Mammaprint results and treatment

Kringle, I had an intermediate Onco -score, but never did the mamma-print test. With a Grade 3 tumor and high Mammaprint, I would think guidelines would suggest chemo, but your MO will give you their opinion. Keep in mind, that a higher Grade tumor usually responds better to chemo than a lower grade.There may be other determining factors, such as your age or any other health issues you may have. Have you had genetic testing done? Family History of BC? There are a lot of pieces to the puzzle. Best wishes moving forward.

Were the ITC checked to ensure that they are invasive cancer and not displaced DCIS? When ITC are found in diagnoses of pure DCIS, the assumption is that the cells were accidentally displaced into the nodes by a surgical instrument. I know that there is a particular staining test that can be done that may be able to confirm if this is the case (i.e. if the ITC are DCIS cells or invasive cancer cells). And are you certain that you had ITC (less than 0.2mm) and not micromets (greater than 0.2 mm and/or more than 200 cells, but none greater than 2.0 mm)? This makes a big difference because ITC are considered node negative: Breast Cancer Staging American Joint Committee on Cancer

pN0 No regional lymph node metastasis identified histologically

• Note: Isolated tumor cell clusters (ITC) are defined as small clusters of cells not greater than 0.2 mm, or single tumor cells, or a cluster of fewer than 200 cells in a single histologic cross-section. ITCs may be detected by routine histology or by immunohistochemical (IHC) methods. Nodes containing only ITCs are excluded from the total positive node count for purposes of N classification but should be included in the total number of nodes evaluated.

.

pN0(i−) No regional lymph node metastases histologically, negative IHC

pN0(i+) Malignant cells in regional lymph node(s) no greater than 0.2 mm (detected by H&E or IHC including ITC)

.

With a 2mm ER+/PR+ tumor, and technically being node negative, according to the NCCN Treatment guidelines, normally chemo would not be considered. This changes for micromets, where the Oncotype score (or in your case, the Mammaprint score) comes into play.

https://www.nccn.org/professionals/physician_gls/d... Patients guidelines are available but they are not very detailed. The Physician Guidelines are extremely detailed however you have to register to be able to access them (although registration is easy).