Missing PR result

Ask our Nurses your questions
1

Hi, I was diagnosed with ER weakly positive, HER2- stage 2b (two lymph nodes invoked) in November last year. Since then I’ve had five rounds of chemo (three EC and two docetaxel). My tumour has shown growth since my last scan in Feb so I’m not having the last round of docetaxel and am instead going to surgery earlier, in two weeks.

I did notice at the time but didn’t realise it might be important, but my PR status was not tested and isn’t in my pathology report from the biopsy back in November. No one has mentioned this is an issue, but I’m now worried that this would have impacted decisions so far.

is this normal that PR wouldn’t have been tested? Or usual given that one result was positive and the other negative (ER positive and HER2 negative).

I’m assuming the full pathology will be established after my surgery and the decision to give me chemo was based on tumour grade and lymph node involvement, but I’m now worried something’s been missed.

2

Hiya

My uneducated guess is they haven’t tested for a reason, but the best thing you can do is to ring your BCN and have a chat with her about it. They do sometimes overlook things so it is better to nudge them. I’m in a similar position re not responding to Neo adjuvant chemo as well as hoped, so had final docetaxel cancelled and an earlier op. I get full pathology next Friday which will be four weeks post op. That is where I expect to get news of grading and lymph node involvement.

Good luck. x

3

I was an 8/8 estrogen positive & HER2 1 I think & like you no progesterone was shown either in my biopsy or after my mastectomy. I haven’t questioned it in amongst everything else that was happening so also a question for next time I’m with the team. Will share if I get an understanding before you x

4

Hi Jaygo, thank you for your reply and I’m sorry to hear you’ve had similar experiences to me. I think after reading more about it the PR isn’t relevant to the decision for me to have chemo, I think I’m just so confused by the situation (I responded initially then stopped and it started growing again) that I’m trying to rule out any obvious reasons.

I hope your pathology report is as positive as it can be, good luck.

1 Like
5

Hi, thank you for your reply and yes please do update. From reading more around it it sounds like it might be if you’re ER+ and HER2- they don’t do the PR testing straight away as it doesn’t impact on the treatment plan, but that might not be correct. From what I can tell the results will come back for PR after surgery pathology. I’m definitely going to ask when I next speak to my BC nurse though.

6

Hello lucyblue,

Thanks for your post asking about whether it is normal not to have your PR status checked as part of a breast cancer diagnosis.

Most breast cancers are ER-positive. If your breast cancer is ER-positive, including if it is weakly positive, you will usually be offered hormone therapy as part of your treatment. Breast cancers are also usually tested for progesterone receptors, This may be done on the initial biopsy but then may be repeated or confirmed following surgery. Most PR-positive breast cancers are also ER-positive.

You will still usually be offered hormone therapy if your cancer is both ER-positive and PR-positive. The benefits of hormone therapy are less clear for people whose breast cancer is only PR-positive.

Chemotherapy may be given for different reasons, including the size and grade of the breast cancer.

A treatment plan, including the decision to recommend chemotherapy does not alter depending on PR-status of the breast cancer.

As your PR-status is not showing in your pathology report, it may help to talk about this with your treatment team or breast care nurse if you have one, as @Jaygo and @whataloadof suggest. You will get more information following your surgery, including another pathology report, as you say. However, it may help to know that information on the PR-status will not impact on your treatment plan.

We offer a range of free supportive services which you may be interested in. They include face to face and online courses and events. You may also be interested in our Speakers Live sessions which cover different topics in breast cancer.

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Best wishes,

Teresa

Breast Care Nurse

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