Expert: Claes-Gustaf Nordquist, M.D. - 11/3/2008

Question
Diagnosed 10/2006. Oncogene score: 33 high risk for recurrence. Had dose
dense A/C, 1 Taxol followed by Taxoterre. On Arimidex for 5 months,
stopped because of extreme joint pain. On Tamoxifen for 4 months, just
stopped because of muscle cramps plus overall fatigue, depression and hot
flashes.
Prognostic markers: ER-. PR+ . Her2neu (DAKO Hercep test) Score 1-
(negative). Mib-1: 40 of cells positive. Invasive ductal carcinoma Nottingham
grade II of III: 2.2cm. Four Lymph nodes: negative. 3 points for poor tubule
formation, 3 points for high nuclear grade, 1 point for low mitotic activity.
Plus high grade ductal carcinoma, intermixed with the invasive component,
which accounts for approx 1/4 of the tumor.
AJCC Pathologic stage: pT2/pN0(i-)/MX.

My oncologist told me that hormone therapy following surgery and chemo is
as important as the chemo was in "curing" my breast cancer.

My question is because I am ER-/PR+ , will the hormone therapy actually
help to prevent recurrence? I wonder if the hormone therapy with its many
side effects is worth the misery since my tumor is estrogen receptor
negative?

Answer
This is a tricky question. Yes such therapy is probably less certain here. But since - even though you have tried to provide me with all necessary facts - my clinical knowledge of you is extremely limited I must ask you to discuss this matter with the dr. in charge of your medication since I have a firm principle here of not usurping that position! You are not helped by a back seat driver with limited information! Good luck!