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Old 06-25-2009, 05:41 PM   #1
Cal-Gal
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Join Date: Jun 2009
Location: Los Angeles, CA
Posts: 309
Pathology questions?

Hello Ladies and Gentleman,

I am still learning on this journey--and while I am done with my chemo regiment--I still have questions regarding my surgical path report.

What do the following notations on my pathology refer to?

1.) "Intermediate for Lymphovascular invasion"-it notes that D2-40 immuno stain examined--when I looked and found that--(I think in the lymph node biopsy noted area.) It noted this;
"equivocal, foci suspicious for lymhovascular invasion not present on stain." I was rated negative or 0/1 node. And what are foci??

2.) Ki-67 20%?

3.) SPR(tubule,nuclear, mitotic) Score 8/9 on 3 tumors 7/9 on the other?

I found through reading etc. that #1 refers to the spread of cells into the bloodstream--not sure if that is correct or not? and that is usually reported as positive or negative? mine is intermediate?

I found through reading that #2 and #3 refer to a metric to score the rate at which a tumor is growing?--but I could not find what the actual scores or numbers really mean.

I would appreciate any of you that have any feedback or explanations for me.

I remain high on life today---and grateful for all of you---


__________________
DX: 11/08 Age: 53
Surgery: 1/09
Bilat Mastectomy, no reconstruction
ILC-4 tumors-1.7 cm,1.5 cm (2).8 cm
DCIS-11 cm
All tumors Grade 3
All tumors ER-0%/PR-0%
All tumors HER2+
IHC-all tumors Overexpression/borderline
FISH 2 tumors Her2-Negative
FISH 2 tumors Her2+ Equivocal
Stage I, 0/1 nodes
LVI-Indeterminate(treated as positive)
SPR Score 8/9
Ki-67 20%
BRCA genetic test 1/2=negative
Chemo: 6 rounds TAC Feb-June 2009 w/Neulasta
Herceptin: 6/12/09-6/4/10 52weeks
HNPCC genetic test: negative
Port Placement-9/23/09 Port Removal 6/25/10
Echo's every 3 months-All normal
2/09 Staging PET/CT showed 0.2 micronodule upper R lobe-lung-Onc does not think this is mets--
6/5/09 AND 10/09 CT scan 0.2 micronodule unchanged
1/10-PET/CT-uptake in nasopharynx-
1/10-MRI All normal
6/10-Bone Scan-clear
12/10-PET/CT-All Clear-NED
12/11-PET-All Clear-NED

12/12-PET-All Clear-NED
12/13-CT w/contrast Head, Torso-All Clear
12/14-CT w/contrast Head-All Clear
2/15-Core needle biopsy-R scar line

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Old 06-25-2009, 08:01 PM   #2
Jean
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Join Date: Oct 2005
Location: New Jersey
Posts: 3,154
Hi Cal gal,
All good questions...and you are so smart to question, knowledge is power.

KI 67 is another tumor market test which shows the aggressiveness of the tumor. The level of the score is a predictor or demonstates the risk of recurrence. This test shows how fast the cells are growing. Newer research correlated Ki67 levels along with tumour size and nodal status to make treatment choices and decisions. I can hear your next question...what are the scores...0% to 15% are classified as low. 16% to 25% are classified as medium, 26% to 100% as high.

When I was first dx. Dr. Slamon used my Ki67 levels as a means to determine chemo/herceptin. When he reviewed my pathology report and saw 40% he said that was enough to detertermine treatment in his mind
(back in 05 early stage bc) early stage (1) bc was not treated with chemo/herceptin.
Ki67 levels are a strong way to help make treatment decisions with early stage bc.

Tumors and cancer cells grow with a blood supply,
so bc tissue has a blood supply like normal tissues in our body. If cancer cells under examination appear to have invaded into the blood vessels or lymphatic channels of the tumor, there is the possiblity the cancer cells have spread to nodes or other areas in the body increases.
Your test showed negative for any invaded blood vessels. This is favorable.

Foci means the the locialized area or main site of the tumor.
Hope this helps, many good wishes being sent to you.

Hugs,
Jean
__________________
Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006

Last edited by Jean; 06-25-2009 at 08:06 PM..
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Old 06-26-2009, 01:34 PM   #3
Cal-Gal
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Join Date: Jun 2009
Location: Los Angeles, CA
Posts: 309
Thanks Jean for providing this information to me!!!!

Hugs back to you,
__________________
DX: 11/08 Age: 53
Surgery: 1/09
Bilat Mastectomy, no reconstruction
ILC-4 tumors-1.7 cm,1.5 cm (2).8 cm
DCIS-11 cm
All tumors Grade 3
All tumors ER-0%/PR-0%
All tumors HER2+
IHC-all tumors Overexpression/borderline
FISH 2 tumors Her2-Negative
FISH 2 tumors Her2+ Equivocal
Stage I, 0/1 nodes
LVI-Indeterminate(treated as positive)
SPR Score 8/9
Ki-67 20%
BRCA genetic test 1/2=negative
Chemo: 6 rounds TAC Feb-June 2009 w/Neulasta
Herceptin: 6/12/09-6/4/10 52weeks
HNPCC genetic test: negative
Port Placement-9/23/09 Port Removal 6/25/10
Echo's every 3 months-All normal
2/09 Staging PET/CT showed 0.2 micronodule upper R lobe-lung-Onc does not think this is mets--
6/5/09 AND 10/09 CT scan 0.2 micronodule unchanged
1/10-PET/CT-uptake in nasopharynx-
1/10-MRI All normal
6/10-Bone Scan-clear
12/10-PET/CT-All Clear-NED
12/11-PET-All Clear-NED

12/12-PET-All Clear-NED
12/13-CT w/contrast Head, Torso-All Clear
12/14-CT w/contrast Head-All Clear
2/15-Core needle biopsy-R scar line

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