• After lumpectomy, path results show triple negative in the primary tumor and ER+ only in the secondary one. What's next?

    Asked by Loafer on Sunday, September 30, 2012

    After lumpectomy, path results show triple negative in the primary tumor and ER+ only in the secondary one. What's next?

    Does this mean I am triple negative or mixed? The tumors are both grade 3 with no lymph nodes impacted. I was trying to avoid chemo, but don't think it's likely now. No family history(adopted), Caucasian, catholic and over 50 which doesnt qualify me for the BRAC testing. Are there other tests or trials I should participate in?

    11 Answers from the Community

    11 answers
    • lynn1950's Avatar

      Hi Loafer, The good news is it hasn't spread to your lymph nodes. Your oncologist will tell you what comes next...whether or not you are a candidate for chemo and/or radiation. You don't say your HER-2 status. Any old way, it is one step at a time.

      You can go to csn.cancer.org ; it has a trial finder link on its site. It is also a great support site.

      almost 8 years ago
    • SueRae1's Avatar

      Get the BRACA test, you don't know what the history of your birth family, so you can never tell. your team will met with you and inform you of what they think is the best treatment plan for you at this point. There other mutation available, which can help with your treatment. I am currently having a BreastNext Panel (http://www.ambrygen.com/tests/breastnext) being performed to determine what mutations I have that may trigger cancer. In addition Foundation Medicine (http://www.foundationmedicine.com/) is sequencing both my cancers to find out what mutations they contain, with an eye to cross over mutations. My team is hopeful the results will help put together a more targeted treatment plan

      almost 8 years ago
    • nancyjac's Avatar

      I'm not a hundred percent sure about this because it is such an unusual situation but in any case, I think it would be worth discussing with your oncologist. I have never heard of having different ER results from 2 different tumor of the same cancer. So it seems to me that you have 2 different cancers that were growing separately resulting in 2 separate tumors. In any case, being ER+ or ER- is rarely a determining factor for chemo. The only difference it makes is whether are not hormone suppression/blocking meds are appropriate post active treatment.

      almost 8 years ago
    • Blepta's Avatar

      Is the reason for not qualifying for BRAC testing your age? It must be, because my Mom had invasive infiltrating ductal carcinoma, is white, and Catholic. Our BRCA comes from the Norwegian lineage, so if you look Norwegian at all I would not rule it out. Knowing whether you have BRCA or not is helpful in that you will know that you are at higher risk for ovarian cancer, and would also cause you to consider bilateral mastecomy rather than lumpectomy. Also, if you have children they would benefit from the information. If I were you, I would get a second (or third) opinion regarding the BRCA testing. Best wishes to you on your journey to healing.

      almost 8 years ago
    • carm's Avatar

      Although it sounds like you have not had the BRCA testing, it seems that you are BRCA1 and BRCA2 positive. BRCA1 is the triple negative, and BRCA is the ER+. Genetic counseling could get you the tests you need as more and more BRCA testing is considered preventative, if not for you than for your offspring. As for the results you have so far, the treatment would be the choices suggested to you by your oncologist and that includes any prophylactic surgeries. Because yours is involved in the ducts, sometimes removing the ducts are the option especially if no lymph involvement is evident. There is a website called the chemotherapy advisor at chemotherapyadvisor.com and next to the home tab there is a cancer type tab. It is free to join the site and you can look up ductal carcinoma and it will tell you the common treatments for it. Best of luck to you, Carm.

      almost 8 years ago
    • ruthieq's Avatar

      I was over 50 when I had BRCA testing, what does age have to do with it? If you have children they may be impacted by a positive test. I am also Caucasian. Who told you these criteria? As for status on the hormones, They probably will treat you as a ER+ because in one tumor you are.(which qualifies the secondary as another primary actually) The treatment is the same for both its the hormone therapy after chemo and rads that is different (TNBCs don't get AIs). Get the BRCA test if you have children or known natural siblings. hugs and good luck.

      almost 8 years ago
    • DebD's Avatar

      Since you have one tumor that is ER+ you will most likely need to take an anti-estrogen treatment like tamoxifen for 5 years. There are several different kinds of them, my tumor was triple negative so that's not an option for me. There anti-estrogen treatment will not affect the triple negative tumor, but is indicated when you have a ER+ tumor.
      Why no BRCA testing since you're over 50? I have never heard that before. Since you have no family history I would strongly suggest you get tested.

      almost 8 years ago
    • Nellie's Avatar
    • SandiD's Avatar

      I had the Oncotype Test as well as BRAC. I don't know my mother's history, but there is no cancer on my father's side. This is my 2nd cancer. I did not test positive!

      Your oncologist should be able to answer all your questions along the way. Also the nurses are usually very helpfull too, so ask! A very good resource is www.breastcancer.org. I use that all the time.

      Whatever happens I wish you the best. Fight like a girl with all you've got my friend!

      almost 8 years ago
    • Lindy's Avatar

      BRAC testing applies to you only, information if positive would impact vigilance. I had it done at 67 so don't know why you do not qualify. I did it for my daughters and then found out they would have to be individually tested :-(

      almost 8 years ago
    • Loafer's Avatar

      Thanks everyone for great advice! Met with onc today and moving forward with oncotype and braca testing. Have stage 1 cancer, with grade 3 cells. Recommending 4 rounds of docetaxel & cytoxan.

      almost 8 years ago

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