Somatic analysis report

[Payal108]

Got Somatic analysis report ( see attachment) , i have included information which I thought is most relevant. Talking to doctor on this report did not helped much, How to use it now?

[kontak TeamBCI]

Hello Payal the report is not clearly readable.

[Payal108]

Oh, Forum further reduced the size of the picture. Will upload it on external site and provide the link. Thanks.

[roxboxfox RadiationOncologist]

You have already spoken to the Genetic counsellor and she has already mentioned before you opted for this test that this report is not going to change her chemo plan or her treatment.

If for some unfortunate reason she does have a relapse of her cancer, you may choose to have one of the drugs as mentioned in the report....which of course we would have normally offered anyways to any other person with Her2 positive, Er and PR positive patient.

Perhaps it may be useful to catch hold of that Genetic counsellor and the Doctor who recommended this test in the first place....as to how would the management of your wife differ if you had or did not have this test !! 😉

Just out of curiosity, how much did this test cost ??

[Payal108 in reply to roxboxfox]

Any way she is taking Herceptine, there is no other Chemo drug with enhanced response mentioned in the report.

Her Identified mutation gene is TP53 ( V73fs).

I had two round of counseling before going for this test. Infact our Dr first asked Germ line, for which I was not convinced.

When I did talk to Doctor on this report, he did mention that it is common mutation (~50%) and there is no targeted drug for it. Report will help in case of relapse. (I believe in case of breast cancer TP53 is responsible only in 20% cases).

My problem is if I want to engage our Doctor in a conversation, I need to have question to ask, other it is not going to be any useful discussion, will get over in 2-3 min.

Genetic counselor did mention that many cases radiation may not have much advantage in case of TP53, and I should discuss with my radiologist. I yet to discuss with one.

I knew before hand it is not going to change medication , or Doctor may not use it much, but went ahead .. if it can fill any gap now or in future.

It costed my ~24k for the test.

[sumeet_shah Administrator]

In addition to what Dr. Rohit has mentioned above, I wish to tell you that a genetic testing and interpreting results is an EXTREMELY delicate affair, not to be taken lightly. I sincerely suggest you that you meet the doctor who suggested the test to you and sort it out. A genetic counseling session goes on for ONE HOUR. Mark my words - One hour. And sometimes, two or three or even four sessions are needed to make the patient and relatives understand the implications. So you can imagine how much discussion is done and you will also understand that it is beyond the scope of this forum to answer any questions related to that, just by seeing one uploaded report. Though, of course, we do understand your apprehension and we can clearly see a communication gap. The doctor who suggested the genetic test, is the right person to answer your queries.

[Payal108 in reply to sumeet_shah]

How do I engage them in discussion ? What should I ask?

Sorry to say our Dr's team is not that forthcoming for any detailed discussion.

[roxboxfox RadiationOncologist]

Its all going to be hypothetical at the end. What we could say is that she has an intermediate - aggressive cancer, which has high probability of nodal spread, chance of metastasis is high and chance of relapse is high. Few studies mention of poor response to anthracycline chemotherapy and perhaps to Radiation.

But at the same time, not giving her chemo or radiotherapy is statistically going to increase her risk of cancer. So management does not change and she still ideally needs all those treatments. There are no known targets as of 2016... and perhaps her management does not change at the end.

[Payal108 in reply to roxboxfox]

Thanks Dr.

>> we could say is that she has an intermediate - aggressive cancer

Was this based on my previous post?

[roxboxfox RadiationOncologist in reply to Payal108]

That's what your report read on Google drive 2nd attachment under prognosis. Which says clinical impact: Poor and an intermediate aggressive phenotype. !!!

[Payal108 in reply to roxboxfox]

Thanks

[Payal108]

Not sure if my earlier update on this link was deleted or It did not got saved in first place

Somatic Analysis report link:

drive.google.com/folderview...

[kontak TeamBCI]

All the 5 pages were seen earlier in the goggle drive folder