Stage 1 Breast Cancer: Key Factors and Prognosis

Stage I breast cancer

Hello, my mother has completed all the tests, and today when reviewing the report, the doctor indicated that it is a malignant tumor, approximately 1.1 cm in size, and currently there is no evidence of metastasis.
The relevant report data is as follows: 1.
ER: Moderately positive intensity in 90% of tumor cells (positive?) 2.
PR: Negative (negative?) 3.
HER2: No staining (-/+++, negative HER2 protein expression) (negative?) (Ab: thermo, clone: SP3) 4.
Ki-67: Positive in 9% of tumor cells.

Is it generally better for ER/PR to be positive? What does it mean if one is positive and the other is negative? Is it generally better for HER2 to be negative? How would you assess the severity of these symptoms?

Ms. Wu, 60~69 year old female. Ask Date: 2016/06/14

Dr. Lai Yicheng reply Oncology

Hello Ms.
Wu,
Thank you for your message.
Here are my responses:
1.
Is it generally better for ER/PR to be positive? What about one positive and one negative? If ER/PR is positive (+), that is considered better.
If ER/PR is positive (+) and negative (-), the positive/negative result is secondary.
If ER/PR is negative (-), that is the worst outcome.
2.
Is it generally better for HER2 to be negative? Yes, HER2 being negative (-) is the best scenario.
If it is positive (+++), there is a one-third chance of metastasis and recurrence.
3.
How severe are these symptoms? Your mother has early-stage breast malignancy.

Reply Date: 2016/06/14

More Info

Understanding Stage 1 Breast Cancer: Key Factors and Prognosis
Hello, it’s great to hear that your mother has completed all her examinations. Based on the information you provided, it seems that she has been diagnosed with an early-stage breast cancer, specifically Stage 1, which is a crucial stage in terms of treatment options and prognosis. Let’s break down the key factors from the report and what they mean for her condition.

1. Tumor Size and Stage: Your mother’s tumor measures approximately 1.1 cm, which is relatively small. In breast cancer staging, tumors that are less than 2 cm and have not spread to the lymph nodes are classified as Stage 1. This is a positive indicator as early-stage breast cancer generally has a better prognosis compared to later stages.

2. Hormone Receptor Status:
- Estrogen Receptor (ER): The report indicates that 90% of the tumor cells are moderately positive for ER. This means that the cancer cells grow in response to estrogen. ER-positive tumors are often treated with hormone therapy, which can significantly improve outcomes.

- Progesterone Receptor (PR): The report shows that PR is negative. While ER positivity is favorable, having a negative PR status can sometimes indicate a more aggressive tumor. However, the presence of ER positivity still plays a significant role in treatment decisions.

- Implications: Generally, tumors that are ER-positive and PR-positive are associated with a better prognosis and response to hormone therapy. In your mother’s case, the combination of ER-positive and PR-negative is not uncommon and can still be managed effectively.

3. HER2 Status: The report indicates that HER2 is negative (no staining). HER2-negative tumors tend to have a better prognosis compared to HER2-positive tumors, which are often more aggressive. HER2-negative status means that targeted therapies for HER2 are not necessary, which simplifies the treatment plan.

4. Ki-67 Index: The Ki-67 labeling index is reported as positive in 9% of tumor cells. Ki-67 is a marker that indicates how quickly the cancer cells are dividing. A lower percentage (like 9%) suggests a slower growth rate, which is generally favorable. Higher Ki-67 levels can indicate a more aggressive tumor.

5. Prognosis: Given the factors above, your mother’s prognosis appears to be relatively good. Stage 1 breast cancer has a high survival rate, especially when there is no lymph node involvement and the tumor is small. The treatment plan will likely include surgery (lumpectomy or mastectomy), possibly followed by radiation therapy, and hormone therapy due to the ER-positive status.

6. Follow-Up Care: Regular follow-up appointments will be essential to monitor her recovery and any potential recurrence. The standard recommendation for follow-up care includes physical exams and imaging tests as needed, typically every 6 to 12 months for the first few years after treatment.

In summary, while your mother’s diagnosis of breast cancer is understandably concerning, the early stage and the specific characteristics of her tumor suggest that she has a favorable prognosis. It is crucial to maintain open communication with her healthcare team to understand the treatment options available and to make informed decisions moving forward. Encourage her to ask questions and express any concerns she may have regarding her treatment and recovery process.

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