[Becky]

Jean



I understand what you are asking. It is relevant that if one is PR neg but ER positive that resistance of an (anti) hormonal can occur. However, all that “resistance” means is that the cancer recurs. Way back when only ER and PR were tested for, doctors realized that women who weren’t strongly positive or only had one receptor positive tended to recur more than those who were strongly positive for both receptors. This is because these women tended to be positive for something else that wasn’t measured. In our case, Her2. For other women who are ER+ but PR neg but also Her2 neg, they are probably Her1+ (or positive for something else). Remember, your antihormonal still works but something else is also driving the cancer. Also, the Herceptin with an AI combo is excellent in the metastatic setting so I believe it is the one-two punch we need right now in the early adjuvant setting to really shut down 2 receptors at once (with the AI working well later too – it is PROVEN to work well alone (in HER2+ women) as well and it is PROVEN to work better for those that are ER+ but PR neg). Most cancers do not change pathology to go from positive to negative (but do change vice versa).