Estrogen positive tumors and ERT

I had my hysterectomy done last September for Stage 3c Ovarian Cancer at 26 yrs old. I am now reading more and more opinions about my type of tumors (MPSC) and the thought that they tend to be estrogen positive. My question is, can they still find out if my tumors are estrogen positive from only my pathology slides? I called my Dr's office and his nurse seemed to almost laugh when I mention my concern, telling me I must have breast cancer and Ovarian cancer mixed up, as it's mostly breast cancer that is Estrogen positive. I don't feel comfortable taking my ERT (Premarin .625mg/day) knowing that there may be a posibility that I'm feeding these tumors - what can I do about it now? I was treated at Sunnybrook Hospital in Toronto, so I'm not sure if I can even request my slides or not.

[Annekathryn Goodman, M.D.]

Hi Tybear,
You absolutely can get estrogen and progesterone receptor information on the tissue from your tumor. Once tissue is removed from your body and sent to the pathology department, it is placed in a fixative solution (formaldehyde or some similar agent). Then the tissue is cut into pieces and each piece is put in a little tray that is about one inch by a half an inch by an eighth of an inch deep. Liquid paraffin is poured into this little cassette and the tissue is "fixed". Then, thin slices of the tissue are shaved off the paraffin block and put onto a glass slide. A stain is applied to the tissue on the glass slide so that different parts of the cellular structure has a different color. (For instance, the usual stain makes the nucleus of the cell blue or dark purple and the cytoplasm of the cell pink.)

It is easy to go back to the paraffin block and make new slides and put different stains on to evaluate for other things - such as receptors, immune cells, and so forth. Basically the paraffin block is the storage system for the tissue. It does not go bad and one can go back years later to test for new things.

I do not know how it works in Canada, but it cannot hurt to call the pathology laboratory of the hospital where you had your surgery. Just explain that you want to understand how to order estrogen and progesterone receptors on the paraffin blocks of your tumor. Who can authorize that, how is it paid for and so on.
Good luck and best wishes.