Appointment sheet
Luminal androgen receptor triple-negative breast cancer (LAR)
Prepared with OnCo (onco.cc/prep/tnbc-luminal-androgen-receptor/). 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
11 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 Androgen receptor by immunohistochemistry, FOXA1 and GCDFP15 expression, PIK3CA mutation, Lower Ki-67 than basal-like tumours), 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?
Stage II to III
- 5.For my situation (stage ii to iii), which of the standard options do you recommend and why?
- 6.Am I a candidate for Pembrolizumab, and what side effects should I expect?
- 7.How do the results of KEYNOTE-522 apply to someone like me?
Metastatic, androgen receptor-positive (trials only)
- 8.For my situation (metastatic, androgen receptor-positive (trials only)), which of the standard options do you recommend and why?
- 9.Am I a candidate for Bicalutamide, Enzalutamide, and what side effects should I expect?
Any stage
- 10.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 11.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
The words I may hear
- Androgen receptor-positive triple-negative breast cancer: Some triple-negative breast cancers carry the androgen receptor, the protein that prostate cancer runs on.
- Ki-67 in triple-negative breast cancer: Ki-67 is a stain that marks dividing cells.
- Luminal androgen receptor (LAR) subtype: Luminal androgen receptor is one of the four molecular subtypes of triple-negative breast cancer.
- Pathologic complete response (pCR): No invasive cancer left in the breast and lymph nodes when the surgeon removes the tissue after pre-surgery treatment.
Tests and results to bring
Biomarker results to ask for: Androgen receptor by immunohistochemistry (more than 10 percent nuclear staining in the trials; over 0 percent in the enzalutamide trial's intent-to-treat group), FOXA1 and GCDFP15 expression, PIK3CA mutation (enriched), Lower Ki-67 than basal-like tumours.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Stage II to III: As for triple-negative disease; the subtype's lower pathological complete response rate is a research observation. (KEYNOTE-522, Pembrolizumab)
- Metastatic, androgen receptor-positive (trials only): Bicalutamide or enzalutamide showed clinical benefit rates of 19 to 33 percent in phase 2; not approved for breast cancer, so within a trial or after the approved options. (Bicalutamide, Enzalutamide, Androgen receptor)
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