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Old 11-11-2007, 10:52 PM   #1
TSund
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Location: DFW area (TX)
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Pathology changing?

I've been meaning to write about this for a while, but finally getting to it. While thrilled with the result of Ruth's pre-surgery chemo, when we got the marker results several days after initial pathology came back, the lab now marked the cancer as 50% ER+ and PR negative. I was stunned by this, nurse said not to worry, it happens all the time because of the chemo.

?? What does this mean? Why does it happen? Is it likely to be the same throughout the body if there are any cells left?

And, if the chemo causes a changing pathology, then what does this mean for post chemo treatments like hormone treatment? Now that Ruth is on it, it's really not going to do as much good because the receptor cells have changed?

I welcome any thoughts.

THX

TRS
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Terri, spouse of Ruth, Dallas/Ft. Worth area
Ruth dx 05/01/07 (age 50) Filipino
multifocal, several tumors .5 -2.5 cm, large area
Breast MRI showed 2 enlarged nodes, not palpable
100%ER+, 95%PR+, HER2+++
6x pre-surgery TCH chemo finished 9/15/7 Dramatic tumor shrinkage
1 year Herceptin till 6/08
MRM 10/11/07, SNB: 0/4 nodes + Path: tumors reduced to only a few "scattered cells"
now 50% ER+, PR- ???
Rads finished 1/16/08
Added Tamoxifen,
Finished Herceptin 05/08
NOW is the time to appreciate life to the fullest.
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Old 11-12-2007, 07:16 AM   #2
Becky
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Get repeat readings on the slides - both the new slides and the original slides from another laboratory. This is extremely important because Ruth's hormone profile (most recent) is exactly like mine and for PR neg but only moderately ER+ does not respond well to Tamoxifen. Therefore, being postmenopausal is more important now.

Send the slides to a large teaching hopsital for a second opinion pathology. I did this and sent to both Sloane and Johns Hopkins as Sloane said something different versus my local hospital. Johns Hopkins conferred with Sloane (I also had a separate DCIS that I wanted to ensure did not have an invasive component. All 3 labs said no).

Do it! Its important to ensure the right pathology.
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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