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AskedPublicly Submitted Question
6/21/2017My mom is 42 years old.
Right breast cancer, invasive ductal carcinoma NOS
Tumor Size: 2.4 cm
SBR grade 3 ( tubule formation 3. Nuclear pleomorphism 3. Mitotic count score 2.)
Ductal carcinoma in situ is present ( intermediate to high nuclear grade with central necrosis)
NO lymphovascular invasion is seen
Immunohistochemical stains are done and invasive malignant cells show the following results:
-ER POSITIVE (moderate nuclear staining in about 70% of the invasive cells Allred score 7/8)
-PR POSITIVE ( Moderate nuclear staining in about 40% of the invasive cells Allred score 6/8)
-Her2-neu Negative Score 0
Ki-67 index : 40%
E-cadherin POSITIVE.

Done with 2 chemotherapy sessions before the surgery "Lumpectomy" and after the surgery continue 4 sessions of chemotherapy in total 6 sessions done. After her lumpectomy surgery we knew that she still has positive deep margins on her chest wall and on her lateral side. Her doctor suggested to do an MRI scan and theres a possibility to undergo another surgery to clean the margins and after if its came out clean she would undergo radiation for a month.

*Was chemotherapy a good approach for her situation?
*Does her ki67 index:40% means that she's in high risk of recurrence ?
* I am her daughter and I have a twin sister we're 22 years old, when do we start screening? should we test for genetic testing?
RepliedJHU's Breast Center Reply
6/21/2017Commonly chemo is done first to shrink tumors to become smaller if they have some size to them, or if the cancer is ER negative and HER2 positive. Her situation was a bit different. inquire if oncotypeDX test was done or not. Request too that her case be presented to the weekly breast cancer tumor board for a team discussion to determine how to address the positive chest wall margin.

for you and your sister, take your mother's age and subtract 10. if that number is below 40, that is the age you will likely begin breast imaging screening. From a genetics perspective, it is best to test the family member who has had breast cancer. if she has no gene mutation then you don't need testing.

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