Forum Discussion
Mets now in my brain
Hi Everyone my latest scan has been a shock and made me sad. I was on enhurtu and hoping for big success. However after 4 round 2 of my liver mets increased and now i have mets in the right side of ...
So I have a brain mri this Friday and see the radium oncologist Tuesday for results and next steps. I think that based on my regular oncologist discussion I am having 1 more chemo of enhurtu on 9th September and then a scan to see if i stay on that or more to another chemo drugs. The radium will need mapping etc before I get zapped and I am not sure if chemo will stop while that do this. I think my oncologist runs both treatments parallel.
Unfortunately the cancer in me is Luminal B which faster growing and a very poor prognosis.
Breast cancer of course has all the different subtypes of her2 status hormone positive or negative etc but people need to be aware of the Luminal status which the ki-67 factor is part of.
My early bc had a very high ki-67 factor and hence needing chemo when my early bc was diagnosed. I hadn't realised at the time that it is also important to understand ones ki-67 factor and their Luminal type. Luminal A is very slow growing and treatment is more effective for that but Luminal B is the most aggressive and has a poor prognosis.
I don't want others to be frightened by this but again information about our disease is important to help us manage it and ourselves and balancing our expectations of treatment.
My goal is quality of life and extending my time while now making sure I am prepared for next steps.
All the best for the MRI and ongoing discussions with your Rad Onc Cath62 xx. Thank you so much for your reply and opening up the discussion on Luminal A & B xx
Like Tri, I've never heard of Luminal A or B .... it looks like we really DO need to have an understanding of how important it is to a long term prognosis. xx. Thank you for mentioning this - knowledge is power xx.
My ki-67 was 25% with a hotspot within the tumours of 50% ....
Luminal type wasn't mentioned, but it said the Mitotic Score was highest in the 'hot spot' .... and looking up Mitotic Score, it sounds sort of similar to Luminal ....
In breast cancer pathology, the mitotic score, also known as the mitotic index (MI), reflects the rate at which cancer cells are dividing and multiplying. It is a crucial component of the Nottingham Prognostic Index, a system used to assess the aggressiveness of breast cancer and predict its behavior. A higher mitotic score typically indicates a more aggressive tumor with a higher chance of recurrence
And then comparing Luminal scoring vs Mitotic Scoring ......
In the context of breast cancer, "luminal" and "mitotic score" are two distinct but related factors used in pathology reports to assess the characteristics and behavior of a tumor. Luminal refers to a subtype of breast cancer characterized by the expression of estrogen receptors (ER) and/or progesterone receptors (PR), while the mitotic score indicates the rate of cell division within the tumor, a measure of its aggressiveness.
Luminal Subtypes:
- Luminal A:
- Characterized by ER and PR positivity, HER2 negativity, and lower proliferation rates (often indicated by low Ki-67 index). They generally have a better prognosis.
- Luminal B:
- Characterized by ER positivity, and either PR negativity or low expression, and HER2 positivity or negativity. They tend to have higher proliferation rates and a less favorable prognosis compared to Luminal A.
Mitotic Score:
- The mitotic score, also known as the mitotic index, is a measure of how quickly cancer cells are dividing.
- It is typically assessed by counting the number of mitotic figures (cells undergoing division) in a specific area of the tumor (e.g., per 10 high-power fields).
- A higher mitotic score indicates a higher rate of cell division, suggesting a more aggressive tumor.
Relationship between Luminal Subtypes and Mitotic Score:
- Luminal A tumors typically have a lower mitotic score (less aggressive) compared to Luminal B tumors.
- High mitotic activity (high mitotic score) is often associated with Luminal B, triple-negative, and high-grade tumors.
- A high mitotic score in combination with other factors like high Ki-67 index is often associated with poorer prognosis.
In essence, the mitotic score provides an indication of how quickly the cancer cells are growing and dividing, while the luminal subtype classification helps to categorize the tumor based on its hormonal receptor status and proliferation rate, both of which are important for determining prognosis and treatment strategies.
I think the Luminal status can really only be determined after they see how the cancer behaves but certainly a high ki-67 factor is a strong indicator of it.