Liver Mets: What Does 60% Progesterone Positive Mean

[KDR]

I was just reading the pathology on my liver mets, there were three small lesions. The report indicated they were ER-, Progesterone + 60%. What does this really mean?

[Becky]

It means that when they stained a piece and looked at the tumor, 60% of the cells showed an over abundance of progesterone receptors. That is what the percentages mean (and when they stained some for the estrogen receptor, they didn't see any cells that had an over abundance) - hence ER negative, PR 60%.

[KDR]

Hi, Becvky, thanks for writing. OK. Does this mean that progesterone is fueling the tumor? Where does that come from and can I avoid it? I will be seeing my onco on the 22nd and I know these are questions for her, but I've been learning from this board and I like to go in to my consults with "options."

[Becky]

Like estrogen, I believe that Tamoxifen or an AI might be of assistance however, if I were you, I would have my pathology slides sent to a large research cancer center (MD Anderson, Johns Hopkins, Sloan Kettering, Fox Chase etc) and have them redo the pathology. The reason I am suggesting a second opinion is that being moderate/high on progesterone only is a very odd thing. Quite rare in fact and if I were you, I would want to know that the estrogen receptor isn't involved too because that insures the anti hormonals will really work. Just my two cents. Having a positive estrogen receptor and a negative progesterone receptor is rare too but much more common than vice versa like yours.

Are you premenopausal? If so, an oophorectomy may be helpful. Talk to your oncologist.

[KDR]

Hi, Becky,
I am at MSKCC. I'm going to print this information and show it to my onco on Wed. I want to understand what's going on, what to expect, really understand where I am at. Onco has told me that I am ER- and weakly PR+. When I opened the envelope from the institution that had done the liver biopsy, this is what it said. Then, those slides where send overnight to MSKCC, hence my onco's report.
I was 48 at diagnosis, still having regular periods. Had my daughter at 42, naturally, no hormonal treatment.
What is an oophorectomy?

[Lien]

oophorectomy is surgical removal of the ovaries. That way they will no longer produce hormones. This will make you postmenopausal overnight.

There was a question about Er-/Pr+ breastcancer on breastcancer.org that may be a bit helpful:

http://www.breastcancer.org/treatmen...uestion_09.jsp

Jacqueline

[KDR]

No, I'm not having ovaries removed. That hasn't even been suggested. I will also ask onco about that and report back with the response.
Best,

[Jackie07]

[Also from breastcancer.org http://www.breastcancer.org/news_res...uestion_07.jsp]
Page last modified on: July 1, 2009

Question from Deirdre: Is there ongoing research as to exactly what PR+ means to breast cancer? We all know that ER+ means that the lesion is fed by estrogen, but when I look up PR+ it states that the lesion is affected by progesterone but not that it feeds the cancer. Can you explain where the research is on progesterone and breast cancer? Thanks!

Answer —Nicholas Robert, M.D.: The progesterone receptor, we think, is positive when there is an impact on the functioning estrogen receptor. In patients where both receptors are positive, we think that hormonal/endocrine therapy will be more effective. There is an uncommon subset of tumors where the estrogen receptor is negative and the progesterone receptor is positive. We think in that group there are still some benefits to using hormonal treatments, although the benefit is less.

[Becky]

Hi

I wanted to point out an article that Soccermom just posted in "Articles of Interest" on testing tumor blocks for ER and PR. It mentions the ER neg PR positive types and that they should be retested as it is almost too rare to be seen.

Just wanted to make sure you caught that article.