Pathology result

Hi, I was told by my consultant that I had an early hormone positive HER negative breast cancer with a good prognosis. I received a letter today that states that the tumour was ER positive , PR Negative , HER2 negative . The PR negative result is worrying in that I read the prognosis is not so good. Can you explain the result for me

My breast care nurse said they dont co sider pr starus significant. But you could email the breast nurses on here to ask.

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Can you call your consultant‘a office and speak to a breast cancer nurse there who can talk you through your results? If not, call the BC Now nurses on 0808 800 6000 and they may be able to give you some clarity. Hormonally fed tumours are normally described as Er+ which means oestrogen so it may well be right that the Pr element is less relevant.

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I was never told what my Progesterone result was. When I asked my consultant she said it was irrelevant and didn’t matter. Still don’t know. Can anyone else explain its relevance?

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Only nurses will respond to this query. If you’d like to ask general readers though you can post this question to them. The simple answer is it’s not relevant in regards to treatment although studies do show it is relevant in prognosis. For example, people with higher progesterone levels tend to have lower oncotype scores. Of course nothing is set in stone though.

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You have a hormone positive breast cancer. Generally that means you have a better prognosis than someone with hormone negative breast cancer. But it also depends on so much else like HER2 status, node involvement, type of cancer, size of tumours etc. Likewise, there can be upsides to having a more aggressive cancer than a slow, inert one. It’s simply not a one size fits all thing.

You have a very common cancer. I have the same as you with it being ER+ 8/8 and HER2 low. I’ve had surgery, as mid-chemo (EC-T) and I will also have 3 weeks of radiotherapy. I had node involvement though so you may not get the whole shebang.

Right now, you are gobbling up info and I did the same and it kept me sane. This gets much easier once you start treatment and are focussed on that. I found it also becomes more reassuring once you’re through surgery and onto oncology with more support and touch points.

HER2 only dictates whether they give chemo before surgery or after. HER2 negative wouldn’t normally have chemo first unless they need to get the tumour to shrink to operate.

ER+ has the gift of Tamoxifen which has transformed survival rates. It blocks estrogen receptors on cancer cells so that they can’t absorb any estrogen and ‘feed’. They can’t stop you producing estrogen because it’s not just ovaries that do that. Fat cells do it too. So instead, they often given a ovarian suppressant or they can be removed if they offer that. Chemo puts you into menopause anyway (if you haven’t already been through it). It’s hard going emotionally when that happens (and I don’t even want more kids!) but I think that’s also because Chemo is damn hard so it’s a lot to process when your body has already changed from surgery.

You’re at the hardest part of all of this. It gets easier once you get to actually battle it rather than feeling redundant and impatient. You will be happy again. You will stop worrying again. You will find some absolute beauty and amazingness in cancer and it will blow you away. Yes, it’s not easy, but it’s honestly not all bad.

Everything crossed for you! X

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Hi llanwinno123

Thank you for posting. It is understandable that you have questions about your hormone receptors having received your letter today.

Breast cancer cells are routinely tested for both oestrogen (ER) and progesterone (PR) receptors to determine which treatments will work best. Hormone therapies are only of benefit to cancers that are oestrogen positive. A cancer that is ER positive and PR negative is classed as hormone positive and is still likely to respond to hormone therapy. Some studies have suggested that some breast cancers which are strongly PR positive may be associated with a better prognosis than those that are PR negative but the evidence is not clear and more research is needed. However many women who are ER positive and PR negative will respond well to hormone therapy and not have a recurrence. As @Jolow, @Tigress and @Frances55 say the progesterone receptors are not usually thought as significant as the oestrogen receptors.

Prognosis describes the likelihood of the cancer returning (recurrence) after treatment and is estimated by looking at a number of factors as well as the hormone receptors, such the type of cancer, the grade and the size and whether any lymph nodes were involved.

As suggested in some responses, it may be helpful to talk with your breast care nurse or treatment team about your pathology results and how your treatment plan will help reduce the risk of recurrence for you.

We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.

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 more 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). If you would prefer one of our nurses to call you. To do this, please complete this form ticking the box agreeing to a call back.

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Best wishes


Breast Care Nurse

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