Mamma print ki67 score 30% Help is this gray area for Chemo

Jackster, sounds like taxotere let her down why would she think it would help her stage 4 cancer if it didn't seem to prevent recurrence?

Hi Postivie2strong:

Did you obtain a second opinion from a medical oncologist from an independent institution? That is the most reliable source of additional advice that you could obtain.

BarredOwl

Positive, Bring someone with you; bring comforting music with headphones, bring things to do (crosswords, etc). Chemo is boring, but I found the time passed faster when I brought things with me. I don't sit still long; I get bored. I sometimes just walked around in there with my IV pole. I was one of the lucky ones who tolerated chemo very well. I wish the same for you.

I had Taxotere and iced during the infusion. I have no neuropathy.

Painting your nails a dark colour seems to help protect the nail bed. My breast nurse advised me to to this and I never lost any nails.

Wishing you the very best.

Positive2strong,

I couldn't help but reply to you after reading all of your concerns. I too, had a very similar diagnosis with a much higher ki-67. After Mammaprint results came back, I was also placed in this same high risk group. After much going back and forth, I had my TC chemo treatments last year starting January 12. I survived!! It was doubtful at times. The sitting there for 2-3 hours was easier each time, as I talked to nurses and patients around me. I also listened to good music on my phone, and even read some. You can do it, if you have the right mindset. I don't know if you take anything for the anxiety, but MO suggested I start taking Lexapro, and it did seem to help. I am 58, and have just had to have another biospy last month. (same breast) Got the results two days before Christmas that it was benign!! Best gift ever! I will be praying hard that the chemo will be easy on you!

Hi Positive2strong:

The MammaPrint test is a completely separate test from Ki-67 percentage.

The MammaPrint test (a gene expression profiling test that looks at mRNA levels of 70 different genes) was performed at Agendia Inc. The output is a MammaPrint Index (a number on a scale of -1.0 to +1.0) reflecting the degree of correlation of the tumor's gene expression profile with a low risk template profile), which is further classified into one of two risk categories (High or Low). The result was: High Risk.

The Ki-67 percentage, which uses labeled antibodies that bind or "stain" Ki-67 protein using immunohistochemical methods (reported as the percentage of cells that show staining for Ki-67) was determined by standard pathology.

If you'd like to fix the title of the thread, you can send a PM to the Moderators with a request. Be sure to include a link to your thread.

Based on the information you provided, the title should probably read something like: "MammaPrint/BluePrint: High Risk Luminal-type (B); Ki-67 20%: Help is this gray area for Chemo?"

BarredOwl

Mellee, I was reading your diagnosis, and have a question . I had a double mastectomy Jan 26, this past Thursday. I was planning to have reconstruction . I had the sentinel biopsy and found micro. So, my plastic surgeon said no with the expanders or drop in implants. His theory is if I need radiation the implants might get in the way, or other issues may come up.

Honestly, that ticked me off. I don't have the greatest relationship with him.

Now it's the waiting game for the final pathology report.

Question: was there any deliberating about your reconstruction after 2 nodes came back positive? Do you need any radiation?

Lisabekind, there was no deliberation. My PS went ahead with my direct-to-implant reconstruction knowing about the positive nodes. While radiation has the possibility to cause complications to the reconstruction, my PS thinks that reconstruction is more difficult after radiation because the tissue has been compromised. And implants don't "get in the way" of radiation therapy. An RO is perfectly capable of radiating around them.

Here's what OncoLink has to say (I've bolded some of the info, but you may want to read the entire article for a more complete picture -- (https://www.oncolink.org/cancers/breast/treatments...):

Immediate versus delayed reconstruction

Once a decision has been made between a patient and the plastic surgeon for breast reconstruction, one of the first decisions to be made is regarding either immediate (at the time of mastectomy) or delayed (after mastectomy) reconstruction. Most patients are eligible for immediate breast reconstruction.

Delayed breast reconstruction refers to reconstruction of the breast after completion of mastectomy and all chemotherapy and/or radiation therapy. Some physicians feel that delayed reconstruction may help a patient receive the chemotherapy and radiation she needs more efficiently and with fewer risks of side effects than she might develop if the reconstruction were done right away; however, with modern approaches to radiation and chemotherapy delivery, most physicians no longer have these concerns. Modern radiation equipment, which incorporates CT scan three-dimensional planning and computer modeling in virtual reality, allows sophisticated treatment plans to be developed for most patients with or without a reconstructed breast. Another reason for delaying reconstruction may include patient preference because she is not certain she wants reconstruction at all, or if she is medically not a good candidate for the procedure. In some cases, there may be a concern that scheduling and recovering from reconstruction could introduce an unacceptable delay between mastectomy and chemotherapy. This fear may be greater for a patient with locally advanced breast cancer than one with early stage breast cancer. Delaying reconstruction until after completion of all adjuvant chemotherapy and radiation does have some potential downsides: It may mean a patient waiting 6-9 months for the procedure - which may be unacceptable to some women. In addition, delayed reconstruction requires that a patient undergo a second major operation. Finally, delayed reconstruction may be more difficult for patients who require a breast implant for their reconstruction. Because decisions regarding delaying reconstruction are so complicated and individualized, they should be discussed carefully with a plastic surgeon.

Immediate timing of reconstruction, when the breast is reconstructed during the mastectomy, will provide the patient with an important cosmetic and psychological benefit - not awaking from mastectomy with a complete absence of a breast. Immediate reconstruction is also associated with avoidance of a second major operation, since both the mastectomy and reconstruction of the breast are done at the same time. Again, the decision of whether to pursue immediate or delayed reconstruction is complicated, and should be discussed with the treatment team before the mastectomy is performed. Having some more information regarding types of reconstruction may be helpful, and these details are discussed below....

melle, thanks for the information!! I'm 46, and grade is 2. Radiation was mentioned to my husband, when I was in recovery. I will not know treatment until the final pathology is in.

I really need to talk to my ps, so I can hear with my own ears why he went that direction.

Thanks again!

Can mammaprint work on triple negative? I know oncotype won't but book I have says mammaprint will....onc I see says she doesnt do them for triple neg....but think thats cause she only does the oncotype

Oncotype is not typically done on triple negative because the purpose of Oncotype is to help make a decision on the benefit of Chemotherapy. Triple nagative typically means you get Chemotherapy since it is the only systemic treatment available