Question about how to test for having Estrogen+ cancer cells

Posted by stephsteiger @stephsteiger, Feb 19, 2023

My mom was just diagnosed with DCIS breast cancer. She has met with two surgeons in the past 10 days to determine the best path forward. When I compare the reports of each doctor one thing stands out as very odd - one report says that her cancer is estrogen positive and the other says that it's estrogen negative. How is this possible? To me it's like saying someone is "kind of" pregnant. Either you are or you aren't. Is there any explanation for this kind of discrepancy?

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This has to be clarified to go forward with treatment.

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Was one test from a biopsy and the other from surgical specimens?

I had conflicting results for HER2. This kind of discordance needs to be retested and/or explained. I actually got 4 opinions until I felt certain.

Are your mom's two ER scores close to the line between negative and positive? That might explain it-?

An Oncotype test usually guides treatment choices with ER+ and HER2-. Your mom needs certainty on the ER to move forward, as @timely said. Estrogen status can often be key to treatment because when highly positive, hormonal meds may be effective without chemo.

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I appreciate both of you for responding.

@windyshores – the specimen was from a single biopsy. We got some more information today – apparently the first facility we met with possibly didn't share all of the biopsy slides with the second facility? There have been a few eyebrow-raising things now that concern us about the first facility's handling of my mom's situation so we are going with the second facility.

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@stephsteiger

I appreciate both of you for responding.

@windyshores – the specimen was from a single biopsy. We got some more information today – apparently the first facility we met with possibly didn't share all of the biopsy slides with the second facility? There have been a few eyebrow-raising things now that concern us about the first facility's handling of my mom's situation so we are going with the second facility.

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Different parts of the tumor can have different characteristics. Is that how the first facility explained the discordance? Glad you have a facility you trust at this point!

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