I was diagnosed with cancer in left breast in early October (grade 2 idc, c10mm, oestrogen progesterone both +, HER2 -ve), I’m 56 and postmenopausal. I had magseed guided wide local excision and sentinel node biopsy at the end of the same month. My histology from op was 14.4mm grade 3 idc with high grade dcis, ER8, PR8, HER2-ve, all margins clear, NPI 4.288 SNB 0/3.
I am currently awaiting score from oncotype testing. These actual results/numbers weren’t discussed/provided at my post op meeting with surgeon so wasn’t aware of them/would have asked what they meant then. Chemotherapy wasn’t discussed at first diagnosis (just radiotherapy and endocrine treatment) but the oncoscore will be used to help decide if would be of any benefit.
Just would like to know what ER/PR, NPI numbers mean/indicate? Many thanks
Hi perrie68
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@perrie68 I’ll reply just now to save you waiting. I don’t know about NPI but can help with the rest. ER and PR are estrogen and progesterone and the scale gives from 1 to 8 with 8 being the highest. It means your tumour is highly ‘sensitive’ to estrogen and progesterone. The grade of tumour is 1-3 with 3 being the grade that looks the most different from normal cells. For the Sentinel biopsy 0/3 means none of the 3 nodes had cancer cells. I was diagnosed in July 23 and also had ER8 and PR8 with grade 3 (I had 2 tumours that were ca 25mm each). It sounds scary but for me I rationalised it by thinking my cancer would be more responsive to the Aromatase inhibitors and this seems to be the case. I was stage 3 prior to surgery but after surgery (and ca 2 months of AI) both were grade 2. I had oncotype test which came back as 18. So <1 % benefit to having chemo. So just 5 sessions of radiotherapy followed by 4 boost to target area. Had my 1 year mammogram in August this year and all good. On a couple of other things to minimise recurrence, but so far so good.
Hope that helps and good luck on your journey ahead.
Hi perrie68
Thanks for posting.
It’s natural to have questions about your histology and want to understand why treatments are being recommended.
You say you are waiting on an Oncotype test to determine if you need chemotherapy and want to know what ER, PR and NPI score means. While we are unable to comment on your individual pathology results, we can explain in general what the terms mean.
The Nottingham Prognostic Index (NPI) is a scoring system that estimates prognosis. The number given helps your treatment team plan your treatment. As your surgeon didn’t discuss the NPI score with you, it’s important to go back them to ask about it as they are best placed to discuss what your score means for you.
As @bordercat says ER and PR are oestrogen and progesterone receptors. The histology results give a score between 0 and 8. This is known as an Allred or quick score and shows the amount of hormone receptors on the cancer cell and the proportion of cancer cells with receptors. The higher the scores, the more ER+ or PR+ the breast cancer is, usually any score above 3 will mean that treatment teams will recommend endocrine treatment.
Our booklet understanding your pathology results has further information that you may find helpful.
Talking to someone who has had a similar experience can often be helpful. Our Someone Like Me service can match you with a trained volunteer who’s had a similar experience to you. You can be in touch with your volunteer by phone or email and they can share their personal experiences to answer your questions, offer support or simply listen to how you are feeling.
You can ring the Someone Like Me team on 0800 138 6551 or email them at someone.likeme@breastcancernow.org, so they can then match you to your volunteer.
We also offer a range of free supportive services which you may be interested in.
Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).
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Best wishes
Louise
Breast Care Nurse
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