Strong ER/PR positive, no pCR.
Hi all, I am almost done with neoadjuvant chemo though I still have two more A/C to go. So far the lump is just half size smaller so I don't think I can achieve a pCR. I know strong ER+ patient usually cannot achieve a pCR, but I still have some kind of worries. Does anyone have similar experience? Can I just totally rely on hormonal therapy after surgery and radiation? Thanks!
Comments
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Understand that everything I'm about to tell you is from extensive research on this board and from going through the motions recently. Achievement of a pCR based on your numbers and markers according to my wife's oncologist only happens about 5% of the time. This seems to be fairly normal. The only things that may be of concern based on the little I can tell is your age, grade and nodal involvement. Even that at this point is not of huge concern. Remember more people in your situation make it through this than don't. Take a deep breath. It will get easier. You will have other concerns as you go along with each part of the course and there will be fear but you'll get through it because you're strong. It will be a rough year, but you'll do it. The heads up right now that I can give you is to talk to your oncologist about clinical trials and possibly a tumor board evaluation, everything else should be pretty straight forward based on what you know so far. If you have questions don't ever be afraid to ask. There are a lot of great people here.
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Hi Steph, I had neoadjuvant and was very strongly hormone positive (100%). I didn't have a PCR and still had traces in 9 out of 18 nodes after surgery. I will be 6 years from diagnosis at the end of the month and doing really well. At the time I fixated on every little thing and what it might mean but I can honestly say now I struggle to remember the number of nodes. You will get there, it is just a process that takes time. Look at the 5 & 10 year threads they were my sanity check when I was struggling and gave me so much hope.
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Wow Lucca06, this is amazing! You truly give me hope!!
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Hi, Steph. I didn't get PCR either after neoadjuvant TAC chemo; the mastectomy pathology report indicated there were still extensive tumor emboli in the skin above the lump.
You might ask your MO about another course of chemo (Xeloda, usually). Most doctors aren't currently prescribing more chemo in your circumstances (ER+) but some consider it. Every case is unique.
Radiation therapy is very effective a "moping up" any cancer nits that might be left behind.
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Hi Steph, I'm in the same boat...I think we've chatted a little on the other thread. I went to 5 oncologists, and no one recommended more chemo for me, but it's certainly worth asking about (e.g. Xeloda, as sbelizabeth mentioned). You have a lot of favorable things going for you: your strong ER/PR positivity and low Ki67 appears to put you in the Luminal A category; Luminal As don't generally have a great response to chemo, but they have an excellent response to anti-hormonals, so I really think you're in good shape! And it's actually great that you're even seeing some response!! Hang in there. I completely understand your worry and disappointment.
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Mom_of _twins, thank you so much ! Your answers are always so helpful!
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Steph--oh you're so welcome! I know how hard all of this is. I'm still struggling myself. Is your surgery scheduled yet?
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Not yet. Hopefully it will happen early April.
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I am also in the same boat here. My tumor did not shrink one bit during chemo but turned out to have shrunk from 6,5 x 4 cm to 2,5 x 2 cm after operation, the rest was scar tissue...Clean margins, but I am also very concerned of my high numbers. My Ki65 was 30% but then went down to 6% after pathology report was done. I am done with my radiation, doing scans for bones, lungs but for some reason not the brain, which I intend to ask for as well. I have no clue what all this really means anymore, just holding on to hope at this point, hoping for the best. Not sure about my grade either at this point, read that if the tumor size was as big as mine it should be grade 3 but for some reason I was told early on it was grade 2. Any clarification appreciated from the board.
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I had a post-chemo ultrasound today. The lump has shrunk from around 2.8 cm to 1.8 cm, and the involved lymph node now looks as normal as others. I'm glad chemo does do its job to shrink the lump and clear the node, but I'm still worried there actually might be some "micromets" in more than one nodes. I will see the breast surgeon next week, let's hope for the best.
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