[dlaxague]

"I explained that I was confused because I thought I was at stage IIIA. I had 7/12 nodes involved but it hadn't spread to any other organs. The nurse said that because I had it in my lymph nodes, it probably was in my blood stream and then considered it metastic."

A NURSE said that? That's wrong, and she should know better. It's pretty universally accepted that "early" breast cancer is anything short of stage IV. Metastatic breast cancer, advanced breast cancer, and stage IV breast cancer are the same thing, and they do not describe stage IIIA.

Any breast cancer can have spread through the blood stream (including stage I), which is why they are looking for better ways to evaluate individual breast cancers. But unless those cells take up residence somewhere else (typically bones, liver, lungs), there's no way to know if they're there or not, and you don't say that the breast cancer is metastatic just because you think it "might" eventually be that. Jeeze! I hope that you talk to the onc and that he straightens out his nurse. If she didn't know for sure, she would have been much better off to say nothing.

Now, it is possible that the neratinib trial has some specifications that exclude you (like maybe they only want stage I or II). But that still doesn't mean your breast cancer is metastatic.

There is a gray area sometimes, in the language, because pathology reports will describe lymph node involvement as "metastatic to lymph node" (or something like that, using the mets word) but that is not the same as distant (stage IV) metastatic disease. I'm in a rush and hoping this makes good enough sense. I didn't want you to be fretting one second more than necessary.

Debbie, also stage IIIA (8 years ago)