Bcl2 status-ILC

matic22 · August 2011

Hello dear survivors!

How are you doing?

It has been extremely hot in Slovenia, it is nearly 38 degree C.

I just want you to know I have got the results from testing tissue and tumour cells are difusely strongly positive for bcl2 and up to 25% of nucleoles are positive for p53.

So, that is great news-bcl 2 high expression in breast cancer is very favourable and p53 is negative.

I will keep in touch. Now I have to work:)

Kind regards from Sovenia:)

Matic

MandaLynn · September 2011

Matic-

Can you please explain what the bcl 2 is and how it's important or women with lobular cancer?

Also have you read about the polish study which showed there is a gene - the chek 2 I157T allele which gives women a increased risk for developing lobular cancer at younger ages (is it just polish women?). I want to know because I have three daughters and was diagnosed at 44 with lobular cancer.

Do you have any info on using metformin to lower reoccurrence in ER positive cancers?

Thanks,

Amanda

matic22 · October 2011

Dear Amanda;)

Sorry for late response, I have seen your post today.

Bcl-2 is an antiapoptotic gene that codes protein bcl-2 and is a factor of good prognosis in breast cancer. One explanation is that tumors expressing bcl-2 do not have angiogenic ability to metastasize as other tumors that do not express bcl-2. It is determined by IHC staining on paraffin-embedded tissue.

I have to admit I do not know about 2i157t allele BUT I can do a research of that if you want to. I have studied a lot of ILC and have found there are some germ line mutations of E-cadherin genes ,that is the reason why almost all ILCs are E-cadherin negative. It is a mutation that is a very early molecular step in lobular oncogenesis.

Metformin is currently under validation /trials in clinical studies. I am not sure about preventing metformin for particular subtype of breast cancer, but I believe metformin will be once standard of therapy for those breast cancers that we do not have any other "targeted" therapy as triple negative breast cancers are, especially basal like triple negative breast cancer has an extremely poor prognosis according to my clinical practice. It is especially rapidly progressive disease after first systemic relapse. And it usually infiltrates serosal surfaces such as pleura, peritoneum, meninges, pericard.

Best regards, Amanda and take care.

Matic

MandaLynn · November 2011

Thank you Matic,

Is the bcl2 test something I should consider now if I was diagnosed 3yers ago? Would it give me any information that I don't already have?

Being stage III I'm looking for anything encouraging.

Amanda

matic22 · November 2011

Dear Amanda!

I understand but bcl-2 status correlates with other clinico-pathologic parameters that are associated with favourable prognosis of breast cancer. Of course, you can ask your oncologist for that -it is really an easy IHC test that is done by pathologist on paraffin-embedded tumour tissue. I see your tumour was ER,PR positive HER-2 negative, intermediate grade, lobular cancer ,so I assume your bcl-2 status would be positive. I suggest you stay long time on antihormonal therapy, it is the most important therapy for lobular breast cancer, much more than chemotherapy.

And your stage is not 3A but rather 2B. Stage 3 cancer needs to be more than 5 cm and lymph nodes affected, stage 2 breast cancer is 2-5 cm with or without nodes (4 nodes positive does not mean you are absolutely stage 3, AND STAGE IS ACTUALLY NOT THE MOST IMPORTANT PARAMETER IN BREAST CANCER!!!!!!).

Best regards

Matic

toomuch · November 2011

Matic,

I have read your posts with interest. What would you say the most important parameter for ILC is?

Thank you for posting your educated opinions for all of us!

IllinoisNancy · November 2011

Hi Matic,

I'm considred stage III even though my nodes have always been clear and my ILC has been small. My problem is that I had a local recurrence on the breast skin. They threw dose dense chemo at me for 20 weeks followed by a double mx and now Arimidex for 5 years or more. Do you think the chemo was unnecessary? My oncotypedx was 9. I respect your opinion and would appreciate your comments.

Thanks,

Nancy

matic22 · November 2011

Dear ILC ladies!

Toomuch: I think the most important prognostic markers in ILC is gene expression of proliferative markers and apoptotic ability for cancer cells. That is the reason why an antihormonal therapy is the most important therapy for ILC, when ER,PR positive and it should be for a very long with switching method. I do not think stage is important in ILC, but it is also true most ILCs are stage 3 because they are not discovered many years. Anthracyclines are important drugs in ILC because they also have proapoptotic effect and some studies suggest some ILCs have long term worse survival when they are not treated with an athracyclines. I think there is no need for taxanes for ILC except if it is ER,PR negative HER-2 positive, which is quite rare for ILC. But remember: not ILCs are the same, not all are slow growing-Some have really very poor prognosis.

IllinoisNancy; I remember you well yes, but I would not say Oncotype dx failed you. You had firstly lumpectomy if I am right? Well. oncotype dx has insight of biology of every individual tumour for its distant spread but I agree, your tumour was biologically not a classical one-am I correct?It was grade 3 after all. I think the biggest problem here was the residuum of cancer cells in your breast locally, because we do know cancer cells are aproximatelly 2 and more cm away from the dominant tumour mass and they can survive radiation-in lobular pleomorphic cancer there are more mutations, on the other hand oncotype score was really low.

I would not say chemotherapy was unnecessary. I would also give you both I think if you recurred locally-anthracylines and taxanes to prevent distant spread.

I suggest you stay on antihormonal at least for 7 years and I would do switching-you can also switch steroidal to non-steroidal AIs. Maybe in that time there will be another antihormonal agent you could take.

Of course you have to weigh SES and benefits!

I wish you all the best and best regards from cold Slovenia:)

Matic

toomuch · November 2011

Matic - Interesting comment on switching the AI's up. At what interval do you recommend this? Are there published articles to support this that we can take with us to our MOs?

IllinoisNancy · November 2011

Hi Matic,

Thank you so much for your comments. I am finally feeling back to myself and getting some hair back. I live in fear of ILC coming back in the skin that remains but try not to let it ruin my life. Going from Stage 1 to Stage 3 in 4 short years makes me crazy. I hope to get 10 more years so I can watch my daughter get married and maybe even some grandchildren. Your advise about the antihormonals sounds good. I hope the medical profession finds a cure to BC in the near future.

Take care,

Nancy

Anonymous · July 2012

Is Bcl-2 favorable for people with IDC invasive ductal carcinoma? Or are further tests needed to determine? I am researching to see if using natural bioidentical progesterone cream vaginally would benefit me no matter what, as I am ER+ PR+ at 90% each. Wondering if the bioideentical progesterone would be used by the progesterone receptors on the cancer cells in a favorable way.

Thank you.

Diane (Essa)

hlya · July 2012

Bump up, a very interesting thread.

How do we keep antihormone therapy for at least 7 years if we are still post-menopausal?

Bcl2 status-ILC

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