Change in Stage??

Alice F · 07-15-2007, 08:41 AM

Hi All,
At the time of my dx (8-06)I was classified as IDC Stage 2,(T2-N1-MO) Grade 2, triple positive. Had neo chemo A/C) taxol/herceptin, bilat mast w/full node dissection, radiation, ongoing with herceptin, and began tamoxifen in April. After my mastectomy my pathology report said my tumor stage was pT1b, pNO, pMX. Does this mean my stage changed or will I always be considered a Stage 2 despite what good outcome I received from the chemo? Also my HER2neu went from 3+++ to 2+. Does a weakened HER2 make for a somewhat better prognostic factor or not? I'd appreciate any replies. Thanks so much.

Alice

Karen Weixel · 07-15-2007, 10:28 AM

I think you are always considered the stage you are first diagnosed with.

Karen

07-15-2007, 10:37 AM

Hi Alice,

I have no idea if technically your stage changed or not. But I honestly don't think so far as your health is concerned the stage matters. I'm stage 1a but I also have markers that are higher than many women on this board with stage IV cancers. What really matters is that you stay on top, check out symptoms if you get them, and get the tests and scans you need, as they come due.
Some women go from stage 1a (or even from pure DCIS) to Stage IV, and many, many women in Stage 2 never recur or advance.

I have no idea about your question re HER2+ or HER3+++, except to say that we all have different FISH results (mine is 4.7); other women have higher numbers and others have lower, but most doctors say, don't concern yourself about the numbers, just do the treatment. I don't think any of the trials found differences between the FISH numbers with respect to recurrence. So if your tumor is responsive to herceptin, it should respond whatever the number.

So, bottom line, you responded to the neoadjuvant treatment, and that's great.

Brenda_D · 07-15-2007, 11:56 AM

I kind of wondered the same thing.
I was dx'ed StageIV at presentation. Pet/CT scan showed mets in bones. After chemo and before rads, I had a bone scan that showed NED to bones. Although I have a positive IM node, and won't get a new CT scan to check that one until around October, I wondered if being NED as far as bones, would that change my Stage?
I don't think so, but it's nice to know nothing is showing in my bone right now.

Adriana Mangus · 07-15-2007, 12:14 PM

Dear Brenda:

What procedure rule out mets to bone? I have been experiencing pain in my knees, elbows and shoulders for a while now. I had a bone scan and it showed minor arthritis to joints? I'm concerned, I hope this is not a mistake. Any suggestions??

Brenda_D · 07-15-2007, 01:02 PM

I had a bone scan after chemo and it states they see "no evidence of metastatic disease to bone", and "no evidence of bone destruction".
It did say there is some evidence of degenerative disease in the right knee and ankle. Probably arthritis.

I did want to add that if you read my Pet/CT scan report, it would scare the heck out of you, and I had 3 doctors tell me (including my Onc), that what it said it what it is. But, when I got to my Rad Onc, he poo-poo'ed the report and said it shows things that aren't there. That's why I had the bone scan.
Whether the Pet/CT was accurate or not, I was happy to see "no evidence of disease" on the bone scan report.
I'd also add that I think if you have pain in joint areas, it's more than likely arthritis.
If it's in the middle of a bone area, it could be something worse.

Sherryg683 · 07-15-2007, 01:15 PM

You are always the stage that you were diagnosed with, except if you progress. Once a stage IV, I cannot go back to being stage I. But a stage I can advance to stage IV...sherry

Alice · 07-15-2007, 03:28 PM

Hi Alice,
It's so nice to have another Alice on the board (Not that I want anyone to have to be here). It is my understanding that the original staging is the one that you keep unless of course it increases. The best news you have is the very good responce to chemo. I also had neo-adjuvant chemo and had a good responce. I was sceptical for a long time about not having surgery first, but looking back I am so glad I had the chemo first. There are so many out there that don't know if the chemo was effective or not due to having surgery first. I know it is not the most common rout or the best rout for everyone. Are you also hving radiation?

LAURIE · 07-15-2007, 05:05 PM

At diagonosis I was stage II because of suspected tumor size, after chemo and then surgery I became a stage IIIc because of my large lymph node involvement. It was explained to me as first it was a clinical staging then a pathological staging. My tumor did shrink with chemo but micrscopically it did not. They still had to take out the same amount to make me have clear margins.

Sherryg683 · 07-15-2007, 06:35 PM

Laurie, I am sort of like you. I was told at first diagnosis that I was Stage I, because of the size of my tumor, it was small. It took them almost a month to do surgery, so for month I figured I was pretty much going to be just fine. Then right after surgery they could see that at least 13 lymph nodes were positive so I was told I was a IIIC. A week later they did a PET/CT , 2 small spots lit up on the PET scan in my lungs, so I was told I was now stage IV. It was one hell of a month to say the least. ..sherryg683

Alice · 07-15-2007, 07:23 PM

My staging was also changed after chemo and surgery. At first I think all they have to go on is what they can feel and sometimes that is just not enough. I was originaly diagnosed as stage 2 but after all was said and done I was stage3. I think everyone should get a pet scan prior to being told their stage. I know that the staging process is somwhat subjective, and the scans, including the pet scan are not as acurate as we would like them to be. I also am aware that cancer doesn't have to go through step by step staging as we would like it to have to do. It can skip when it wants to. I also know that we can not see what is hapening on the cellular level " yet".