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Ovarian Cancer (Expert Forum)
In the background of a borderline tumor
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center
Boston - MA
In the background of a borderline tumor
by Ramsay14, Jun 24, 2009 01:38PM
Hi Dr. Goodman,
I very recently had the tumors from my debulking tested for hormone receptors. I wanted to have this information because I have recurrent low-grade serous carcinoma and the possibility of using a hormonal therapy in the future is very attractive. The report says "This is a low grade serous carcinoma arising in the background of a borderline tumor. The section submitted for immunohistochemical stains shows borderline tumor which is positive for ER and PR." I understand the ER and PR part.
What does "in the background of a borderline tumor" mean?
What does "section submitted...shows borderline tumor" mean?
Thanks,
Ramsay
I very recently had the tumors from my debulking tested for hormone receptors. I wanted to have this information because I have recurrent low-grade serous carcinoma and the possibility of using a hormonal therapy in the future is very attractive. The report says "This is a low grade serous carcinoma arising in the background of a borderline tumor. The section submitted for immunohistochemical stains shows borderline tumor which is positive for ER and PR." I understand the ER and PR part.
What does "in the background of a borderline tumor" mean?
What does "section submitted...shows borderline tumor" mean?
Thanks,
Ramsay
Doctor's Answer
by Annekathryn Goodman, M.D., Jun 27, 2009 08:53AM
, Jun 27, 2009 08:53AM
Hi Ramsay,
thank you for your question
basically the report says that you have two different types of cells in the tissue . One is a malignant neoplasm called borderline tumor and the other is the low grade serous carcinoma. Now they may be related. It could be that your tumor started out as a borderline and then changed into an invasive cancer. That may be fairly common in advanced (that is stage 3 and 4) borderline tumors.
Ultimately What is important is the most aggressive component of the tumor which for you is the low grade serous carcinoma. Treatment decisions are based on that. So one question to ask your doctor is whether the estrogen and progesterone receptors are in the invasive carcinoma or only in the borderline
best wishes
thank you for your question
basically the report says that you have two different types of cells in the tissue . One is a malignant neoplasm called borderline tumor and the other is the low grade serous carcinoma. Now they may be related. It could be that your tumor started out as a borderline and then changed into an invasive cancer. That may be fairly common in advanced (that is stage 3 and 4) borderline tumors.
Ultimately What is important is the most aggressive component of the tumor which for you is the low grade serous carcinoma. Treatment decisions are based on that. So one question to ask your doctor is whether the estrogen and progesterone receptors are in the invasive carcinoma or only in the borderline
best wishes
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If the ER and PR are only in the low-grade carcinoma what implications does that have as far as hormonal therapy?
What if the ER and PR are in both?
take care
I asked her if the test should be done again and she said she really doesn't think it will help. She said we can't control what samples are sent and they could keep sending borderline samples. They can't tell what they are sending because they have to be sent unstained. She's pretty confident that the invasive carcinoma would turn out positive for ER and PR due to the fact that the borderline was positive and because of the low-grade of the invasive carcinoma. She said the lower the grade the more likely the tumor is to be ER and PR positive. Do you agree with this? The not knowing for sure makes me nervous.
Should I ask for my original hospital to re-run the test until they get a sample of the invasive carcinoma? Or do you agree with my doctor's approach of assuming that the invasive carcinoma will most likely be ER and PR positive and giving hormonal therapy a shot when the time comes?
I do agree with your doctor.
best wishes