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

woodstock99's picture
woodstock99
Posts: 106
Joined: May 2021

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.
RainbowRita's picture
RainbowRita
Posts: 51
Joined: May 2021

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's picture
woodstock99
Posts: 106
Joined: May 2021

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's picture
RainbowRita
Posts: 51
Joined: May 2021

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's picture
NoTimeForCancer
Posts: 2914
Joined: Mar 2013

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's picture
Dak82
Posts: 82
Joined: Dec 2020

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
Posts: 21
Joined: Jun 2021

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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