Newbie Again - Can Someone Tell Me What this Means In Doctor's Note

woodstock99
woodstock99 Member Posts: 206 Member
edited May 2021 in Uterine/Endometrial Cancer #1

Sorry for all the questions.  I noticed on mychart that my gyno onco surgeorn posted after visit note from a video call we had last Tuesday.  Not copying entire message but can anyone tell me what this means?  MMMR Intanct?  Performance status is 0.  

 

Recent pathology shows high-grade endometrial carcinoma, MMR intact. Performance status is 0.

 

 ASSESSMENT: High-grade endometrial cancer, mismatch repair intact.

 

PLAN: We will proceed with a laparoscopic hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node dissection, possible pelvic lymph node dissection, possible exploratory laparotomy, omentectomy, peritoneal biopsies, peritoneal washings and any other indicated procedure. Patient understands the need for possible laparotomy incision. I reviewed her pathology with her in detail again today. We discussed that the final pathology will determine the need for adjuvant treatment. We also discussed the need for a CT scan to determine whether there was presence of distant metastatic disease, which may alter our surgical plan. The patient wants me to call her with the CT scan results, which I will do.

Comments

  • RainbowRita
    RainbowRita Member Posts: 72 Member
    #2
    MMR Intact -what it means

    I believe your result of "MMR Intact" means that you are at a low risk for Lynch syndrome. People who test positive for Lynch syndrome are at a higher risk for colon cancer in addition to uterine cancer.  This is what my screening report said in regards to MMR. 

    MMR Screening for MSI

     

    Results of Immunostaining for Mismatch Repair Proteins (MMR), block c13

    - MLH1: Intact nuclear expression

    - PMS2: Intact nuclear expression

    - MSH2: Intact nuclear expression

    - MSH6: Intact nuclear expression

     

    Interpretation:

    This is a normal pattern of staining without loss of nuclear expression of MMR proteins. It indicates a low probability of microsatellite instability. If clinical suspicion remains high for Lynch syndrome or if the patient is under 50 years of age, referral to genetic counseling (oncology) is recommended.
  • woodstock99
    woodstock99 Member Posts: 206 Member
    #3
    RainbowRita said:

    MMR Intact -what it means

    I believe your result of "MMR Intact" means that you are at a low risk for Lynch syndrome. People who test positive for Lynch syndrome are at a higher risk for colon cancer in addition to uterine cancer.  This is what my screening report said in regards to MMR. 

    MMR Screening for MSI

     

    Results of Immunostaining for Mismatch Repair Proteins (MMR), block c13

    - MLH1: Intact nuclear expression

    - PMS2: Intact nuclear expression

    - MSH2: Intact nuclear expression

    - MSH6: Intact nuclear expression

     

    Interpretation:

    This is a normal pattern of staining without loss of nuclear expression of MMR proteins. It indicates a low probability of microsatellite instability. If clinical suspicion remains high for Lynch syndrome or if the patient is under 50 years of age, referral to genetic counseling (oncology) is recommended.
    Thank you.  I had no idea

    Thank you.  I had no idea what "MMR" meant.  I recall now in our conerversation that she said my biopsy did not show that it was genetic or hereditary but she did not use this term. 

  • RainbowRita
    RainbowRita Member Posts: 72 Member
    edited June 2021 #4
    So that is good news.

    My gyn oncologist wanted me tested for Lynch syndrome because my mother also had endometrial cancer. One type of cancer is enough...am I right? Wink

  • NoTimeForCancer
    NoTimeForCancer Member Posts: 3,515 Member
    edited June 2021 #5
    After watching the video link

    After watching the video link I posted a few days ago, and knowing what I know now, I would be asking for biomarker testing on the followng:

    PDL1

    TMB

    MMR

    Lynch

    MIS

    P53

    HER2

    POLE

  • Dak82
    Dak82 Member Posts: 109 Member
    edited June 2021 #6
    NoTimeForCancer said:

    After watching the video link

    After watching the video link I posted a few days ago, and knowing what I know now, I would be asking for biomarker testing on the followng:

    PDL1

    TMB

    MMR

    Lynch

    MIS

    P53

    HER2

    POLE

    Agree NTF!

    I found out after further testing that my MLH1 testing was positive for methylation--and I had some degree of MS instability. While it was a relief to my sisters and kide what I didn't realize at the time was that this could mean my cells weren't expressing the proteins required for the immune system and chemo to enter the cancer cells. They were essentially armor plated. dMMR and MSI usually go together and may explain cancer recurrence and/or resistance to chemo. In subsequent genome testing I also found out I have the BRCA2 mutation which potentially opens the door to PARP inhibitors--typically used for n breast cancer treatment.

    It's an amazing medical world out there but I'm really glad your tests came back "normal"!

    Deb

  • Lusafag
    Lusafag Member Posts: 21
    #7
    NoTimeForCancer said:

    After watching the video link

    After watching the video link I posted a few days ago, and knowing what I know now, I would be asking for biomarker testing on the followng:

    PDL1

    TMB

    MMR

    Lynch

    MIS

    P53

    HER2

    POLE

    Which video link ?

    Can you please post or send the video link.

     

    I asked an oncologist,posting my question,I also send your comment screen shot, and his reply.

     

    Sir,is it always done in Endometrial cancers ?

    Do i need it ?

    My wounds are still intact.

    Radiotherapy delayed twice.

    Microbiology suspicion is now of AFB,MTB/MOTT.

     

    Radiotherapist has advised just brachytherapy,taking pT2b as oncology stage 1,which another radiotherapist disagreed and advised EBRT and possibly chemo too,keeping in mind my pre op Chest CT where there were 6-8 nodules,largest being 4.8 mm.

     

    Should we go for review CT/MRI ourself if primary RT doesn't agree ?

     

     

     Reply.

    MSI testing is costly and immunotherapy too

    If you can not afford immunotherapy then there is no need for MSI

    Review of CT scan is your call

    Atleast give brachytherapy

    Rest depends on primary consultant

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