Please help me with my Pathology report

[Jax]

Hi Everyone,

I had DCIS grade 3 (dx on 3/27/06) and had a Lumpectomy with Sentinel node biopsy on 4/17/06 and the surgeon said it was a small DCIS with some cancer cells just alittle beyond the clip the radiologist had inserted during stereotactic biospy and I had clean margins and negative SNB node.

Now I got a report over the phone saying that the lab at the hospital says I am ER + and PR - and HER2/NEU + and they going to do further test on the HER to make sure it is indeed positive.......

SO my question is, if the above path report turns out correct for HER being positive, what would the treatment be for it, I mean are they going to give me Tamoxifen for ER+ and Herceptin for the HER +??????

I am very frightened of the treatment for this, I mean I am going to get 6 weeks of radiation but what will the next treatment(s) be?

If anyone has a close dx and knows something, please let me know, I really appreciate it.

Going crazy again,

Jax

[saleboat]

Hi Jax,

I don't think our pathology reports are similar, but just wanted to write and lend my support. I am sure that it is difficult to make sense of all the info that your doctors are giving you. It does sound like your doctors will likely give you something to combat the hormonal positive nature of the tumor that you had-- if you're premenopausal, they're likely to suggest Tamoxifin-- if you're post-menopausal, they're likely to suggest another drug-- the class is called 'AIs' for aromatase inhibitors. I'm not sure if your doctors will suggest Herceptin given the size of your tumor-- it is definetly worth discussing.

Good luck with everything,
Jen

[Jax]

Hi Jen!

Thanks so much for your reply, every little bit of info helps me to figure out what's in line for me next. I am the type that just reads and reads and researches until I can't take it anymore. Anyway, I just turned 45 and was diagnosed at the latter part of age 44. What a bummer to have had this happen right around my birthday....anyhow, I'd rather be alive no matter what.

It seems like I'm going to go the Tamoxifen route but I won't know the real deal until my radiation doc gets the final pathology report and then he will refer me to a medical oncologist. My surgeon could explain the final report to me too but I saw her a week after surgery and she checked my incisions and answered just told me the good news of clean margins and negative node (SNB).

Thanks again and God bless you!

Jax

[Sheila]

Jax
It is bad to get this news as a birthday gift...I did when I was 50! I dont ever remember asking for THIS!!! The probably did the IHC test on your tumor, and now are doing a FISH test to make sure the Her2 is positive, because the IHC tests can have false positives. It sounds good that the SNB was neg, and they will probably do the Tamoxifen or something newer in pill form for the ER +. Hopefully you can get the Herceptin if your tumor is a strong Her2 as it is very promising at preventing a recurrence in newly diagnosed...wish it was available when I was diagnosed 4 years ago! Radiation will probably be added if you just had a lumpectomy, and since it is DCIS and not invasive cancer, you may not need any chemo....don't be afraid to ask questions here...there is always someone who has been in your shoes....or had a given treatment....the biggest fear is fear of the unknown...and we all help each other with that. Be comfortable with your Dr and oncologist...if you are not, seek another opinion...many of us have done that! Welcome to our club....we wish people didn't need to join, but we are here for you!!!

[karenann]

Jax,

Did you have invasive cancer, too? If I remember correctly, most DCIS (if not all) is Her2+++ and because it is not invasive, it is usually treated with one of the estrogen blockers and rads (if you have a lumpectomy). Typically it is not treated with chemo and Herceptin. Maybe Her2+++ DCIS is being treated differently now. I don't know???

Karen

[Jax]

Thanks Sheila and Karen, you guys are so kind to respond to my concern about this HER2/NEU + thing.....I bet the lab is doing the FISH test to be sure but I will surely ask!!

I will be bugging my docs tomorrow about this......

Thanks again,
Jax
(I never had invasive cancer, first time and it's DCIS g3.)

[Sheila]

Jax

Please keep us informed when you get your results so we can help you more....I know you must have alot of questions right now, but you are VERY lucky if it is just the DCIS instead of invasive...the prognosis is much better!

[Jax]

Thanks Sheila, I will keep you posted on my prognosis once I get it hopefully early next week......I do have a lot of questions and am so delighted that people like you really care and want to help out....I have to admit that I was crying alittle today and then had to take a xanax cuz it was just all getting so overwhelming for me....Tamoxifen, Herceptin, Bla, bla bla........

Thanks again and I will post as soon as I find out the final diagnosis.

PS I've already made an appt. w/a good medical oncologist to discuss the results in detail......I wish my surgeon would discuss it too but I don't see her for another 6 months.

Best Regards and ((((Hugs))))),

Jax (Jackie)

[VaMoonRise]

Jax, Hi, Hon, and welcome to the group. I am sorry that you have had to join us but if you had to join a support group this is one of the best.

I don't want to scare you but I would rather you be as informed as possible rather then not, and of course your story may be, and hopefully will be, very different then mine.

I was diagnosed with microcalcifications non-invasive DCIS in March of 2004. I too had a stereotactic biopsy and was grade 3 but I was ER PR positive . They didn't remove any sentinel nodes (wish they had). I had a lumpectomy and radiation and even had a second lumpectomy to recheck the margins which came back clean. I was assured that by 99.9% that they had gotten it all and that I was cancer free. Well, in December 2006 I had a gallbladder attack and went in to have it removed and when they went in they found cancer spread throughout my liver. I also have two spots on my spine and I am HER2 positive but the metastatic cancer to the liver is ER PR negative. I am currently on a clinical trial of Herceptin, Taxol and Lapatinib and receive Zometa once a month as a bone strengthener. Perhaps if they had removed the sentinel nodes I wouldn't be in this stage now, stage 4, but the onc says even if they had removed any sentinel nodes that they probably at that time would have come back clean and may still be clean. They seem to think that it traveled through my blood stream as opposed to the lymphatic system.

If I were you I would definitely push for some type of therapy other then just radiation, but that is just my opinion for what it is worth.

Here is a great article to read on DCIS called "Is it really DCIS?" I wish you all the very best, please keep us informed on how you are doing and what your treatment plan will be.

http://www.annalssurgicaloncology.org/cgi/content/full/8/8/617

Big Hugs,
Nicola

[Jax]

Thanks Nicola, I will definitely keep you all posted, I was never on a more compassionate website on this.....thanks so much.

I am so sorry for what you are going through and hope and pray that the light at the end of tunnel will be shinning for you soon, I will keep you in my prayers.

This disease is so despicable and insidious, I wish someone out there would find a cure or preventative for it.....hopefully in our lifetime.

I will check out the website on DCIS that you advised...

Best and warmest regards,

Jax

[sadie]

I was diagnosed 10-03-05 after a routine mammo revealed small cluster of calcifications.
No lump to feel, although surgeon said he could feel a firmness in the area.
Post menopausal.
Biopsy results were DCIS 6mm with spotty margin. Her2+++
Lumpectomy results IDC 4mm more with clean margin. Sentinol node negative.
HER2++ (IHC test) No fish test done per Onc because if HER2++ or greater, it is known to be a true positive (I have heard conflicting reports on that).
ER+/ PR weakly positive.
Treatments:
Adramyacin & Cytoxin every 3 weeks x4 (not bad; alittle queaziness;meds helped)
Herceptin & Taxol every week x 12weeks (better; a few aches & pains)
Herceptin to continue thru Feb 2007 for 1 year total. (should be even easier)
Radiation will begin mid-May 5x/week x6weeks
Will then take Arimidex.
Treated aggressively because of Her2 status. Even tho sentinol node negative, they wanted to do chemo & herceptin "just in case one cell "got away thru the blood stream".
Had mammogram to affected breast 4/25/06; came back negative.
Prognosis: Onc said she "would be shocked if there was a recurrence. I should live a long & happy life".