QuestionQUESTION: 1.There are No HER2 receptors.
2. You ask to see all my pathology results. The only ones that I had were the ones I sent to you when I asked the question "I am Puzzled" and the one before that, I have wrote to you twice and both times were the pathology results.
Do you need for me to re send
ANSWER: Dear De Etta, I answer a very big number of questions over time here (all together there are close to 12000 questions & answers in my library now). I can not -except in some very special situations - search for old answers and questions. If you send in new questions as completely new ones with no connection to the old ones I have no reference to the old ones. So PLEASE send me all the material you have so I can study it all together!
You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 There is no restriction to the number of questions there.
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QUESTION: These are the results from allonly had 2:
First Biopsy: because of my weight I needed a Incisional Biopsy called a partial mastectomy. Diagnosis-Left Breast Ductal Carcinoma In SITU, Nuclear Grade 2,papillary,micropapillary and cribriform Types with associated microcalcifications.The ductual carcinoma is present in 6 of 17 blocks and extends to less than 0.1cm of the posterior and anterior margin of resection. (B.)2008- Last Exam Findings after the lumpectomy for breast cancer: There are scattered fibroglandular densities. S/P lumpectomy. Benign, no evidence of malignacy.
2009- IMPRESSION - Left Breast Category 5
Status post lumpectomy. Calcifications in the subareolar region suspicious for DCIS. Sterotactic biospy is recommended. Right Breast Negative. no evidence of malignancy. Normal interval.
There are No HER2 receptors.
Second Biopsy:January 2010
The Specimen consists of eight tan needle cores of soft tissue, the largest measuring 5.7 cm in length and 0.6 cm in diameter and the smallest measuring 101 cm in length and 0.7 cm in diameter.
Section: in toto
A1-A4 - left breast (2each)
ah
The Final core biopsy pathology results are left breast: Ductual Carcinoma IN SITU of Breast, intermediate to high grade, Comedo, micropapillary, and cribriform patterns, with microcalcifications.(see Immunohistochemistry results)
Stromal and periductal fibrosis of breast.
ER / PR By IMMUNOHISTOCHEMISTRY
Type of % of positive Staining Interpretation
Receptors Nuclei Intensity of results
Estrogen 80% Intermediate Positive
Progesterone 40% Intermediate Positive
to strong
Comment: Both Estrogen and Progesterone nuclear receptors are positive In the DCIS lesion
Breast Cancer:
Numerous studies on formalin-fixed paraffin embedded tissue sections using Monoclonal Anti-Human Estrogen Receptor Clone 1D5 to be accurate in providing prognostic information regarding endocrine therapies with a sensitivity of 98% and specificity of 73%(if 10% positive nuclei cut-off is used). We report a positive staining for both ER and PR when 10% or more tumor nuclei are positive.
Clones used:
Immunohistochemical evaluation for Estrogen Receptor (ER) and Progesterone Receptor(PR) was performed on formalin-fixed paraffin-embedded tissue sections using Monoclonal Anti-Human Estrogen Receptor Clone 1D5, Monoclonal Progesterone Receptor clone Ab-8 (hPRa2+hPRa3) and the Vector ImmPress Peroxidas Anti-Mouse 1g detection system.
The pathologist Joseph F. Tomashefski,Jr., M.D.
There are No HER2 receptors.
ANSWER: Thanks! So you unfortunately have more cancer in situ (cancer stage 0) in your left breast. In this situation - since more than one cancer were found in your left breast and your cancer is hormone receptor positive - I suggest a full mastectomy of your left breast (can be combined with a breast reconstruction there), Postsurgical hormonal therapy and regular frequent check ups of your right breast including mammography, MRI & ultrasound breast scans and at least needle biopsies of any lesions seen there.
You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 There is no restriction to the number of questions there.
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QUESTION: What exactly does(cancer stage 0) and cancer is hormone receptor positive and Postsurgical hormonal therapy mean. My doctors are not recommending a full mastectomy.
AnswerA cancer in situ = a cancer stage 0 = a cancer that has not yet spread outside its immediate site of origin. Well according to your pathology reports it has been demonstrated that your breast cancer has receptors (= is sensitive for) for female sex hormones (just like ordinary breast gland tissues) both estrogen and progesterone.
Hormonal therapy is a treatment with drugs (antihormones or hormones) that will try to stop cancer in your breasts from growing and developing. Since you now have developed at least 2 cancers in situ in your left breast and therefore seem to have a tendency of developing cancers there (and probably in both breasts) I think it proper to inform you that one way of eliminating your risks of breast cancer in your left breast is a mastectomy there. If your risks of any breast cancer should be eliminated completely you need a bilateral mastectomy (both breasts). An alternative is lumpectomy of your remaining cancer in your left breast followed by radiation therapy of your left breast and then hormonal therapy and regular very frequent breast check ups of BOTH breasts as I have previously described. Actually I think it should be the duty of your doctors to inform you of these things! How else an you make any informed consent to any treatment suggestions?! Good luck!
You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 There is no restriction to the number of questions there.
