- Question from Peg: My recent pathology report after lumpectomy stated, "estrogen and progesterone receptors negative." Should I ask for more details (i.e., percentages to get a more specific diagnosis)?
Estrogen and progesterone receptors are reported as positive or negative. Laboratories establish a cutoff point related to the percentage of cells which stain with the antibody. If the number of cells which stain is greater than that predetermined cutoff point, the result is called positive. If the number is below that number, the result is called negative.
The pathologist may also provide a percentage of cells that are positive for each receptor. Or this percentage may only be given if the cells are at the borderline of what's considered positive or negative, like being 5 to 10 percent positive. This is explained in the pathology report. We think it's best to report both pieces of information: if it's positive or negative, and what percent positive.
Marisa Weiss, M.D.
If your hormone receptor status is positive, that predicts two things—first, a better overall outcome, and second, a good response to hormonal therapy. The difference in outcome between positive and negative test results is only moderate. The meaning of the test in terms of choosing treatment options is much more important. The higher the percentage of estrogen receptors positive, the greater your chance of responding well to hormonal therapy. The lower the hormone receptor positivity, the better response you'll have to chemotherapy.
Some centers will say the cancer is hormone receptor negative if 10 percent or less of the cells shows receptors. Some centers will use a 5 percent cut-off. Still, cancer with this level of estrogen- receptor positive energy can still have a good response to hormonal therapy.
The important take-home message here is, find out if your estrogen receptor negative result is 0 percent, 5 percent, or 10 percent. If it's 5 to 10 percent, you might want to be able to take advantage of an important type of treatment that could make a difference to you.
The Ask-the-Expert Online Conference called Your Operative and Pathology Reports featured Beth Baughman Dupree, M.D., F.A.C.S. and Ann Ainsworth, M.D. answering your questions about details of pathology and operative reports and the importance of discussing them with your doctors.
Editor's Note: This conference took place in November 2004.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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