Study: Small tumors can be aggressive in early stage BC patients

Traveltext
Traveltext Member Posts: 2,089
edited October 2017 in Stage I Breast Cancer

Even small tumors can be aggressive, according to a study in patients with early stage breast cancer that will be presented at the ESMO 2017 Congress in Madrid.

Researchers found that nearly one in four small tumors were aggressive and patients benefited from chemotherapy. Aggressive tumors could be identified by a 70-gene signature.

https://www.news-medical.net/news/20170904/Even-sm...


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  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited September 2017

    What about small tumors classified as low-risk not just clinically but via OncotypeDX? Should every Luminal A patient get a MammaPrint, Prosigna or other 70-gene test, regardless of Oncotype? (Mine was 16 and my MO said definitely no chemo).

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  • grainne
    grainne Member Posts: 245
    edited September 2017

    This seems to mean that grade is more significant than stage. Is that really new? All the prognostic calculators factor in both.

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  • macprer
    macprer Member Posts: 5
    edited September 2017

    This is all news to me. Can you advise me what to ask my MO next week?

    I am 47 and grade 3 but stage 1A. My MO did not do an Oncotype since he said the result would not be valid given the size (<1cm.) I don't know much more: MammaPrint, Prosigna, 70-gene test? Any other things I should ask about?

    I did the "spit test" and that was not a concern. However, when I elected to stop Tamoxifen and I asked about my tumor sensitivity to estrogen, he said it was in the 90%, I think.

    I had a lumpectomy followed by radiation. I did not do well on the hormone meds so I stopped.

    If you can suggest more questions for me to ask, or more research I should do I would much appreciate it.

    Best

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  • windingshores
    windingshores Member Posts: 704
    edited October 2017

    I think this says that clinical info such as grade are less predictive than genomic info.  So a person with a grade 1 tumor might have higher risk and/or greater need for and benefit from chemo than someone with a grade 3 tumor with a lower Oncotype or Mammaprint. It specifically dealt with Mammaprint  but I have read the same is true for Oncotype.

    My personal situation was that my tumor was grade 3, highish proliferation rate, LVI, but my Oncotype was 8. This is the reverse of the situation in the study but demonstrates the same point.  I was so surprised by my Oncotype that I had it redone- exact same score.






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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    More bad news.


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  • KBeee
    KBeee Member Posts: 5,109
    edited October 2017

    This study is another reason why everyone needs to advocate for yourself. If you are ER positive and HER2 negative, you should insist on Oncotype, Mammaprint, or a similar test to help make a chemo decision. If they assume it is not aggressive and it turns out to be, then you could end up not being offered everything possible to reduce your risk of metastasis. 25% of the time is alot!

    I had one of the upper midwest's best known medical centers tell me that my <1 cm tumor did not need chemo, and an AI was all I needed. They were "sure" it was not aggressive and refused to offer any testing of the tumor. I transferred back to a more local MO and asked for oncotype. I was willing to pay if insurance denied it (they covered it). My oncotype was 40.

    This study should be in your hands when you bring it up to MO.

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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    Kbeee I am interested in the 70 gene test because I didn't get chemo. I downloaded the PDF. I hope my MO doesn't call it "patient brought in pieces of paper from the Internet".

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  • KBeee
    KBeee Member Posts: 5,109
    edited October 2017

    Those tests are an important tool... not the only tool, but an important one, in helping to make the best informed decision. Good luck!

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  • Traveltext
    Traveltext Member Posts: 2,089
    edited October 2017

    KBee, that's a telling story. Yes, we do have to be our own advocates, and there is a tendency to under treat. Fortunately us IBC folks present with a roaring chest and get sent off for everything but the kitchen sink.

    marijen, sounds like your MO has a good sense of humour.


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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    Funny! She does

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