Appointment sheet
Carcinoma with medullary pattern (medullary breast cancer)
Prepared with OnCo (onco.cc/prep/medullary-pattern-breast-carcinoma/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
8 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Triple-negative receptor status with grade 3, Dense lymphoplasmacytic infiltrate, Germline BRCA1), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
Early disease
- 5.For my situation (early disease), which of the standard options do you recommend and why?
- 6.How do the results of KEYNOTE-522 apply to someone like me?
Any stage
- 7.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 8.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
The words I may hear
- Tumour-infiltrating lymphocytes (TILs): Immune cells that have got inside the tumour.
- Germline BRCA testing criteria for triple-negative breast cancer (UK): In the NHS a blood test for inherited BRCA1 and BRCA2 faults is offered to every woman under 50 with triple-negative breast cancer, whatever her family history, and hospital testing criteria now extend that to triple-negative disease under 60 and any breast cancer under 40.
- Basal-like breast cancer: Basal-like is a breast cancer subtype defined by the genes its cells switch on, which resemble the basal cells lining the milk ducts.
Tests and results to bring
Biomarker results to ask for: Triple-negative receptor status with grade 3, Dense lymphoplasmacytic infiltrate (high stromal tumour-infiltrating lymphocytes), Germline BRCA1 (medullary tumours are BRCA1-related).
Scans and tests linked to this cancer: Germline (hereditary) testing.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Early disease: As for triple-negative disease of no special type, including germline testing; the medullary pattern is recorded because of its better prognosis but does not change the NICE pathway. (KEYNOTE-522, Germline (hereditary) testing, Tumour-infiltrating lymphocytes (TILs))
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call