Uncertain ER and PR test results

Hi Dr. Goodman,

This is a follow up on a question I asked a week or so ago.  I had my cancer tested for hormone receptors and the results came back ER and PR positive on the borderline cells.  (My official diagnosis is Low-grade carcinoma arising in the background of a borderline tumor.)

You suggested I ask my doctor whether the estrogen and progesterone receptors are in the invasive carcinoma or only in the borderline.  I went back to my doctor and asked her this question and she said that she doesn't know for sure.  The piece of tumor that was sent from where my surgery was done just happened to have no invasive carcinoma.  It only showed borderline tumor just as the report stated.  

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 so 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?  What do you think makes the most sense?

[Annekathryn Goodman, M.D.]

Hi There
I would agree with your doctor that most low grade cancers are ER positive.
I think that the best person to ask is a pathologist. It maybe that the pathologist who reviewed your slides would be able  to chat with you about their findings.

best wishes