Thank you Dr Griggs ❤ the chair analogy makes it very clear for me!

@yerbba

8 ай бұрын

We are so glad you found the analogy helpful! Thanks for watching.

Thank you, Dr Griggs, for your medical advice, very helpful.

@yerbba

8 ай бұрын

Thank you for supporting our channel!

Thank you Dr Griggs..you explained that very well and was very helpful.

@yerbba

8 ай бұрын

Thank you for watching. We are so glad you found this video helpful!

Thanks again for the great video ! Is there any research that showed in what years after initial diagnoses the breast cancer estrogen driven, mostly reccured? I have heard that the risk goes 1% up yearly for this molecular type ? I have seen somehwere the graph thad showed it reccured mostly in 7th year, than 12th year, but unfortunately I did not save it. Sure enough we are all aware that it can reccur any time after diagnoses or treatmant. I am asking about hormone positive early BC, not metastatic at initial diagnoses. I would greatly appreciate your answer...

@yerbba

8 ай бұрын

It is true that tumors that are hormone receptor positive can recur many years later. This is in part because the majority of people are alive many years later and in part because the tumors can "wake up" after being dormant for many years. Overall, however, most people are disease-free throughout their lives and die of other causes. Recurrences can occur at any time, and there does seem to be a "bump" at 7 years. These data come from people treated before the aromatase inhibitors and other advances. It may be a while before we have a good picture of outcomes in people treated with current treatments.

Very helpful, thank you.

@yerbba

8 ай бұрын

Thank you for watching. We are so glad you found this video helpful!

Thank your. The chair analogy is good. Could you also say it’s like putting a Teflon coating on?

@annakarenina3188

8 ай бұрын

Receptors generally, whether that's your body's hormone receptors, or receptors for neurotransmitters, or for opiates/endorphins (we all have them), cannabinoid receptors (we all have them), dopamine, serotonin...... Imagine it's like the chair analogy, but they're seats on a train going through 20 stops on its journey: at first the seat is labelled as free, so say, codeine can sit in that seat. But three stops in, you have morphine who bought a ticket for that seat, so codeine has to move over, and morphine occupies the seat. Then ten stops in, the transport police get on in the form of buprenorphine or naltrexone or lofexidine, and they think morphine and codeine have been causing too much trouble, so they throw them off the train all together -- and then those three can sit in the seat and not let any other opiates sit there. The latter three I mentioned are what would be called blockades. You can also have things like pre-synaptic reuptake inhibitors -- so this is more neurosciences, not hormones..... If you imagine the journey of the neurotransmitter to be like a plane flight through nerve cells, and across an ocean (synapse). Well, serotonin has to make a return journey to where he originally flew from, but when he gets back to his original country, customs (the reuptake inhibitors) hold him thinking he has a false passport, and send serotonin back over the ocean, and serotonin will keep doing this journey back and forth between countries until (the reuptake inhibitors wear off and) his original country says "oops, yeah, we recognise your passport, come on home and recharge for a bit". But then the reuptake inhibitors go back on shift, and so serotonin goes for another trip as normal, and comes home to find he gets deported back to the new country all over again. Repeat. This is a really basic model of how things like SSRI anti-depressants work.

@yerbba

8 ай бұрын

Whatever image works for you is useful! Teflon coatings don't have the ability to be specific for a particular part of the object they're on, so it may be a little less helpful for many people.

Hi how can you have positive lymph nodes but clear margins ?

@yerbba

8 ай бұрын

Great question. Yes, you can. The margins refers to the primary tumor and how much of the tumor was removed along with a rim of normal tissue around it. The lymph nodes are separate from the primary tumor and can be positive or negative.

thank you ... i started AI s 2 weeks ago ( stage 2 hormone positive her2 negative) after 16 chemos and radio ...i took an overdose after 10 days ive suffered very serioius PND 30 years ago i know the mechanics of the AIs stripping the estrogen is similar i am very very worried ...

Hi i have triple negative and her 2 positive breast cancer and 2 of the lumps are in one breast. My body did not respond to Trastuzumab, Cyclophosphamide, Doxorubicin, Pembrolizumab, Paclitaxel, Nab-paclitaxel, Taxane. Herceptin, AC and DDAC which none was affective. I completed treatment tumors double in size spread to lungs should i take the Car T cells trial. I have stage 4 breast cancer?

@yerbba

8 ай бұрын

Thank you for writing to us. You have been through a lot. At this point, CAR-T is being studied in breast cancer but in not part of the recommended treatment for breast cancer. There are a lot of obstacles to overcome for CAR-T to work in solid tumors. There are studies being done in people with breast cancer and pancreas cancer.

Do you have any information about whether Turkey Tail mushrooms ca be effective in the prevention or treatment of breast cancer?

@yerbba

4 ай бұрын

Thanks for the question. Turkey tail mushrooms may help with the tolerance of chemotherapy (especially nausea). There is no purported effect on the development of or prognosis with breast cancer.

Hi doc I am fighting the Breast Cancer and currently on treatment trastuzumab and now I have new treatment which is Leuprolein can you tell me what is Leuprolein? Thank you

@yerbba

8 ай бұрын

It's possible that you're talking about leuprolide. Leuprolide is a type of hormone, an LHRH analog. These medications cause a "medical menopause," temporarily putting the ovaries asleep. This is an effective treatment to decrease the risk of recurrence and are often combined with other endocrine therapy such as tamoxifen one of the aromatase inhibitors.

I have T2 G3 invasive ductual carcinoma HER2 negative ER and PR positive not sure after chemotherapy and radiotherapy what my plan will look like have you any idea.

@gena.9564

8 ай бұрын

I had the same tumor charasteristics, I finished my active treatment some months ago I and am now on tamoxifen for a couple of years then I ll have to switch to anastrazole . I also take abemaciclib for 2 years because of high risk for recurrence

@yerbba

8 ай бұрын

In general, people with hormone receptor (ER and PR)-positive breast cancer are offered endocrine (also called hormonal) therapy. We generally start this about 30 to 60 days after other treatment has finished. Some people start endocrine therapy during radiation therapy with no problems.

Hello Dr Griggs, Great fan of your content. By using harmonal therapy, my mom's breast cancer is reducing, i wonder if what would be the next step is it surgery or radiation.

@yerbba

7 ай бұрын

This is so encouraging. If your mother has advanced cancer (cancer has spread throughout the body), surgery may be considered for some people. If there is no evidence of metastatic disease, generally surgery is done first followed by radiation therapy. Thank you for watching.

@Subbaraosongs

7 ай бұрын

@@yerbba My mom's MBC has spread to the nearest bone and swelling is visible upon the breast by lymph nodes under arm pit. By using harmonal therapy for 4 months the swelling has decreased a lot, still 2 more months to go before PET CT scan. Is surgery needed or they would proceed with same harmonal therapy or radiation? Please help and your reply is much appreciated. Anyway thank you for your reply. Great fan of your content always and a small suggestion, try to explain the topic by a case study so that every viewer can compare themselves and gets involved more.

Doctor, may I ask for you to cover the topics of ki-67, luminal A & B, mucin, and various other Quirk's associated with lobular carcinoma -- all of which appear to either correlate or cause faster growth or worse longer term prognosis for >5 years recurrence (it seems us lobular ladies, especially younger with higher stage, get to 7 years, and our recurrence risk starts going through the roof. Peer review literature suggests that lobular lays down micrometastases early on in many women, which seem to be chemo & radiotherapy resistant, and lay dormant or slow growing even with hormone blockade -- potentially due to the factors mentioned above: ki-67, the luminal subtyping, pleomorphic subtype, mucinous type, high mitotic counts, little or no LCIS in amongst the main ILC tumour..... Coupled with the way lobular carcinoma acts like cobwebs, so is immensely hard to image in breasts, let alone on the torso staging CT scans (we don't do whole body, nor FES PET scans here in the UK -- therefore questions over bone pains or other symptoms remain) It would be great if someone could break down exactly what all this means, as I want to access my pathology report, and be able to self advocate when speaking to the oncologists about chemo and radio, and if I should be having further scans? Thank you for your work on here.

@yerbba

8 ай бұрын

These are important questions. Lobular breast cancer has an excellent prognosis compared to other types of breast cancer despite the quirks and growth pattern. The 5-year survival is over 90%, and the 10-year survival is close to 85%. Ki-67 appears to be an important prognostic factor in a 2014 study. Still, tumor and lymph node status are the most important independent prognostic factors. Pleomorphic lobular carcinoma is an unusual type of lobular cancer and appears to more aggressive. We hope this is helpful.

Hello doctor, can you please tell me if the tumor characteristics( ER/PR positive, HER 2 negative, Ki 67 - 5 percent) change from the initial biopsy of the tumor and the entire tumor after surgery. I have been watching your videos, these helped me a lot to understand breast cancer. I thought these tests have to be repeated on the entire tumor also, after surgery. But the doctor that did the lumpectomy says these tests don’t have to be repeated as it stays the same. However the grade was changed from 1 during the initial biopsy to 2 after the surgery. Also, during lumpectomy if the invasive mucinous tumor(negative sentinel node biopsy, tumor size 2.2cm, post menopausal state) also had focal DCIS, in the portion that was taken out, does both these have the same tumor characteristics? Thank you

@yerbba

7 ай бұрын

These are great questions. While the removed tumor is often retested for HER2, ER, and PR (particularly if the biopsy specimen was small), it may not be necessary. The tumor grade often changes from the biopsy to the final tumor because the biopsy often does not get a big enough specimen to see all the architecture of the tumor.

@Smath01

7 ай бұрын

@@yerbbathank you so much doctor for the reply

Hi Dr Griggs kindly explain what it means receptors areER8/8 PR3/8 ..what do these numbers implicate ..thank you in advance..

@gaurikris9420

8 ай бұрын

Actually it means it is highly hormone related which means we know the key is hormone which is a good thing because it can be very well treated with hormone blockers and recurrence is low

@yerbba

8 ай бұрын

Hormone receptor scores are based on the percentage of cells that are positive for estrogen and progesterone receptors as well as the intensity of staining. The score goes from 0 to 8. A score of 2 or lower is negative. A score of 3 or higher is positive. In this case, the estrogen receptor score is 8 out of a possible 8, so this tumor is strongly positive for the estrogen receptor. The progesterone receptor score is 3/8, so this is positive but not strongly positive. We hope this is helpful.

Hi, I was looking up SERDS and found this research. " The first-generation selective estrogen receptor degrader (SERD) fulvestrant has activity against ESR1 mutant tumors but requires intramuscular injection and has poor bioavailability that precludes optimal drug dosing. This led to the development of second-generation SERDs which are potent and have improved oral bioavailability and pharmacokinetics. Several of these oral SERDs are now in phase III trials in both the early and advanced ER positive breast cancer settings." This was on an NIH website. What are the side effects of SERDS? I've been lucky, so are on anastrozole but time will tell.

@yerbba

8 ай бұрын

We do have a video about the side effects of the SERDS. We are excited about the possibility of oral SERDs of course. Thus far, these are being studied in people with advanced disease. kzread.info/dash/bejne/e5lr1NeFm9zYoLw.html

Hi Dr Griggs ,kindly assist and advise if removing ovaries help to delay recurrence of breast cancer

@yerbba

8 ай бұрын

Blocking or reducing estrogen will decrease the risk of recurrence in people with hormone receptor breast cancer. In people whose ovaries are still functioning, there is a role for either removing the ovaries or for putting the person into a "medical menopause" with injections. The benefits of medical menopause are that the onset of menopausal symptoms is more gradual and that it is reversible. The benefits of surgical menopause are that is does not require regular injections and that, in high risk people, it can decrease the risk of ovarian cancer if the fallopian tubes are also removed with the ovaries.

How does the more complicated treatment of a triple negative pathology and increased susceptibility to recurrence relate to DCIS? When I have brought the subject up with my oncologist and surgeon, they both just tell me I don't need to worry about it because mine was DCIS and had good margins and radiation. I get confused by educational discussions on the internet about this because they don't specifically distinguish between DCIS and other stages to say whether there is a difference in the prognosis their topic is focused on. Can you offer any clarity? Should I be concerned or more relaxed?

@yerbba

8 ай бұрын

DCIS has a different molecule signature from invasive cancer. The vast majority of DCIS is hormone receptor positive and HER2-positive, which surprises a lot of people (including scientists). Despite the HER2 being positive in most people, the prognosis is better even without HER2-directed therapy. The significance of the hormone receptor status pertains mostly to the benefit of endocrine therapy; people with DCIS that is hormone receptor-negative do not seems to have the same benefit from endocrine therapy. Other than that, the "triple-negative" label does not apply to DCIS in terms of prognosis or treatment recommended.

@lynnworrell9697

8 ай бұрын

@@yerbba thank you, especially for your last sentence! I feel I can relax a bit now. Much appreciation for your time and response.

Hi Dr Griggs . My mother diagnosed with bc . Her tumor status is : Er strongly positive (Allred score 8/8) Pr negative (0/8) Her2 negative Ki67 40% Grade 3 As you said we can’t say hormone receptors positive is both receptors aren’t present so what do you think about this case ? Is it like triple negative? Hormone therapy will be helpful?

@yerbba

8 ай бұрын

With this high a level of ER, this is a strongly ER-positive tumor. So it's not a triple-negative tumor. Let us know if this helps.

@kanishkarasouli8915

8 ай бұрын

Thanks for your helpful comment Dr Griggs . With these characters of tumor what do you think about prognosis? Actually I’m concerned about Pr negative and high ki67 in 4cm tumor . So I will be happy if know your analysis of this case . Thank you!

I am a TNBC patient stage 2a..finished 8 sessions of chemo..is this enough for me...do i need to take up herbal supplements...since i dont have maintenance doc?

@yerbba

6 ай бұрын

As long as you have a healthy diet and no special medical problems, you most likely do not need to take supplements. Talk with your medical team to see if vitamin D might be appropriate for you.

please make a vide on pregnancy-related breast cancer

@yerbba

8 ай бұрын

Thank you for your comment. Feel free to check out our video on breast cancer and pregnancy kzread.info/dash/bejne/kX53vMZtiJnTocY.html .

I had HR cancer 23 years ago and again in April of this year. I went through testing and had a mastectomy last month. I’m post menopause but my estrogen receptor was 99% and progesterone was 60%. I’m scheduled to meet with an oncologist next month.

@yerbba

8 ай бұрын

Thanks for writing about your story. The menopausal status of a person and the tumor characteristics are not related. In fact, postmenopausal women and men are more likely to have estrogen receptor and progesterone receptor positive tumors. Meeting with an oncologist is an important step, and they will provide you with guidance based on your specific situation. Wishing you the best in your meeting with the oncologist and in the steps ahead.

@theresahickscch6581

7 ай бұрын

Hello Doctor. I had an appointment with my Oncologist and she suggested Letrozole. She was hesitant to prescribe the meds as I have arthritis and live with a fair amount of pain. I decided that I would try Letrozole and see how I feel. So far, doing fine. I never did understand how I manufacture estrogen and progesterone due to being in menopause. I didn’t know that there are other sites where hormones are made. Thank you for explaining how it happens and what the hormone does in our body.

Does an estrogen and progesterone levels of 95 percent mean the cancer can recur more?

@yerbba

5 ай бұрын

Great question. These features do not indicate a higher risk of recurrence. There is a high degree of benefit from endocrine therapy, however.

If these drugs don't allow you to live a normal life what is the point I think this crap is more harm than good

@yerbba

Ай бұрын

It's completely understandable to feel frustrated if the side effects of your medications are significantly impacting your quality of life. The decision to undergo any treatment, especially for conditions like breast cancer, involves balancing the potential benefits with the possible side effects. For many, these medications can be crucial in reducing the risk of cancer recurrence, which is a significant benefit. However, when the side effects become overwhelming, it’s important to voice these concerns to your healthcare provider.