Are you positive it's negative?


I've always thought that the challenge of the pathology report was understanding it. I'm talking about my challenge as a patient. Now the front page of the New York Times tells us that the tests are shaky that determine whether a tumor is HER2 negative or positive, meaning whether it has extra copies of a protein called HER2. If it's positive, the tumor should respond to Herceptin. The problem is that tests are not uniform. The patient profiled in the times is a doctor, and her tumor was tested four different times with four different HER2 tests. The first test was positive, the second negative, the third positive, the fourth negative.

My tumor was fed by estrogen--or was it? Tests for estrogen sensitivity are wrong 10 percent of the time. I will have to think about this and figure out if there's anything I can or should do about this. Get the tumor tested again? I did send it to a pathologist at Vanderbilt who came to the same conclusions that the doctor at Fancy Hospital did: that the whole breast needed to be removed. But I don't think he re-tested the tumor.

Just because a tumor hasn't been inside you for three years doesn't mean it can't still cause trouble.

[The photo above is of a low grade fibromatosis-like metaplastic breast carcinoma chosen only for the color of the dye.]

2 comments:

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