Expert: Claes-Gustaf Nordquist, M.D. - 6/10/2010

Question
QUESTION: First Name i mention is my mother.63 yrs of age.
she gone through the surgery of left breast.
MRM -16X14X3CM
HER histopathology report came now.
Impression:Features are consistent with invasive ductal carcinoma-Not otherwise specified,MBR grade III,involving left breast with free resected margins,no(0/12)lymph nodes involvement.
Pathologic staging -pT1c pNo pMx.
Advised IHC with ER,PR,Her2 Neu.
after seeing this report Dr.told me report is ok,no need to do chemo-radio.
He advised 2 test
1.ER/PR
2.HER-2-NEU

i need ur opinion sir.
surendra
Hyderabad
9948045248

ANSWER: Yes I think those tests of her tumour should be done - should actually be done automatically, but that no decision on any further treatment can be made until the results of those tests have been seen. Furthermore I need to know how big was her tumour and what treatment has she received so far - what kind of surgical treatment?





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---------- FOLLOW-UP ----------

QUESTION: Dear sir,ER,PR,Her2 Neu.report came today,
here the reports details
Impression:Features are consistent with invasive ductal carcinoma -Not otherwise specied,MBR
grade III,involving left breast with
free resected margins,no(0/12) lymph nodes involvement.
Pathologic staging -pT1c pNo pmX.
immunohistochemistry:
1.ER:Grade II nuclear positivity in 60% of invasive tumor cells(Greade III positivity in 95% OF cells of DCIS)
2.PR:Nuclear positivity in 80 % of tumor cells
3.Her 2 Neu: Grade II Membrane positivity in 90 % of tumor cells.

now tell me what should i do?
i need ur opinion for further treatment,precautions.
thanking you in advance.
warm regards
surendra

ANSWER: With these findings BOTH (anti-) hormonal therapy & chemotherapy SHOULD be used! If not her complete breast was removed also radiation therapy SHOULD be used! Good luck!






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---------- FOLLOW-UP ----------

QUESTION: Thanq sir,here Dr. advised a F.I.S.H.Her 2 Neu.test.
He told me no need of Radiotherapy.for chemo he advised me above Test. is it beneficial for further treatment?if chemotherapy advised how many cycle need to give?how much gap in days required in two cycles?

regards
surendra

Answer
I NEVER give detailed advice on chemotherapy here as there are too many unknown factors involved. Factors only her own doctor knows. So you MUST discuss her chemotherapy with her doctor. With regards to radiation therapy that depends on how her surgery was done. If only a part of her breast was removed I would prefer to recommend radiation therapy. But other doctors may reach another conclusion. Yes that test should be done!





You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128     There is no restriction to the number of questions there.