Achieved PCR! Now what?
I’m 34 and was diagnosed with multifocal grade 3 invasive ductal carcinoma of the left breast. My tumor was ER low positive (about 10% weak staining), PR very low (1–2%), HER2 negative, and molecular profiling classified it as basal subtype, so biologically it behaved more like triple negative breast cancer.
I completed neoadjuvant chemo with 4 ddAC followed by weekly Taxol (12), and just got my final pathology after bilateral nipple-sparing mastectomy.
The pathology showed a complete pathologic response, which is amazing! No residual cancer in the breast and the 2 sentinel lymph nodes removed were negative. My surgeon said no radiation is needed.
Soon I’ll be meeting with my medical oncologist to discuss hormone therapy, and I’m feeling very conflicted.
Because my ER expression was low and my tumor had a basal-like profile, I know the expected benefit from endocrine therapy is a lot smaller than in strongly ER-positive cancers. At the same time, I’m only 34, so I want to do whatever meaningfully reduces my recurrence risk.
For anyone with ER-low positive breast cancer who achieved pCR, did you choose to take hormone therapy? If so, what regimen did you do (tamoxifen vs ovarian suppression + AI) How difficult were the side effects? If you were in my situation, would you still do it?
I know this is ultimately a personal decision with my oncologist, but I’d really appreciate hearing from others who have faced a similar choice.