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Things that make ya go hmmmm…. Question on biopsy results

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justagalwholoveslife
justagalwholoveslife Member Posts: 46

Hi! I'm newly diagnosed and I've been researching the information on my pathology report. I have a question that I'm going to bring to my doctors but I thought I'd share it here and see what information or thoughts you may have. I've already met with the doctors and discussed these results, but I have questions

My report shows a minimal amount of er and pr so because of this hormone therapy isn't an option for me. It is listed as + but clarifies that it's minimal. It also shows HER2-

Now from what I'm reading wouldn't this be considered Triple Negative Breast Cancer (TNBC)? I ask because from how I'm understanding it, there is no difference, when it comes to treatment, if I have minimal er+ and/or pr+ or er-/pr-. That's because neither one can use hormone therapy. And if I'm right then the American Cancer Society website says that TNBC has a worse prognosis. Thoughts?

I'm told that my cancer is treatable. Which, right now, I believe it is. But I ask a lot of questions. I'm waiting on the BRCA test results. Then I'll know if I need a double mastectomy or just a lumpectomy. If I do a lumpectomy then I need 4-6 weeks of dailyradiation because of its size. Then top it off with some Chemo.

Hmmmmm….
Thank you in advance for any thoughts you may have.

Kristen

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  • nume
    nume Member Posts: 81
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    Hi justagalwholoveslife!

    ...I had a 3cm lump found last summer in august and I just had double mastectomy two weeks ago, after neoadjuvant chemo.

    I know how scary Triple Negative is but it responds better than all other sub types to chemo. The prognosis is worst just few percentages so don`t feel discouraged.

    I think the treatment is depending on the gene mutation results. BRCA 1,2, PALB etc are bit more targeted, responsive to carboplatin and later on, after surgery, to Lymparza for maintenance. Myself, I had no genetic mutation and had carboplatin added anyway. Ask for the PDL-1 too. If PDL-1 is positive(as mine was), it will respond well to immunomodulators/pembrolizumab(Keytruda). (The name of the study is Keynote 522)

    Things will calm down once you have a treatment in place.

    If you want to ask me anything I will be more than happy to help.

    XO

  • nume
    nume Member Posts: 81
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    Hi justagalwholoveslife!

    ...I had a 3cm lump found last summer in august and I just had double mastectomy two weeks ago, after neoadjuvant chemo.

    I know how scary Triple Negative is but it responds better than all other sub types to chemo. The prognosis is worst just few percentages so don`t feel discouraged.

    I think the treatment is depending on the gene mutation results. BRCA 1,2, PALB etc are bit more targeted, responsive to carboplatin and later on, after surgery, to Lymparza for maintenance. Myself, I had no genetic mutation and had carboplatin added anyway. Ask for the PDL-1 too. If PDL-1 is positive(as mine was), it will respond well to immunomodulators/pembrolizumab(Keytruda). (The name of the study is Keynote 522)

    Things will calm down once you have a treatment in place.

    If you want to ask me anything I will be more than happy to help.

    XO

  • maggie15
    maggie15 Member Posts: 855
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    Hi Kristen, It seems like there are now some guidelines on how to treat ER low bc. I'm attaching a paper but the important part to read as far as recommended treatment is section 9.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504145/

    Your genetic testing results are relevant and an Oncotype DX (genomic test on the tumor) gives an idea of how effective hormone therapy would be; in some cases it is helpful. It's hard having unusual aspects in your tumor pathology (I have different ones) since there is not much research done on "different" cases. Make sure to ask lots of questions and maybe get a second opinion. I hope they come up with an effective treatment plan.


  • justagalwholoveslife
    justagalwholoveslife Member Posts: 46
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    thank you for your insight!

    I have some reading and note taking to do!