[SunDiego]

Here is the full background....

We recently discovered (mid June 2010) a lump in my 32 year old wife's right breast, and immediately followed up with ultrasound > core needle biopsy > MRI > mammogram. Long story short this all led to initial pathology of multifocal DCIS with suspicious areas of invasion, as well as multi-focal areas of calcification. Fast forward to July 13th, when my wife had her lumpectomy done (3 weeks after discovery) by a the most highly regarded surgeon in the area the most highly regarded multi-disciplinary center (no names here). The pathology just came back yesterday (7/19/10) and the results were NOT what we were hoping for. She goes in for med. onc and post-op with doctor tomorrow... and have lined up second opinions as well in a few weeks with another med onc and surgeon - just in case.
I'll list all the key words and phrases here in the hopes that others with similar experiences can please chime in with words of support or suggestions or experiences.

PATHOLOGY

* Sentinel Node 0/13
* ER+ 10% in invasive carcinoma & ER+ 80% in DCIS
* PR- (report said "mostly negative, only 5% positive in invasive, 10% in DCIS)
* HER/2+++ (3+ on ASCO/Dako in both invasive and DCIS)
* mBR Grade 3 (score: 8) "multifocal invasive ductal carcinoma arising from extensive high grade DCIS with comedo necrosis and calcifications"
* Invasive Tumor Size: 0.7cm
* Lymphatic Vascular Invasion: Suspicious
* DCIS polarization: Poorly Developed (Comedo Necrosis visible)
* Stage 1a is what we've heard thus far (NOW STAGE IV - see bottom)

Margins (3 areas were removed)
1. Lumpectomy: True margin focally positive for DCIS
2. Right Lateral Margin Around Cancer: High Grade DCIS, margins clear
3. right true posterior margin excision: margin focally positive for DCIS
Additionally this was in pathology report
Resection Margin for Invasive Tumor: Clear 0.15cm

Additionally we are not planning on having more children (current age of kids is 7mo & 3yr), also she has Endometriosis, is BRCA1/2 negative, and mitro-valve prolapse. Otherwise in good health 5'6", 110lbs, and has no problem doing a bilateral mastectomy with reconstruction, but is scared to death of chemo, herpectin and the related side effects.

We are concerned about the following and would love ANY input anyone has:
- the seemingly discouraging combination of ER+/PR-/HER2+++. Makes it seem like no matter what she needs to have herceptin and chemo of some type with bilateral mastectomy
- what seems to be significantly increased chance of recurrence with HER2+++
- the terrible side effects of Herceptin, Chemo, etc for a 32 year old.
- the high grade 3 invasive part, the HER2+++ and the focally positive margins all share the crud out of us



(Update August 2010: additional staging found a 3cm liver lesion, which was biopsied and confirmed to be breast metastasis)
CTC Score: 0
Tumor Markers 15-3/27-29: 678/1003
THC started August 9