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Should I know Myriad scores pre-surgery? ER/PR % concerns

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rbevins
rbevins Member Posts: 3
edited April 2023 in Just Diagnosed

Hi,

Newbie here just trying to navigate this new normal and all the information.

I'm scheduled for a lumpectomy May 1st. My surgeons office took blood for a BRCA test (Myriad) three weeks ago, but I just learned because of a nurse error, they haven't run the test yet. (My doctors office isn't being very cooperative correcting the error). Myraid told me it will take at least a week to get results after the test is run which bumps up dangerously close to my surgery date.

Wouldn't it be best to have these results to determine if a mastectomy would be a better choice than a lumpectory? (I'm wondering how much to bother the surgeons office. Don't want to alienate them.)

I'm also wondering about my ER/PR percentages which are 98%/90% respectively. Does this high percentage have any bearing on anything? (For example chemo needed of definite need for AI?)

Thank you so much for being here!


Comments

  • harley07
    harley07 Member Posts: 316
    edited April 2023
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    Welcome to BCO. I’m sorry you had to join us but I think you’ll find this site is a great resource. The high ER/PR indicates an AI. The chemo would be determined by your Oncotype or Mammaprint score, along with tumor size, Her2 status and if there is lymph node involvement.

    If it were me I would definitely want to know the results of the BRCA test prior to the lumpectomy so you can make an informed decision. I did not have this info as my surgeon was pushing to do the second lumpectomy quickly. As it turned out, while I do not have the BRCA mutation, I do have another mutation that increases my risk for breast and ovarian cancer so I had 2 lumpectomies without realizing I did not have all the information needed to make a good decision.

    Good luck with your surgery. We are here for you.

  • rbevins
    rbevins Member Posts: 3
    edited April 2023
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    Thank you for the warm welcome and helpful answers, Harley07. There is so much to absorb with this!

    Sorry to hear you didn't get all the info you needed prior to your lumpectomies. That must've been so frustrating! I was an unpaid caretaker for a while and dealing with the local medical community was often a challenge.

  • maggie15
    maggie15 Member Posts: 1,075
    edited April 2023
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    rbevins, If the BRCA test results will influence the type of surgery you would opt for you should let the surgeon's office know that you will have to delay the surgery until you have them. That might motivate them to contact Myriad and ask them to fast track your sample. Surgeons do not usually deal with mundane things such as test orders but since these companies depend on doctor's orders for their business a call from a doctor is given weight. The nurse might not want to bring up the error but having the correct surgery for your situation is way more important.

    I ran into a similar situation when my Oncotype sample was delayed by a pathology lab error. Since that informs whether chemo is recommended and that decision must be made before radiation begins (or insurance won't pay for the test) I refused to start until I received my Onco score. My entire radiation sequence had been scheduled so Exact Sciences was contacted and I got a call from my MO with the results three hours before my first scheduled radiation treatment. I had already decided that unless chemo was definitely recommended I would skip it (the score was borderline) so I started as planned.

    Your ER/PR scores will be recalculated in the surgical pathology. It's most likely to be ER+ given the biopsy results so tamoxifen or an AI will probably be recommended.

    Good luck with your surgery. Remember that your medical outcome is the focus here, not the feelings of the office staff.

  • rbevins
    rbevins Member Posts: 3
    edited April 2023
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    maggie15 that is a great idea about telling them my surgery will have to be delayed until I have the results! Thank you for that.

    So sorry to hear about the delay of your own tests! Sounds so stressful. It's a lot of work keeping on top of all these things. Wish it wasn't part of the protocol but self-advocacy is definitely something I'm going to have to improve upon.

    Thanks again!