DorothyB,

How did your doctor KNOW that chemo wouldn’t be needed? Mine said if it’s over a centimeter then a patient should get it. Well I guess it just goes to show that cancer is not an exact science at all. But it’s made and making much progress! Different doctors, different ideas... not just for cancer either.

HI THERE IS NEW INFO OUT THERE..THAT ALL BREAST CANCERS DO NOT NEED CHEMO.. U HAD THE MASTECTOMY AND LYMPH NODES CHECKED.. IM SURE YOU ARE OBSESSING NOW OVER ONCO TYPE.. I NEVER EVEN ASKED FOR MINE.. I TOTALLY TRUST MY BREAST SURGEON THAT SHE KNOWS WHAT SHE IS DOING.. PLUS I HAD ANOTHER CANCER IN MY GOOD BREAST A YEAR AGO LAST JUNE.. I DID WANT ANOTHER MASTECTOMY..BUT SHE DIDNT WANT TO DO THAT..SHE GOT THE CANCER OUT WITH A LUMPECTOMY .THERE WERE 2 AREAS & 2 INCISIONS..IN MY " GOOD BREAST.". THAT IS NO LONGER THAT GOOD..ALSO WITH NO CHEMO OR RADS.. I JUST HOPE U ARE GOING TO A MAJOR CANCER CENTER.. THAT MEANS A LOT.. JUST GO ON WITH YOUR LIFE..AND TRY TO JUST NOT THINK ABOUT IT FOR NOW.. AND MAKE SURE U GO TO ALL FOLLOW UP APPOINTMENTS.. TAKE CARE.. ~HOPE

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thank you I didn’t realize oncotype wasn’t done on site! Although I was grade 3 so an easy candidate for the test, the doctor seemed steering for me not to get it, so I assumed it was lots of extra work for him it was a bizarre appointment, Ihad to agree to get chemo if oncotype number warranted that or I would not have been given the test. That seemed weird too, I certainly will do whatever is best for me with the results, chemo or not. Test not back yet.

Kelley, glad to hear that your MO is trying to get you an Oncotype score.

The Luminal B part is interesting. I've done a lot of reading and there appear to be two (or more) definitions. One puts all PR- cancers that are ER+ and HER2- in as Luminal B. The other allows for a PR- cancer (that is ER+ and HER2-) to be classified as either Luminal A or Luminal B depending on the grade and Ki-67.

Within this second definition, if the Ki-67 is low and the tumor is either grade 1 or grade 2, then the cancer will be Luminal A. However if the Ki-67 is high (generally considered to be >15%) and the tumor is grade 3 (or possibly grade 2 if the mitosis score is a 3, since mitosis is an indicator of high proliferation) then the cancer will be Luminal B. Most low PR / PR- negative cancers have high Ki-67, so most will be Luminal B, using this definition. But not all.

To my understanding, Luminal B defines tumors that have higher proliferation, higher grade and are more aggressive. Luminal B cancers are more likely to be larger and node positive. In your case, while your tumor is low PR, it doesn't meet any of the other criteria for being Luminal B. It seems to me, as a layperson and patient (and PR-, with a small lower grade tumor) that the more flexible second definition makes more sense.

This article talks about the various definitions of Luminal A and Luminal B: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656721/#!po=29.0698

Glad you're getting the Oncotype OP! Mine ended up changing my entire treatment as Oncotype scored me as triple negative. If one of the receptors is weak, I think it's an excellent idea to check and see what the genomic pattern looks like.

I was luminal A with a 1.2 cm grade 2 tumor and a high Ki67--i think it was around 60%. She sent mine out for a Mammaprint saying the research was better than the research behind oncotype and she trusts it more. It definitely changed the trajectory of my treatment, because in the olden days I would have automatically had chemo because of my age at diagnosis and my one positive node. I still don't like the odds of metastatic recurrence, but what you can do?!

thanks Beesie!