Biopsy of Mets shows hormone rec neg?
Has anyone else had mets biopsied and Her2 came back neg when primary was Her2pos.
I just found this out yesterday at MD Anderson .. So for 3 years Ive been treated as pos but Im triple neg. Interesting. |
that is not the only way to interpret the facts
it may be that after being challenged by all these treatments, the cancerous cells which survived were not those that were vulnerable to herceptin, etc (those were killed) but those that were able to mutate so that they were not (or, alternatively, those which had that phenotype predating the treatment and now can multiply and utilize nutrients without the competition of the cancer cells with the other phenotypes.)
Think of it like a lawn with several types of weeds in it. If you use a weed killer effective only against one or two types of weeds, the other weeds that were not vulnerable to the treatment will survive and thrive Dr. Stephanie Jeffries of Stanford has been looking at the phenotypes of circulating tumor cells of those with metastatic breast cancer. She found triple negative CTCs floating around in the blood of Stage IV patients with her2+ breast cancer (at least primarily) while they were still being treated with herceptin. Smart little buggers, those cancer cells! In addition there are epigenic changes (not requiring mutations) that can turn ER- breast cancers ER+ and vice versa. New treatments can try to reverse those epigenetic changes. They are now finding treatments which seem to work on triple negatives (PARP inhibitors, cisplatin, EGFR inhibitors) so that is not to say there won't be tools to attack your new cancer type. See if your doctor can try to determine if there are markers on your new cancer cells which might point to the right direction to take eg. if your tumor cells are EGFR + etc. Good luck, and don't worry...her2 support supports those exher2s too!!! |
My her2 status didn't change, but my ER+ status went to neg upon recurrence...
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You are correct Lani
Thanks Lani,
I just spoke with my Onc. here in Louisiana who told me the exact thing you just posted thank you. Those cancer cells are sneaky buggers. |
Not to mention the fact that individual tumors are heterogeneous and a single biopsy might only give part of the picture. And if there is more than one met, is a single biopsy adequate?
Consider the her2 serum ELISA for additional info on that issue. |
What Rich said... that's what my surgeon and Onc told me when my ER status seemed to change.
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My original bc was HER2+ and ER-. I've had two mets. The lung met was HER2+ but the brain met wasn't. The mets were also ER-.
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