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ER and PR Test. Estrogen and Progesterone receptor status tests will show whether or not one or both of these hormones fuel the tumor Cancer that is hormone-sensitive is slightly slower growing and has a better chance of responding to hormone-suppression treatment. ER and PR Test. ER(+)
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ER and PR Test • Estrogen and Progesterone receptor status tests will show whether or not one or both of these hormones fuel the tumor • Cancer that is hormone-sensitive is slightly slower growing and has a better chance of responding to hormone-suppression treatment
ER and PR Test • ER(+) • Estrogen is causing the tumor to grow • Cancer should respond well to hormone suppression treatments • ER(-) • Tumor is not driven by estrogen • Results will need to be evaluated along with other tests such as HER2 status
ER and PR Test • PR(+) • Cancer should respond well to hormone suppression treatments • PR(-) • Tumor is not driven by progesterone • Another test is needed such as HER2 status
Metastatic Work-ups • Staging Investigations in Patients With Breast Cancer (The Role of Bone Scans and Liver Imaging) • Rajiv Samant, MD; PradipGanguly, MD • The goal of these tests is to identify those patients with incurable disease so that a more realistic prognosis can be given and their treatment can be tailored accordingly • Isotopic bone scans • Isotopic liver scans or liver ultrasound
Metastatic Work-ups • Staging Investigations in Patients With Breast Cancer (The Role of Bone Scans and Liver Imaging) • Rajiv Samant, MD; PradipGanguly, MD • Conclusion • Our results confirm the low yield of routine bone scans and liver imaging among patients with asymptomatic, pathologically confirmed, early stage (T1-2 N0-1) breast cancer. Therefore, we do not recommend these tests for such patients, although intensive investigations are appropriate for more advanced (stage T3-4 or N2) tumors.
PLAN: Radiotherapy/Tamoxifen if ER+
Radiation Therapy • Uses high levels of radiation to kill cancer cells or keep them from growing and dividing -- while minimizing damage to healthy cells • May be used for all stages of breast cancer • Adjuvant therapy to reduce the risk of local recurrence to the chest wall and supraclavicular lymph nodes
Anti-estrogen Therapy • Adjuvant therapy with tamoxifen(Early Breast Cancer Trialists’ Collaborative Group) • 25% reduction in the annual risk of breast cancer recurrence • 7% reduction in annual breast cancer mortality • 39% reduction in the risk of cancer in the contralateral breast • Advantage over chemotherapy: absence of severe toxicity
References • Hormone Receptor Status and Diagnosis - Estogen and Progesterone by Pam Stephan; http://breastcancer.about.com/od/diagnosis/p/hormone_status.htm • Samant, R., Ganguly, P. 1999. Staging Investigations in Patients With Breast Cancer (The Role of Bone Scans and Liver Imaging). ARCH SURG/VOL 134. • Breast Cancer: Radiation Therapy: What to Expect;http://www.medicinenet.com/radiation_therapy_for_breast_cancer/article.htm • Schwartz’s Manual of Surgery