Mitotic Rate
What exactly is the mitotic rate? Does a mitotic rate of 1 mean the cancer is slow growing? My doctor said I have aggressive breast cancer. I have grade 2 estrogen positive and her 2 negative breast cancer
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Hi @jenna1220x, A mitotic rate of 1 means the cancer is slow growing. Grade 2 indicates intermediate grade, growing faster and looking less like normal cells than grade 1 but growing slower and looking more like normal cells than grade 3. Ask your doctor why they consider your breast cancer aggressive since they know all the details of your tumor. It might have something to do with your oncotype score which measures 21 genes to predict the likelihood of recurrence, a more detailed analysis than your Nottingham score (grade) measured by lab staining. Hope this helps.
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@maggie15 Thank you so much for your response. I did have a high oncotype score of 37. He recommended chemotherapy due to the oncotype score but I don't understand how chemotherapy would help if a cancer is slow growing. My oncologist gives me one word answers and is basing my entire prognosis on the oncotype test. I chose ovarian suppression and an AI instead of tamoxifen since I am premenopausal.
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@jenna1220x , In the days before the oncotype test was developed you probably would not have been recommended for chemo. Your MO is basing their recommendation on the statistics from trials using the oncotype score. The 21 gene analysis uses more advanced science and does not always match the Nottingham score. I have grade 3 bc with a mitotic score of 3 but my oncotype score was 24, one point shy of having chemo recommended. My MO gave me the choice to have chemo or not since I was borderline but I declined. You have to decide what you are most comfortable with. A mitotic score of 1 could mean that the cells aren't dividing fast enough for chemo to be effective.
Sometimes there are no easy answers and there is definitely no guaranteed way of preventing a recurrence. All we can do is make the best decisions for ourselves and hope that things work out well.
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@maggie15 Thank you so much for your feedback. I was diagnosed in April with IDC 2.4 cm and micrometastasis to the sentinal lymph node. The surgeon was confident it was all removed and I had 30 radiation treatments. I declined chemo. At first my oncologist said even though the most aggressive chemo was recommended for me, he thought I was making a "reasonable" decision with the ovarian suppression and AI. At my appointment last week, he made it sound like I made a horrible decision and I have been so scared since, but I did what I thought was right for me. None of it made sense to me. All we can do is hope for the best.
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