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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Biopsy report of breast lump showed desmoplasia and mild lymphocytic. Suggestion

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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2617 Questions

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Posted on Sat, 12 Jan 2013 in Breast Cancer
Question: My wife trucut biopsy right breast lump report says histological features of infiltrating duct carcinoma, Grade -2, modified BR score :6(2*2*2), there is a marked desmoplasia and mild lymphocytic...
The breast lump got trucut biopsy and report cance the oncologist has suggested few test like ER,PR,CErbb2 and ki67 and bone scan test ,after that he will start cemotherapy to kill cancer cells ,...
is the line of treatement ok or have to get 2nd opinion.
The HER-2 protein expression assessment scoreis zero and negative and ER/ PR is positive and quick score is 8 ,As per Ki67 is 15 % signification and what help this is going to do ans Dr. has sugested 4 cycles of chemo then surgery and four cycle chemo and further treatement for six months.

yiur valuable suggestion on this finding pl. XXXXXXX
doctor
Answered by Dr. Robert Galamaga 6 hours later
Hello and thank you for sending your question.

Your question is a very good one and I will work on providing you with some information and recommendations.

From the information you provided it appears that she has a mass that is larger than average and in this case the treatment with chemotherapy prior to surgery would be standard of care.

The positive estrogen and progesterone receptors on the specimen are actually a favorable prognostic factor. For her she will receive chemotherapy followed by surgery and additional chemotherapy and then hormonal treatment. The hormonal treatment will continue for at least five years.

Regarding the situation you have described it appears that she is obtaining optimal medical advice and I see no additional recommendations that would benefit her at this time.

Thanks again for sending your question. Please let me know if you have any additional concerns.

Dr. Robert
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga 9 hours later
thanks for your reply but you have not mentioned about side effects of chemo and radiation and what extra care my wife has to take during this period, as i came to know that hair loss ,blood counts wbc and rbc get reduced.How this can be maintained during this period may pl. be described and guided from your end.
rgs



The HER-2 protein expression assessment scoreis zero and negative and ER/ PR is positive and quick score is 8 ,As per Ki67 is 15 % signification and what help this is going to do ans Dr. has sugested 4 cycles of chemo then surgery and four cycle chemo and further treatement for six months.
doctor
Answered by Dr. Robert Galamaga 19 hours later
Side effects are variable but include: fatigue, nausea, vomiting, diarrhea am hair loss. The doctor will prescribe medications to limit these side effects.

Also, chemo can lower blood counts which is why the doctor will also monitor labs through the course of treatment. If counts go low, treatment may be delayed by a week or so while the bone marrow recovers.

The 15 percent in this case does not change treatment recommendations. In more aggressive cancers the Ki67 may be very high - 80 percent or so. In this case the ki67 does not alter treatment or prognosis. This is a new variable that is being looked at in breast cancer and right now there are studies looking at significance of the value. For the time being I would not worry about that number. Again I will not affect additional decisions in her case.

I am confident she will do very well with the treatment recommendations made thus far.

Thank you again for allowing me to put participate in discussion of your medical questions. Please do not hesitate to ask any additional questions if you would like to review those as well.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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