ER+ / PgR- AI treatment vs chemo

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Gaijinloon
Gaijinloon Member Posts: 7
edited January 2019 in Hormonal Therapy - Before, During, and After

I am confused, we are in Japan and the doctors here have given a great deal of conflicting information, and recommended different treatments. One doctor said we are luminal A another said B, and the original oncologist won't even answer our questions.

The main question I have is regarding information about AI vs chemotherapy, there is a lot of information out there, but not so much specifically relating to PgR-, and most of that is based on Tamoxifen. Can anyone help us make sense of the relative risks and benefits of these treatments, and are there many studies that look at ER+ / PgR- node negative cancers with a low Ki-67? If so I'm having trouble finding them.


Thank you to all.



Age 63 (almost 1 year post surgery)

Tumor size : 1.4cm invasive

Grade: 2

ER+ / PgR- / HER2- Ki-67 <10%

Node negative

Ductal carcinoma scirrhous

Oncotype DX 17

Current treatment: anastrozole



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

    http://www.cancernetwork.com/articles/anastrozole-...


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  • Gaijinloon
    Gaijinloon Member Posts: 7
    edited January 2019

    Thank you, I'd not seen that article specifically but I've come across the ATAC data in other places, my concern is that it compares Anastrozole to Tamoxifen and not to chemo. The graphs for the study on the ASCO website show really high risk for the lowest quartile of PgR- patients, but it's unclear if those patients have high ki-67 scores or high HER2 scores so I have no idea if they are relevant to our situation.

    Thank you so much for posting

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  • Murfy
    Murfy Member Posts: 342
    edited January 2019

    Gaijinloon, according to current recommendations, based on literature and practice, it looks to me that you are exactly where you need to be. Low Ki-67, low Oncotype = luminal A and also indicates that you can skip chemo and go right to AIs. How are you doing on the anastrozole?

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

    Gaijinloon, Oncodx gives you an idea of chemo vs tamoxifen and statistics you can then see the additional benefit of anastrozole vs tamoxifen for the er+ and pr negative group.

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  • Gaijinloon
    Gaijinloon Member Posts: 7
    edited January 2019

    I can see the additional benefits of Anastrozole vs Tamoxifen in the ATAC study right? Or are there other studies? We got our oncotype just before they changed to the TAILORx data and they say they won't update our report.

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

    There was another dated 2014. I didn't book mark it. Not a whole lot of studies for er+ pr- I think because is a small subset of hormone positive cancers.

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  • Gaijinloon
    Gaijinloon Member Posts: 7
    edited January 2019

    Yeah unfortunately that's what we have seen.

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  • Gaijinloon
    Gaijinloon Member Posts: 7
    edited January 2019

    The side effects are okay, but some scans have shown a 1cm mass in the gallbladder, which is very worrying but they won't do anything yet. The sc lymph node near the jugular vein has also been enlarged for a long time but the doctor says....... ehhhh probably not cancer. It has been taking a brutal toll on my family.

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