High Ki-67, but low grade and stage?

Options
2

Comments

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    Thank you so much! I used the er and pr as it was on my path report...i only have one number of 100 percent for both er and pr. If i plug in 100 on both it gives me a score in the twenties. If i plug in 300 it gives me 12 to 14. I called the lab. They cant rush it. It was a mistake made by the pathologist. All about specimen id numbers not matching up with their documentation. Now im skeptical of the entire process.

    Thank you for the support. Cancer sucks!

  • Meow13
    Meow13 Member Posts: 4,859
    edited January 2019

    If you are 100%, then 300 is the number you want to use.

  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited January 2019

    I used that formula and it came up with numbers in the 20s. My score was much less. Grade and Ki-67 are subjective to the pathologist.


  • KBeee
    KBeee Member Posts: 5,109
    edited January 2019

    If the pathology lab made an error, maybe you want to get more specifics on that. There was an article in our local newspaper yesterday about a man who had prostrate surgery only to find out that he never had cancer; there was a bar coding error in the pathology lab. I think I'd want more details on that if I were you. I would want a copy of all reports, and would want a written description of what happened with your sample, where the error occurred, and what is in place to assure this error does not happen again in the future. It is complete;y unacceptable.

  • DebAL
    DebAL Member Posts: 877
    edited January 2019

    agree with KB. I'm sorry for the added stress. Waiting is hard enough. Your high PR is in your favor. Lower PR drives your score up. Hang in there

  • MCBaker
    MCBaker Member Posts: 1,555
    edited January 2019

    I found the McGee Equations page. With er & pr at 0, HER2 at 3, size at .3 cm, and KI-67 at 34%, I get a 43.4 on the third equation. The Nottingham score calculation is based on grade and lymph node and size. https://en.wikipedia.org/wiki/Nottingham_Prognosti... That is 2.06 for me, so I have to enter the minimum value of 3. The other two equations result in scores of 35.8 and 37.3.

    Onco reported 7 to 10 percent of recurrence, which would be beyond nasty, and normal lifespan with chemo.

    Low grade and stage means found early, high KI-67 means nasty if it hadn't been.

    https://www.ncbi.nlm.nih.gov/pubmed/30395177 So this set of criteria said that there is no need, in my case, to send for oncotypeDX testing, since it was serious enough for chemo without reservation.

  • windingshores
    windingshores Member Posts: 704
    edited January 2019

    It is always possible to talk to the folks at Genomic Health, the maker of the Oncotype Dx.  I called them a few times!

    So sorry to hear about pathology error in sending sample.  I got to know the pathology people- actually went in to meet them- because my samples were being sent all over the place. Nervewracking. I actually had my Oncotype done a second time and made sure it was the right tissue block.

    I had grade 3 (one lab said grade 2), uncertain HER2 (finally resolved as negative), KI67% at 20, and Lymphovascular invasion, focal.

    But my Oncotype score was 8. Go figure.

    It is possible, someone told me, that the healing biopsy site might increase the Ki67% because healing cells are proliferating. I have no idea if this is true.  For me, the other thing was that my biopsy results were HER2+ but post surgical results were equivocal then negative. I was told that biopsy result may have had a lot of DCIS in it, which tends to be HER2+.

    So this stuff is complicated.

    I went with the Onctoype score and had no chemo. None of us will ever be certain.

    KI67% is only one of several proliferation measures in the test. I would have thought, with LVI, that my invasiveness score would have bumped it up, but maybe 95% ER and 80% PR bumped it way up.

    Thirty percent of grade 3's have low Oncotype scores. Nothing is as it seems!!!!




  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    Hi all!

    I see the oncologist on Monday for labs and to get started on tamoxifen. I'm afraid she's gonna get an earful. I'm going to ask her to call the pathologist and lab both to find out what happened and how they sre now so sure they have the right specimen. Yes this whole thing has me shaking in my boots! And the crappy thing is..we're at their mercy! If its the wrong specimen i will never know. And becsuse my bs didn't get lymph nodes this was such an important piece of the puzzle. And even more worrying is that when there's unsuccessful lymph node mapping studies show there's a higher incidence if lymph node involvement! My breast surgeon and oncologist are one if the best if not the best in Oklahoma city! My profession is in the medical field and I've lost all respect at this point.

    Thank you ladies..you all understand and that means so much to me!💖

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    I called the Genomics lab yesterday and all thry could tell me is that the specimen id number on the documentation from the order sent initially didn't match the specimen id number they received. Took them 10 days to get the specimen and then 7 days to do anything with it! So when your told 10 to 14 days that's after they recieve the specimen! So frustrating!!!

  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    if you got 100 pot both receptors you multiple then by 3 do you would put in 300 for each

  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    that is good to know it makes me hopeful. Did you multiple your hormone receptors by the different levels and add them

    Before you plugged them in? My score has been delayed as well and so anxious .

    So sorry Cjzach10 I sympathize and hope you get your results this coming week

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    im sorry you're having to wait also! Its the worst! When i put in 300 it was between 12 and 16. So i guess intermediate. Im just hoping my high pr pushes under 10!

    Hpfull what was your ki 67?

  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    my ki is 30. What is yours? I know all this waiting is painfu

  • besa
    besa Member Posts: 1,088
    edited January 2019

    About histology results for Ki67 or other markers versus the realtime-PCR looking at same gene expression (realtime results are used to in the calculation of the final oncotype dx test score... ) Histology results can be much more variable. rt-PCR results come back from the machine as a firm number (and are then normalized back to the "reference genes" to account for variations in sample tissue size) In realtime there should be little variation with repeated analysis of the same sample. This is not always true when doing antibody staining in histology.

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    mine was also 30 :(

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    mine was also 30 :(

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    Thanks for the list kbee I think i will ask for all of those things!

  • Meow13
    Meow13 Member Posts: 4,859
    edited January 2019

    Mine gave me low 20s but my actual oncodx result was 34.

  • stephilosphy00
    stephilosphy00 Member Posts: 386
    edited January 2019

    Mine was the opposite, my Ki-67 at biopsy were low both in the breast tumor and lymph node (8% and 7.5%) but had high grade - grade 2 to 3. I had chemo before surgery and never got oncodx.

  • Meow13
    Meow13 Member Posts: 4,859
    edited January 2019

    steph..., do you try the calculator above? This one

    https://path.upmc.edu/onlineTools/mageeequations.h...


  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    hi meow. Yes this is the same one as I posted above but maybe listed under another website ? My score varies as my range for Er is 98-100% so I put 300 for Er and feel good about that but my range for Pr is 41-50% so when I do what they say here to calculate:

    All the required data is generally present in the surgical pathology report. The hormone receptor results will require the semi-quantitative H-score. If not reported initially, this can be easily calculated by the case pathologist by reviewing the immunohistochemical (IHC) stain slides. H-scores are calculated based on percentage of positive cells showing none, weak, moderate, or strong staining intensity. The score is given as the sum of the percent staining multiplied by an ordinal value corresponding to the intensity level (0=none, 1=weak, 2=moderate, 3=strong). With four intensity levels, the resulting score ranges from 0 (no staining in the tumor) to 300 (diffuse intense staining). For e.g. a tumor showing no staining in 10% cells, weak staining in 30% cells, moderate staining in 40% cells, and strong staining in 20% cells; the H-score will be calculated as follows: (0x10)+(1x30)+(2x40)+


    I could have anywhere from 120 up so not sure. I enter it a bunch of different ways and I get anywhere from 16 to 20.


  • Meow13
    Meow13 Member Posts: 4,859
    edited January 2019

    HPFULL, was it close to your actual oncodx score?

  • Murfy
    Murfy Member Posts: 342
    edited January 2019

    My Oncotype score was 52 and Magee equation scores averaged 28. I'm hoping the Magee scores are more accurate!

  • stephilosphy00
    stephilosphy00 Member Posts: 386
    edited January 2019

    I got anywhere from 11 to 17 , low risk?

  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    I don’t know I still waiting on my score that’s why I am making myself crazy trying to figure out what it will be. I should stop obsessin


  • Meow13
    Meow13 Member Posts: 4,859
    edited January 2019

    Hope you get good news.

  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    Cjzach10 I want to call the genomic lab. Can I call and just give my name and they will give me the status

  • MCBaker
    MCBaker Member Posts: 1,555
    edited January 2019

    You will have to give some other information just to verify that you are you. Hip-hip-HIPAA

  • Cjzach10
    Cjzach10 Member Posts: 87
    edited January 2019

    They should talk to you too. The number i got us 1 855 500 0275. Good luck i hope you get some answers!

  • HPFULL
    HPFULL Member Posts: 247
    edited January 2019

    they won’t tell you results if they have it will they

Categories