Tamoxifen for technically triple neg??

I am 2% er+ and will be starting tamoxifin when I finish chemo. My onc figured it was worth a try. Hope it works for us!

Steph

Short version: I am barely ER+ (<1%) and no Tamox for me.</p>

Long version:

I don't know if "retesting" means making new slides or re-reading the ones already done, and I don't know what tests were used (IHC?) to show "how much +" for your HRs. And maybe none of that matters, so long as there's no "mistake." Biopsy is "smaller tissue" sample (does not represent the whole tumor so well) so I think it makes sense to put less weight on those numbers. Since for you & for me, the oncotype seemed to confirm the post-surgery path, this seems most credible, I would think.

I had a fascinating meeting with my pathologist; learned a lot. Saw on my slides that my "small amount of DCIS" in the tumor (IDC) was actually ER+, but that's beside the main point. I had insufficient biopsy tissue to get receptors numbers, so all I got was post-surgery and Oncotype. The post-surgery was Allred Score 2 (less than 1% of cells in tumor were weakly positive ER) and the path report said this is "Positive." In the past, this has been called "Negative." (Oncotype called it "Negative" b/c of too-low number.) Pathologist told me this (calling it positive) is a new guideline, surmising that it was like this because oncodocs may wish to prescribe anti-hormone drugs in these cases. She said if there is One Cell in the tumor that's positive, it must be called Positive! There is, indeed, info out there about the possible usefulness of anti-hormone drugs in cases where HR status is not "highly positive" but the big Q is "where should one draw the line?" I'm not a Dr, so I don't know. (Do Drs know?) I haven't read research that suggests that 1% is "enough" and in fact, all studies I saw lump the "1%" in with the "negative."

My oncodoc says the anti-hormone drugs won't do me any good. He would surely recommend them if they did, since the Tamox would probably also "help" my bad bones. For me, he said "chemo or nothing."

(To confound this, in my mind, it seems that cancers can morph to "more" and "less" receptive, but I don't know anything about this...)

If only a tiny fraction of the cancer cells will respond to this drug therapy, where's the logic in taking the drug to fight the cancer? Or is this simply another case of "we don't understand why it works, but it seems to help"? I don't know. But, both my oncodoc (and pathologist, fwiw) seem to think that it doesn't make sense, in my case, to do the Tamox. Don't know where they would draw the line, though.

You are young and in these cases it seems more common to use every possible tool. I would weigh the side effects of the Tamox, some of which are said to be different for pre- and post-meno (at least those relating to bones). Be mindful in this choice, taking your personal circumstances into consideration... Though it's "targeted" therapy, it still has possible negative side effects.

I hate it when the answers aren't clear-cut. Best wishes and good luck --- to all of you!