Appointment sheet
Secretory carcinoma of the breast
Prepared with OnCo (onco.cc/prep/secretory-carcinoma-breast/). 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
9 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 ETV6-NTRK3 fusionand pan-TRK immunohistochemistry, Triple-negative or low ER status with low grade, S100 and mammaglobin expression), 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?
Localised disease
- 5.For my situation (localised disease), which of the standard options do you recommend and why?
Metastatic disease (rare)
- 6.For my situation (metastatic disease (rare)), which of the standard options do you recommend and why?
- 7.Am I a candidate for Larotrectinib, Entrectinib, and what side effects should I expect?
Any stage
- 8.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 9.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
The words I may hear
- Lumpectomy (breast-conserving surgery): Removing only the tumour with a rim of normal breast, keeping the breast; almost always followed by radiotherapy.
- Grade: How abnormal the cancer cells look under the microscope, from grade 1 (close to normal, slow) to grade 3 or 4 (wildly abnormal, fast).
- Tumour-agnostic (tissue-agnostic) approval: A tumour-agnostic approval lets a drug be used for any cancer carrying a specific molecular feature, regardless of where it started.
- Mastectomy: Removing the whole breast, either for cancer or preventively in BRCA1/2 carriers, where bilateral risk-reducing mastectomy cuts breast cancer risk by 90% or more.
Tests and results to bring
Biomarker results to ask for: ETV6-NTRK3 fusion (about 92 percent) and pan-TRK immunohistochemistry, Triple-negative or low ER status with low grade, S100 and mammaglobin expression.
Scans and tests linked to this cancer: Comprehensive genomic profiling.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Localised disease: Surgery with clear margins, radiotherapy after breast conservation; chemotherapy is usually not indicated for this indolent type (European working group consensus). (Lumpectomy (breast-conserving surgery), Mastectomy, Sentinel lymph node biopsy)
- Metastatic disease (rare): NTRK inhibitors (larotrectinib, entrectinib) under their tumour-agnostic approvals for NTRK fusion-positive solid tumours. (Larotrectinib, Entrectinib, Tumour-agnostic (tissue-agnostic) approval)
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