Path reports scares me

[linn65]

linn65 wrote:

Left breast masectomy with axillary nodes
Invasive ducktail carcinoma
Size 3.2 cm
Architectural score 3 of 3
Nuclear score 3 of 3
Mitotic score 3 of 3
Total score 9
Grade 3
Metastatic cancer 6 of 8 nodes
Largest node 1.5 cm
Extracapsular extension present

I had TCH x 6 and it doesn't seem like numbers have improved.

['lizbeth]

Hello Linn65,

Stressful, concerning . . . but you are not done yet with treatments. Looks like you still have radiation and the hormone therapy for being ER+.

I'm a bit confused. You were diagnosed with a 5.5cm tumor. Yet the path report showed it was only 3.2cm so are they certain the tumors did not shrink with neoadjuvant chemo?

My thoughts about cancer is that a good offense is the best defense. So radiation, the ER+ meds. Perhaps the other board members will have some suggestions. I have noted with ER+ cancer is effected by Body Mass Index. So now is the time to exercise and eat your veggies. Be careful with high content fatty and sugary foods.

A poor prognosis on the "old" cancer standards does not necessarily mean progression. It does mean being very vigilant and getting lots of great help from your medical team to stay on top of things.

Keep learning and be determined to be healthy!

Sending love and prayers for good health your way.

[Lien]

Hi Linn65,

Hmm. Not a very cheerful path report, but nowhere near disastrous. It tells you that this chemo combo did reduce the size of the tumor somewhat, but didn't bring it to its knees. I know of several women who had a similar diagnosis, doing very well on hormonal therapy. This is a stubborn type of cancer and it may take some tweaking before you find the right kind of therapy. May rads and hormonal tx bring you NED (No evidence of disease).

Hang in there! You still have a long, long way to go.

Love

Jacqueline

[linn65]

5.5 cm was the beginning but I am not sure because I had several of them and they were like clumped together. However, maybe it shrank. Just from. Breast MRI before surgery doctor said things stayed the same which was a blow. But he said don't worry the lump that is not what is going to kill you but the spread of the cancer. So that was the reasoning for pre-chemo....the first ultrasound was done by a different doctor and biopsy too. He wanted to do double mastectomy the following week. Went for second opinion in Indy at a breast center and his treatment was complete opposite. So I went with second opinion.

Today the nurse removed my drains and gave me a copy of path report but I have not seen doctor yet. My appt with him is the 7th..... It's been a whirlwind.

July I found a lump and August chemo, then 3 weeks out of chemo masectomy. And radiation in 4 to 6 weeks, herceptin next week for 9 more months .

[linn65]

Oh and doctor after surgery said he removed 4 to 5 nodes and then path said 8. He said relax and don't worry. Okay.

[BonnieR]

It is unfortunate that you were handed a path report without explanation or filter. That is unprofessional and disconcerting. It happened once to me and was a very anxiety provoking. I also once had a doctor tell me to put my worries in a boat and float them down the river. I fired him! ( he was a GP and easier to replace than onc!)
Is there a way you can see the doctor sooner to review the report?
Sometimes when they remove lymph nodes, a few are clumped together and go along for the ride
I can't speak to your actual numbers but wanted to offer support and remind you that these are early days and you will get it all sorted out and devise a plan of attack
Never hesitate to get more opinions as needed for peace of mind
Keep the faith

[Debbie L.]

Hi Linn. I don't have any answers for you, but a few suggestions. It seems unfair to just hand you a path report and then leave you hanging for so long. Is there any way you can get the MD app't moved up to some time before the 7th? I don't know about you, but I do much better with firm information, rather than all-over-the-place mind-wandering.

And the second suggestion, one that I make for almost everyone who has questions, and for some who don't -- is that this seems an excellent time to get a second opinion from a comprehensive cancer center. Often these can be done remotely, by phone or even in some sophisticated places, by remote video. The second opinion may well recommend exactly the same thing your regular oncologist has recommended but that's not a bad thing. A second opinion will help you to go forward with confidence.

Here's a link to a list of comprehensive cancer centers in the US: http://cancercenters.cancer.gov/cancer_centers/cancer-centers-list.html

Oh, and about the number of nodes, my understanding is that the surgeon removes a clump of nodes so doesn't know exactly what's in the clump. The pathologist goes thru the clump carefully and gets the exact count, and the details of cancer presence (or absence).

Keep us posted, please.
Love,

Debbie Laxague

[phil]

I know it sounds scary , but many here have been in similar places. the doc is right about size of lump not mattering so much , many are in that range , surgery takes care of lump. Gone !! then rad is very good at killing cancer in any area it hits. It sounds like you switched to a bc specialist at a research clinic ? Thats the best place to be, to decide on the best systemic tx. Keep us posted .
My wife is doing great , stage iv since 2006 , now no evidence of disease on herceptin t dm-1, which works well for many ( not all ) w/ a high overexpression of her2 + . It should be FDA approved by the end of feb ., if not sooner.