Liver Resection Pathology
 

Last week my metastatic breast care nurse called me with the results of the pathology of the liver tumour removed three weeks ago. The tumour measured 35mm x 25mm x 25mm, and is a metastatic breast tumour, and they got very clear margins at 10mm, and the remainder of the liver is unremarkable (I'll take that thank you!). It is also strongly HER2+ (score was 7.5). However, there is an interesting twist. The tumour is strongly ER+ (95%), whereas my original breast tumour was ER-. My lung tumour has been stable now for years, and generally never changes. Is it possible that the lung tumour is ER- and the liver tumour WAS ER+? That would possibly explain why I get continued good response from the Herceptin for the lung, and maybe why the liver tumour was more stubborn - maybe it needed extra help? (To be certain, I would probably need a biopsy of the lung tumour).

I'll see my oncologist soon, but it looks like I'll be now adding an aromatase inhibibor to the Herceptin. Your feedback on experience on AI's would be great.

Cheers Marie

Re: Liver Resection Pathology
 

Dear Marie,
Sounds like great news about the liver surgery, and certainly the ER+ nature of the tumour would help explain its persistence in the face of Herceptin. I have heard of this kind of difference before, and it lead to my having a bone biopsy; I've never had the liver mets biopsied as they were widespread, but we assume they are also ER+ and Her2+.
I am on Tamoxifen now, but was on Arimidex for 4 years after my first diagnosis. I have found both of theses relatively easy to tolerate - if the world's longest menopause can be thus described. (Hot flushes!) The AIs can also affect bone density, so you need to keep an eye on that.
Adding an AI sounds a reasonable way forward. I hope the side-effects are tolerable and that it keeps any further nasties away.
Best wishes.... Pam

Re: Liver Resection Pathology
 

Hi Marie, I've been on Arimidex a little over a month now, and so far just a few hot flashes right after I take it each day.

So glad you are doing well after your surgery. :)

Carol Ann

Re: Liver Resection Pathology
 

I took arimidex for the prescribed 5 years with virtually no side effects.

Re: Liver Resection Pathology
 

Great news, Bunty! Keep going! Keep us posted on what oncologist says. I, too, have had a bit of a pathology switch, some strongly HER2 and some not.
So glad to hear! This is the way things should be and stay, forever,
Karen

Re: Liver Resection Pathology
 

Marie,

I'm so glad about the clean margins! I'm also delighted for you that you've got a new tool to use. Strange to think that mets can have different characteristics, but in your case it is rather satisfying to get an explanation for the different response.

My original breast tumor was weakly ER positive. My most recent biopsy (from the lung) was ER negative. I was on Arimidex for awhile. It wasn't too bad (world's longest menopause is a good way to describe it) but I wasn't sorry to quit.

Keep us posted!

Re: Liver Resection Pathology
 

Hi Beautiful,

Congratulations on everything, you are doing so well.

That a very interesting twist, I believe women with ER+ do better on Herceptin then the one who test ER-. Also, you have more options to keep the cancer at bay, with the use of tamoxifen, aremidix? spl., and other (s) drugs.

Please keep us posted, it will be a first one for me to see if you are ER+ on one body part but ER- on the other one.

Sending you love and a BIG huge cybernetic HUG.

Adriana

Re: Liver Resection Pathology
 

Good news that your surgery went well. Its time to add another easy drug to the arsenal. I was on Tamoxifen for awhile but I have been on Arimidex almost 9 years now and no problems. If you do have too much joint pain, that usually subsides if you switch to Femara or Aromosin. Ask about Faslodex too. This is injected monthly but the drug actually degrades the ER receptor so estrogen has nothing to bind to. Just a thought since you are eligible because of your Stage 4 status. I know we'll here more from you but good news on the ER status because now you have mountains of new weapons to use.

Continue to heal and rest.

Love and hugs from me.

Re: Liver Resection Pathology
 

Cheers Marie ! How wonderful for you and your family�� Gods blessings to all��

Re: Liver Resection Pathology
 

Dear Marie,

So glad to hear they got clean margins on your surgery. There was no tumor left, only scar tissue, when they did my resection, so weren't able to get an ER status on mine.

I have been on Femara though since 2002 because my breast pathology was weakly ER positive. I think that between being thrown into menopause at 42 from my first chemo, then being on an AI for the last 12 years I am really feeling (and looking.....yikes!) older than my 59 years. My skin has become sooo wrinkly and crepe like, I don't even like to look in the mirror. I would really like to stop the Femara, but my doctor is afraid to "rock the boat" right now, hoping to keep things stable.

The other biggie is the joint pain. That is why I try so hard to stay active, cause it's really hard to get going again once I stop! Oh the price we must pay to keep this disease at bay! And I almost forgot.....my last bone density test was not so great, even though I've been taking my calcium and Vitamin D religiously for the last several years. Probably not what you wanted to hear about AIs, but that's my story.

Hugs to you,
Kim