How many ER+ PR- are there?

[Jean]

Lani posted recently about ER+ verses ER- relapse time.
Becky posed that ER+ PR- is a rare group.
I am just curious how many of us are ER+ PR- if you don't mind....

ROLL CALL...(LOL)

Thanks,
Jean

[BonnieR]

I am in this select group.

[PinkGirl]

I am too ... and I like being weird :)

[freyja]

Here! Er+ pr- her2+++

[Becky]

I am weird too

[bejuce]

Same here...

[Chelee]

Actually...I'm not sure if I count official...but my recent biopsy report from femur said I'm Er + and Pr -.

Orignal dx I was weakly Er & Pr. So you choose which one I am. lol

I think this qualifies me for the "weird" group. :)

Chelee

[DianeH]

I am also ER+ and PR-....

[Patb]

I am ER+ 90 percent, PR-
Really wierd
patb

[PinkGirl]

You're officially weird Chelee! It's actually easier to be weird than
it is to be normal .... you do something weird and everyone just
says ... "oh, she's always weird" .... makes life easier for me. :)

[Nancy L]

Chelee's response is important to remember and a reminder that everytime we are rediagnosed, it is very important to get the tumor reevaluated. Receptor status and Her2 status can change during your journey. I just went through serious surgery to get a surgical biopsy completed in a very difficult spot in my neck because Dr. Slamon said it wasn't enough to know it was breast cancer----he needed to know all the characteristics of my recurrence in the neck to know exactly how to treat me. It wasn't until the past few years that they discovered tumors can change characteristics.

[Jackie07]

ER+ (weakly) PR- both times*. Have had almost 5 years of Tamoxifen. Will discuss options with Onco soon.

Correction: Oncology nurse just called me back - turned out my recurrence is ER -. How about that, he hid the news from me just so he could get me to take 5 years worth of Tamoxifen without getting probed by me... Yet I've continued my questioning regardless... :)

[SuThorn]

I am also in the weird group. ER+/PR-...

Thanks, Suzanne

[Barbara2]

Me, too...ER+, Pr-.

[krisvell]

You can add me to the list.

[Hopeful]

Jean, et al - an interesting abstract from SABCS for you: http://her2support.org/vbulletin/showthread.php?t=42846&referrerid=1173

Hopeful

[Jean]

Thank you Hopeful, as always you are a great researcher. Knowing that the er+ pr- was a subtype
that is unique...now after reading the post there is another level to this...very intersting. Do you know of any other articles or posting?

Yes we are certainly a bunch of weirdo's!!! lol

thanks all,
Jean

[DarleneM]

I'm in...although only weakly ER+

[Jackie07]

This study was presented in the ASCO meeting in 2008. Don't know if (most likely) it's been posted. Thought it might be relavant in the discussion here. It shows the Er, Pr, and/or Her2 status can change in relapsed breast cancer.

***************************

J Clin Oncol 26: 2008 (May 20 suppl; abstr 1000)


Author(s):
R. MacFarlane, C. Speers, H. Masoudi, S. Chia

Abstract:

Background: Relapsed/metastatic breast cancers are presumed to have the same predictive factors as the initial primary tumour. As such, the majority of patients do not have additional biopsies performed at the time of relapse. Recent small studies have suggested that a significant proportion of relapsed lesions may have a change in the hormone receptor and/or HER2 receptor status from the original tumour. We sought to compare the hormonal and HER2 receptor status of relapsed/metastatic breast cancer tumours with those of the original tumour from a large population-based database and tissue microarray (TMA) cohort. Methods: Using the BCCA Breast Cancer Outcomes Unit Database from 1986-1992, patients with biopsy proven relapses were identified. These identified patients were linked to a current large TMA series (n=4,444) of primary breast cancers. Charts were reviewed, and available tissue blocks of the relapsed/metastatic cancer were requested and collected. An additional TMA was created of the relapsed/metastatic tumours. IHC was performed for ER (LabVision SP 1 antibody), PR (Ventana 1E2 antibody) and HER2 (LabVision SP 3 antibody) on both the primary and relapsed tumours. The pathologist was blinded to knowledge of the primary tumour receptor status. Results: 281 cases were linked between the BCOU database and the TMA series. Of the 281 cases, 184 tissue blocks were received, and 160 had adequate tumour for analyses. Of the 160 blocks, 115 (72%) had no changes in either the ER/ PR or HER2 status. Of the 45 (28%) tumours that did have changes in the receptor status, 11 (7%) were local recurrence, 34 (21%) were regional or distant relapses. Among the 34 regional/distant relapses 11 went from ER/PR(+) to ER/PR(-), 14 went from ER/PR(-) to ER/PR(+), 3 went from HER2(-) to HER2(+), and 6 went from HER2(+) to HER2(-). Conclusions: This is one of the largest known studies assessing for changes in molecular phenotype between the primary and relapsed breast cancer. A significant proportion (21%) of relapsed tumours had changes in either ER/PR or HER2 receptor status. This study suggests that biopsies of relapsed/metastatic breast cancers should be performed routinely.

[Jackie07]

And here's the advice I got from my 2nd Sister-in-law's bc oncologist (in Taiwan):

Since your breast cancer is ER (+), although the percentage of ER is 5-10%. Hormonal therapy with tamoxifen or AI (arimidex) is the treatment of choice.

The disadvantage of tamoxifen: Uterine myoma, uterine carcinoma...etc. but less osteroporosis.
The disadvantage of arimidex (AI analogue): severe osteroporosis..

Conventionally, chemotherapy will destroy the ovarian functions, oophorectomy, therefore, is not necessroy.
But if you still have menstration indicating the normal ovary function, oophorectomy and hysterectomy (to avoid uterine tumors) followed by
tamoxifen treatment are treatments of choice.

According to your questions below, my answer is:

If you have still menstration now, surgical removal of ovary and uterus is advised, provided chemotherapy did not destroy ovary functions.
Both tamoxifen for 5 years and tamoxifen 2 years followed by arimidex 3 years are fine for your condition.

*****************************************

[Jackie07]

ps.

Just got a call back from my oncology nurse. It turned out that my hormone status did change from weakly Estrogen positive to Estrogen negative. But my oncologist thinks getting rid of my ovaries is still a good idea.

[So why didn't he ever bring it up? Did he think I would have gone 'crazy' if I couln't have things my way? I had asked him after my recurrence if I should take Arimadex instead and he said 'no' and told me to continue my Tamoxifen. But he never did tell me my ER status had changed.

Things are really getting interesting here. And you would think my doctor and I have known each other well after six and half years...]