. If there is something you don't like or have questions about your treatment or life in general, ask, speak up, don't just go along with it all. Everyone and their disease is different and will react differently to their treatment and life in general. We are not made from cookie cutters, thank God or life would be very boring!! I am now a sponge I cant soak up enough, fast enough, I crave information, all I can get! Good luck with all you do on the treatment(s) you choose. Please keep posting throughout it's very important.

motherdearest said: "Soul mate,-life partner,-significant other,-best friend,-better half,-Lover,-my rock,-my chauffeur,-my nurse,-my chef,-my maid when I'm sick,-my appointment maker & reminder,-and BIG, Lovable, Hugable,-Big hearted,-Teddy bear,-Good kisser,-Mental counselor,-Big shoulder to cry on,-............."

Um, excuse me, but that's MY husband! Has he been freelancing?!?

  Janina, & All other sisters in pain,

Glad to see you all still have a sense of humor... I think it'll be the most important thing to get us through this, or we might fall apart totally. I sometimes make jokes and people look at me like "WTF" you have cancer and your joking about it??

I look at it like someone of a certain race or religion making jokes about their own race, if someone of a different race or religion made a crack about them it would be a slur.............just plain wrong!!............

In the beginning all I could do was fall apart, cry and leave the room and go curl up on my bed in the fetal position. (sound familiar?) My Boyfriend said he was really surprised and proud of how I was handling everything (obviously he isn't home when I curl up on the bed to cry!)

He is wonderful to me and supportive when I need him, but............ we don't see eye to eye on the treatments............... he's a boy!!, he doesn't have Boobies!!, (even though he IS a boob man!) lol.

He is a very get up and go kinda guy. So all this waiting around, testing, hours at each apt. research deciding is making him impatient. He doesn't understand why I just don't do what the Dr's have planned!

He is the type that has a pain or something, goes to the Dr, comes home with a prescription and that's it! I ask him what is the prescription? "I don't know" What did they say was wrong? "I don't know" What is the pain from? "I DON'T KNOW!! I told the Dr about it, and they gave me a script and said," "take this""................I want to explode........................ Why are Men such, Boys?? hehe. He wants the bottom line "Doc". and He doesn't understand "all my questions"

I'm worried about him though. The Dr said he could talk to someone in a group for Men on how to deal with women who have Breast Cancer. He said "No I'm good, thanks" But he's not.
I think, that he thinks, if he makes like everything is OK it will go away. He said we can handle it the Dr's got it all under control, they have a plan, they do this everyday, they're good at it.
But what if "I" don't want to go along with their plan?

 He thinks I ask too many questions and take too many detours.I DON'T THINK I ASK ENOUGH QUESTIONS......... I HAVE A LIST OF 20 MORE FOR MY APT. ON MONDAY!! and I still don't think I'll make a decision this week.

 How long can you wait to start Radiation? I really have to think about having Radiation and or Chemo, or alternative treatments

Janina, I am so sorry for your bills, it just adds so much more stress. I don't even want to know the cost. I praying that because I am already on disability for my back, Medicare and the grants will pay the most of it,..................... cuz I don't have it!!

YES~ EVERYONE~ make sure if you need reconstruction, your insurance pays for it. I believe they have to pay it all. It's a LAW!! It is a very psychological issue if a woman has to have her breast removed.

I Googled~ Radiation for Breast cancer with implants or augmentation~ and ~ breast reconstruction after mastectomy~ there are lots of sites, and some with before and after pictures. Some of them are very disturbing so if your squeamish.... don't go there, but there are a lot of informative ones and a lot of good ones.

There are some amazing Plastic Surgeons out there, they build a Boobie from nothing, they use your stomach, butt, or thigh fat to create one and also a nipple!! Its called a flap? I think.! That's one way I'll get my tummy tuck I wanted but cant afford!! hahaha

On that bad joke I'm gettin off this thing. Maybe take a dip in the hot tub & take a nap. I already have dinner on. S&S BBQ Spare ribs in the crock pot! Hope they turn out OK. It'll totally suck if they do!!!!!! My Man is on his way home from his trip. He should be home from the airport about 6 o'clock. Just in time for dinner. & I wont be on tonight, I don't think, I'm hopin I'm guna be busy. And it ain't doin dishes!!!!!!!!!!!!!!!!! LMAO (TMI?)

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EVERYONE OF YOU ARE IN MY THOUGHTS AND PRAYERS, even if you don't believe, it's comforting to know. There are a lot of us out there even though we don't know each other, we are together in this. So if you need someone to lean on or vent to thats why we are here!! ;-} 

                                                    ))))))))))hugs((((((((((

Janina wrote: Also, a friend of mine told me to make sure during radiation that they protect my heart.  He said his heart is not good thanks to radiation.  I would've never thought of that!!

I know, Janina. That's the part that's causing me the biggest pause in moving forward with just a lumpectomy and radiation. My cancer was in my left breast. I could possibly deal with the SE of the cracked ribs, but heart problems. .. whew. . .that's tough. I don't quite know how to process that information. I'm hoping to meet with some other women in the next few weeks in person (at support groups and Gilda's House) so maybe I can get some first-person comments that address this.

So much to think about, Janina. I know you'll come up with a plan that you can live with. It's the getting there that's the pain in the ass, isn't it?

I'm still consider a bi-lateral myself even after the lumpectomy report showed that the margins were clear and the nodes were not inflitrated.

I've been told that insurance has to pay for BOTH, because of the cancer diagnosis, even if the one is propheylactic. (sorry if that is spelled wrong). But it would be wise to get that confirmed.