[Becky]

The hormone status of your tumor is very interesting. First, does your pathology report tell you how positive your tumor is. For example, my tumor was 50% ER+ and PR negative. You will see other women's "signature" on this board that say similar things.

That said, I would suspect that you may not be strongly positive. The % ranges for low positive (10% - 40%), moderate (40% - 70%) and high is above 70%. Anything below 10% is considered negative but I have heard that that is changed now and that anything below 5% is considered negative.

So let's take me for example - especially that I am truly PR negative anyway. Oncotype DX did not exist when I was diagnosed but if it did, the test (which looks at genes - or a molecular assay) would probably say the same thing for me. That is because when I went to the San Antonio Breast Cancer Symposium in 2007, there was a paper where the researchers looked at what a pathology test said a woman was (lets say ER+PR+) and then they looked at a genetic "blueprint" of the tumor. When you do thousands and thousands of these, you get to see what the "picture" of a ER+PR+ tumor looks like chemically. Same for ER-PR- and ER+PR- etc. The bulk of the paper had to do with tumors like mine (ER+PR-) and that some chemically look like ER+PR+ but some look ER-PR- and that there are some that are truly unique and would actually be ER+PR-. However, there were a certain % of tumors that were ER+PR+ or ER-PR- that actually looked like the reverse in this chemical assay. Perhaps you are like that and perhaps this happens more frequently if a woman is not very highly hormone positive. This might be because my 50% ER+ really means that the pathologist saw that 50% of the tumor cells had estrogen receptors on the surface but 50% did not. However, is there one cell over another that dictates which line is more expressed?

I would pursue an answer to this question. It will not influence your chemotherapy but it would influence getting an antihormonal (Tamoxifen, Arimidex, Femara or Aromosin) after chemo and (maybe) rads are done.

I hope this helps you get your hands around this alittle better. At first, this seems complicated but you will learn more than you ever thought. However, this helps you ask questions and make sure the right things are happening. Your tumor behavior sure is interesting. Let us know how your onco pursues this interesting information.