Dumb Question

[Liz J.]

Hi all,

I have a question that probably does not have an answer, but I must ask it. Especially as I am a little (not myself) right now as tomorrow I will receive my last scheduled Herceptin. Anyhow, I have read over and over again that HER2 is a very fast growing cancer. I am trying to figure this out. I was mammogramed from the time I was about 31 as I was told I had cystic breasts. No family history and not to be graphic they were mosquito bites until I was about 42 hit menopause and gained about 30 pounds. All of a sudden I developed. My point being this. No mammo's picked up the tumor. Although in 2003 I had a biopsy for something they said was not anything. I found this tumor, by the Grace of God while showering. I would swear there was nothing there the day before. I was not doing an exam, just taking a shower. My last mammo tech told me that I must have had this for years if I was able to feel it. This is not the first time I have heard these words. Does anyone have any idea how fast this grows or is it true that once you can feel it yourself it has been there for so long? The tumor was 1.5 cm. Any advice would be greatly appreciated. Thank you.

Sincerely,

Liz J.

[Lani]

one of the indications of how fast your tumor was growing was the ki-67 number in your pathology report. It is a measure of proliferation and indicates what percentage of cells are undergoing cell division in your tumor sample when examined by a pathologist.The higher the number(%) the faster your tumor grew.

When your tumor was removed, was there nearby some DCIS. If so, and with your history of not having had the tumor be visible before, you might be able to convince your doctor to get MRIs instead of mammograms.

They are now felt to be indicated in "high risk" patients and since your mammograms tend to be hard to read, perhaps that makes you one--you can perhaps try to argue that. Unfortunately not all institutions have enough experience with breast MRIs to be able to tell post-op change from recurrent tumor, so see if you can find an institution with a lot of experience doing and reading them.

Also when your tumor removed were you premenopausal? If so, your ki67 may have been temporarily high due to the phase of the menstrual cycle you were in at the time.

All of these are just food for thought.

Hope this helps!

[Becky]

I had mammos from age 35 (baseline) but I have so many benign calcifications that they wanted me to get one every year. It was 8 months since my last mammo when I found my tumor (also in the shower) and it was 1.9cm. I did not have a Ki67 done but I did have a mitotic score of 1 (which is low - slow) but who knows. Mine was about 25% DCIS. My tumor was not associated with calcifications but the DCIS did have clustered microcalcifications.


I hope you are doing well Liz. My last Herceptin was Sept 29 (and I got an extra 5) so I was at that cancer center a long time. It is a weird day to get your last one but I think you will get over it quickly. On Jan 5 I went for my first 3 month check up and since I am almost 2.5 yrs out, my next appointment is in 4 months. It felt strange to go back. I got used to not going pretty quickly. The weirdest day is when you should go for your next treatment but there is no next treatment. After that, you don't think about it too much.

Hugs to you

[Bev]

Liz,

I had a similiar experience. I found my lump showering 5 mos after a routine mammo. Ultrasound, MRI, etc showed it to be 1cm. A month later at surgery, it was 3cm.

But they do say they take 6 to 8 years to grow. I'm reserving judgement on this one. I do think it's faster than 6 -8 years.

But for now, I'm OK with finishing H. Hope that 1 year will takecare of it. BB

[Chelee]

I too have a hard time believing it takes 6 to 8 years to grow. I would swear on anything mine showed up over night. Not literally...but you know what I mean. I was shocked when I found mine. I had my mammo's and I do self exams...it showed up so fast its ridiculous. (But they say otherwise.)

Chelee

[Brenda_D]

I'm still new to all of this, but I also had a rapid growth tumor.

I think when they say it takes years to develope, they are referring to normal slower growing tumors.

I had a mammo a year ago (first mammo) and it showed an area of dense tissue. I had a US a week later and they couldn't find it on US. That was on the outside of the right breast.
They had me come back for a 6 month diagnostic follow up and that mammo was "clear" and I got the little postcard saying it was "normal". I felt relieved.
In Nov. I got the letter for my 6 month diagnostic follow up and before I made the appointment, I found a large lump in that same breast, but on the inner side, not the outside where they saw the dense tissue.
I called the doc, got the appt. for the mammo and US. Then the biopsy. It was a rapid growth IDC. Ki-67 came back as 70%. My doc and the radiologist went over the previous mammo with a "fine tooth comb" and saw no sign of anything in that breast as of 6 months ago.
I had a lumpectomy with axillary node removal. The tumor itself was 3.7 cm.
So, yes, tumors can and do grow rapidly.
I did everything "right". I did my mammos, and follow ups, and still ended up with a large invasive tumor, that has spread to inner mammary node chain and bone (according to Pet/Ct scan).
I'm not trying to scare anyone, but it can and does happen, and faster than most medical professionals realize.

[Hopeful]

My understanding is that bc tumors do not grow an an even rate; there is something called the "Gompertzian Growth Curve" that describes periods of slow and rapid growth. Here is a link to an article that discusses (in a medical malpractice context) bc tumor growth: http://www.lectlaw.com/filesh/tabtumo.htm


Hopeful

[KRISS]

Mine was rapid growth as well. Scored a 34% and was 2.2cm at time of removal. Was not there the year before and did not show up at all on the mam. It was right behind the nipple. I am still very new to all this. Can anyone tell me what DCIS stands for? Thanks, Kriss

[JulesinOH]

Have been lurking here for long time, but never posted and only joined last week. The info you all share is wonderful. I too found my tumor in the shower and was shocked at how big and quick it got there. My surgeon told me it had been growing awhile. However, when I first went to the oncologist she told me it was a very aggresive cancer and had exploded in me and that is why it was suddenly there.


JulesinOH

[MGordon]

DCIS is a "non-invasive" form for beast cancer - often referred to it as "non-invasive" or "pre-cancer". In situ, or "in place", describes a cancer that has not moved out of the area of the body where it originally developed. With DCIS, the cancer cells are confined to milk ducts in the breast and have not spread into the fatty breast tissue or to any other part of the body (such as the lymph nodes).

DCIS may appear on a mammogram as tiny specks of calcium (called microcalcifications), generally too small to notice by physical examination. In my humble opinion - women that have been told they have "cystic" breasts should have ultra-sounds instead of only mammograms because of DCIS - but I am not a doctor and insurance companies could care less about my opinion! Lisa's original 1.5 cm was discovered via ultra-sound and NOT the mammo she had 2 days before!

DCIS is a Stage 0 cancer—the earliest form of breast cancer. Stage 0 breast cancer is a contained cancer that has not spread beyond the ductal system (to the lymph nodes or other areas of the body). The cure rate for DCIS is close to 100% provided that an accepted standard method of treatment is followed and, once again in my humble opinion, the DCIS has detected early and not allowed to progress to another form of breast cancer - especially in HER2+ women.

Though DCIS is a serious condition requiring careful attention, it is not an emergency medical situation. Women have a sufficient period of time to educate themselves and weigh all possible treatment and reconstructive options before any decisions need to be made. Women should maintain an open dialogue with their physicians to best understand the disease and the variety of treatment options.

I am curious though - what are the percentage of women on this board that have been diagnosed with DCIS? Since the doctors refer to it as a pre-cancer is it possible with better detection at the DCIS stage (hmm - Mel and his early detection rant again) before the DCIS advances to Stage 1 that we could help stop thisd disease BEFORE it reaches Stage 1...

[MCS]

My mammo and ultrasound was in 11/05 showed microcalcifications and dense breasts but nothing awry. I received mammos since 40 due to cystic breasts. Barely 7 months later I had bc with small node involvement. Incredible. Actually when I think back now, I feel that if I had gone to get my mammo maybe a month earlier, it would no have been detected. I really feel that it grew overnight. I did not feel anything growing and I did regular exams and knew how my breasts feel when there were previous cysts.

HER2 does grow fast and there's nothing better than early detection

MCS ( maria)

[saleboat]

I think another point that can be made from this all-- the fact that many women had clear mammos right before their dx-- is that mammos are not a good diagnositic tool. The general female population needs something much much better for regular screening.

Jen

[MGordon]

AMEN. I insist that my daughter have ultra-sounds and mammos - and I have even paid for the additional tests myself. Ounce of prevention, pound of cure...

Love and Light
Mel

[tricia keegan]

Like so many of you I found mine in the shower and yes it really did seem to just come up overnight as I've always been dilligent in self exams etc, it was 1.9cm when removed a month after I found it.

I can't believe this was there for years unless completly doormant and something triggered it to grow.
I was saying to my rad onc how I was beating myself up for not finding it sooner and he said possibly 3 months earlier they could'nt have found it either!!
Makes me wonder just how fast this her2 can grow!!!
Tricia

[Stephanie B.]

I had a baby in August and went in for my 6 week check up and they felt nothing. Then in December I found a lump and when they took it out it was the size of a tennis ball!!! They said the horomones from having a baby probably made it grow so fast.

[rinaina]

started 7 years ago. I had an interductal papilloma in the same breast in 2001. A well known breast surgeon removed it and said it was benign. I found this due to a bleeding exudate upon self exam. I was told my mammos were fine until almost 3 years ago, just some small calcifications and density. They called me back for more views but all was fine so they said. then two years ago I went and was not called back and I regret that then I didn't follow up with a surgeon. They said there were no changes 2 years ago. Last March, I had a mammo and called back for further views and they also did an ultrasound and bingo, I had breast cancer. If they had done an ultraound 3 years ago instead of just more views, perhaps something more would have shown. If 7 years ago when I had the papilloma in my breast removed they would have said you need to be followed very closely by a surgeon yearly and have ultrasounds, then perhaps they would have found my cancer earlier at the DCIS stage. A friend of mine had an interductal papilloma last year right before my diagnosis and guess what? She was told that these things are pre cancerous and that she should be followed up very closely by a surgeon from now on. She had further testing done at MD Anderson right away due to an accident with her slides...the doctor dropped them and she lost confidence then in him so took it upon herself to go to MD Anderson and that move on her part might have saved her life. MD Anderson diagnosed her with DCIS. She required only radiation and is on Tamoxifin and doing well. I write this not because I am upset with the doctors or myself but to make all aware that if you have a papilloma of the breast, follow up with a surgeon yearly following mammos. Have them read them instead of the radiologist who in a day reads too many a day and may miss something that a surgeon will see right away. Sorry for the length of this but I wanted to make my point and maybe help someone else.

[AlaskaAngel]

See "Now it is Official--what to tell newly diagnosed breast cancer patients", in the Articles Forum, for some interesting info about speed of growth.

AlaskaAngel