Efficacy of chemotherapy for er+/PR+/her-ve/ki67-12%
pls advise.
Comments
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Hi InvPapCarcinoma, welcome to Breastcancer.org. We're sorry that you have to be here, but glad you found us!
Until you get responses from other members here, you may want to read the article IDC Type: Papillary Carcinoma of the Breast from our main site for information about how this type of cancer is treated, as well as a list of tests to determine the need for chemotherapy.
We hope this helps a bit!
The Mods
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Do you know your percentages ER and PR +. Have you had your tumor send for Oncotype testing? This information is important in a decision as well as lymph node involvement and size of tumor.
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Agree. Oncotupe will likely guide chemo decision song with lymph node involvement, size of tumor, etc
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thanks friends.
My biopsy report does not have er/PR percentages. I was not informed about any oncotype testing unfortunately. Tumor size is 8cms......3 lymph nodes having tumor approx 1cm each.
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Hi InvPap,
Sorry you find yourself here. Please don't be too alarmed that your papillary tumor is large because invasive papillary are known to grow large very quickly due to their cystic content, said my doctors. (My invasive papillary carcinoma grew to 3 cm in just several months.)
PLEEEEEZE get a 2nd opinion on your pathology. Your doctors need to define the "invasive component" first, which would be your primary cancer. You will find this in your pathology report. With invasive papillary, the invasive component would be mucinous carcinoma (25% of cases), conventional IDC-NST (25% of cases), or mixed (25% of cases) or even rarely tubular or endodrine types. Rarely is invasive papillary considered truly "invasive papillary" unless there's a primary invasive type present. Papillary is a highly controversial rare type of cancer which confuses many pathologists. We needed to get 4 different pathology labs involved to figure out my dx (mucinous-IDC, invasive papillary, DCIS, cysts, etc.)
For example, Oncotype is not validated for invasive papillary itself due to less than 1/2 of 1% all breast cancers. Nor is oncotype strongly validated for pure mucinous carcinoma, so this is why it's critical that you know what the invasive component is in your case. Neither papillary or pure mucinous are responsive to chemo, which is why they usually rate low Oncotype scores, and both are usually highly ER+ & PR+. If your invasive component is traditional IDC-NST, then the oncotype would likely benefit you, but it's largely dependent on your invasive component exclusively.
Please check the invasive papillary thread for more information here. Best wishes to you.
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Inv Pap, Also on your 3 positive nodes, please ask your doctor if the cell infiltration in the nodes is of a papillary architecture? Or if it's conventional IDC cells in your nodes? Papillary isn't usually known to be responsive to chemo, which is why I'm asking, and usually averages an oncotype score of 9 or below. Also papillary is known to occur in multiples, hidden multiples. Please be sure your doctors do an MRI on both breasts, but bear in mind that papillary under 5MM doesn't always show in MRI imaging, my surgeon said.
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