[Becky]

Dear Marcia

I am also ER+(50%) and PR neg and there are more of us on the board (Jean and Pink Girl too). There is not alot of data on this pathology especially if you are NOT Her 2 as well like we are. I will tell you what I have learned.

When bc loses the progesterone receptor but not the estrogen receptor, its a pretty good indicator that something else is positive. In our case, we at least know the devil is Her2. If you are not Her2, you are probably positive for another receptor that isn't tested for yet like Her1 (aka EGFR), Her3 or IgGR. At least with Her2, there are drugs for it, plenty of new ones coming out and tons of research.

At lower % of ER (50% or less) and a negative PR may indicate resistance to Tamoxifen or other therapies however, it isn't clear if one is resistant or if another pathway is taking over. For example, when Herceptin didn't exist, you (or I) would take Tamoxifen but that wasn't our "big devil", Her2 was our big devil and a recurrence would likely be that. There is not alot of information on these new times with the advent of adjuvant Herceptin therapy. We are the ones writing the books.

Another interesting study that Jean and I saw together was a researcher who looked at the molecular assay of bc that was ER+PR+, ER+PR-, and ER-PR-. He did not divide these out by Her2 status or any other receptor, just the hormone receptors. When he did the molecular "pictures" of these pathologies he found some interesting footprints. Most ER+PR+ cancers had the same picture as did ER-PR-. However, most ER+PR- cancers looked like one or the other. A small percentage did have their own unique picture and these were considered true ER+PR- but the % was very small. Therefore, your picture might look like ER-PR-, Jean's may look like ER+PR+ - I think you get it. The really AMAZING thing in the study was that some ER+PR+ picture looks like ER-PR- and vice versa which could lead one to think that women who are ER-PR- but recur and new pathology says its still hormone negative just MIGHT respond to Tamoxifen or an AI anyway because the molecular assay doesn't match the pathology.

Keep the faith Marcia! I am still here (almost 6 yrs) and Jean just celebrated 5 yrs and Pink Girl is almost 5 yrs too and so will you.

I will say though, its hard to find anything about the PR- as most studies concentrate just on ER and not what PR is doing in general.

I believe also, in general, that the recurrence rate would be more upfront and the ER+ 6/7 yr blip is due to reawakening of the slower growing ER+PR+ cancer after hormone therapy (5Yr) is complete. It makes alot of sense. One gets 5 yrs of Tamoxifen (and these stats are based on 5 yrs of Tamox, no AI, no 5 yrs Tamox followed by 5 yrs Femara) and it ends. By this time, you are really 5.5 yrs from surgery, maybe alittle longer. The blip is at 6/7. Higher ER/PR values might well benefit from longer hormonal therapy (as the 5 yr Tamoxifen followed by 5 yrs Femara proved to this group).

Unfortunately, only time will tell and its so difficult in the beginning but trust me, it gets better with time!