Low/weak estrogen positive

I had biopsies in 2 places in my breast and one from my node. Two were hormone negative and one of the breast biopsies showed a 6% estrogen receptor positivity. They were all HER2 positive. Following the end of Herceptin treatment my oncologist wants me to take exemetase. The guidelines state that under 10% ER positivity is a grey area. Is anyone in a similar position and has experience or advice to give?

Lala your situation is quite different than mine, esp. the HER2+ That adds to seriousness as I'm sure you know. The only reason I'm responding is based on the thread title about low ER+. I was 2%. I also only had DCIS so important you keep that in mind as you read my response. Your situation is different. I was Grade 3 with expansive comedo necrosis though chose not to undergo AI treatment even though 1% or greater is deemed appropriate for such treatment. I conveyed to my oncologist risks of/experience with toxicity/side effects for little if any benefit was just not worth it to me. Again your situation is different so important you have a heart to heart with your oncologist including questioning whether or not this is worth it in your situation. Hopefully others will chime in as well.

Lala, were all the biopsies PR-? That would factor into the decision as well.

If you have biopsies from three areas, two are ER-/PR-/HER2+ and one is ER+/PR-/HER2+ but the ER is only 6%, I would 1) want to see what the final surgery pathology shows and 2) seek a second opinion before going on the exemestane. You will be having chemo and Herceptin, so it's not as though the anti-hormone therapy is the only tool in your toolkit. I would want to know approx. what recurrence risk I faced after the other treatments, and how much the exemestane would further reduce my risk. These meds come with their own risks and side effects, and do not reduce risk for those who have ER-/PR- cancers. So it's one thing to take these meds with a high risk low ER+ cancer but it may be different if you actually have one tumor and a node that is ER-/PR-.