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Old 11-01-2010, 10:38 AM   #1
meglove
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Help needed in understanding my pathology report

Dear all,
the nurse just faxed me my pathology report after bilateral mastectomy. Forgot to ask for a copy when left surgeon as they were running late and super busy that day.
I noticed in the diagnosis section, there is statement as follows:
A:Granulomatous and chronic inflammation and fibrosis
B: multiple residula foci of mucinous carcinoma (had lumpectomy before bilateral mastecotomy.
C: extensive intraductal carcinoma component (intermediate nuclear grade)

What kind of invasive cancer do I have: IBC or mucinous?
What is the grade for mucinous carcinoma?
Is the DCIS grade 2?

Any thoughts or suggestions are welcome. I am waiting to see an onc next. Do not who yet.

Thank you so much!

Meg
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Aug. 5 2010 See family dr for bloody discharge from right breast (age 38)
Aug. 8 mammo and us, suspicious tumor (tumor has been there since 15 ys old, B9 in 2001 by fine needle biopsy)
Sep 13 lumpectomy and SNB (SNB is clear but margin in breast found DCIS)
Oct 8 abdomen US: clear (fibroid in uterus which was there bf)
Oct 12 whole body scan: clear
Oct 18 BMX: multifocal mucinous (margin 1cm, tumor size 3*2.8*2.5 cm) and multifocal DCIS (margin 0.7 mm, one is 1.7cm) in right breast, left breast found benign lumps
Oct 28 told tumor is triple positive
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Old 11-01-2010, 11:28 AM   #2
ElaineM
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Wink Re: Help needed in understanding my pathology report

I am not an expert, but it sounds like you have a combination of things going on. It is amazing that you have had a tumor since you were 15 without treatment so far. If you are triple positive your doctor will offer some kind of therapy for that.
Take good care of yourself.
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Last edited by ElaineM; 11-01-2010 at 11:31 AM.. Reason: addition
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Old 11-01-2010, 11:34 AM   #3
ElaineM
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Wink Re: Help needed in understanding my pathology report

Triple positive usually means her2, estrogen and progesterone positive. That means all three contributed to the tumor growth.
Take care.
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12 years and counting
http://her2support.org/vbulletin/showthread.php?t=48247
Lucky 13 !! I hope so !!!!!!
http://her2support.org/vbulletin/showthread.php?t=52807
14 Year Survivor
http://her2support.org/vbulletin/showthread.php?t=57053
"You never know how strong you are until being strong is the only choice you have." author unknown
Shared by a multiple myeloma survivor.
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Old 11-01-2010, 07:05 PM   #4
Laurel
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Re: Help needed in understanding my pathology report

Meglove,

You have invasive breast cancer (IBC) that is mucinous. Mucinous BC tends to be less aggressive, with a low miotic rate, meaning it is replicating slowly. It is usually found in the presence of "extensive" ductal cancer in situ (DCIS), which means cancer confined to the ducts. You are right that you are grade 2 DCIS, however your invasive component, the IBC, will determine your staging. I think you said it was a centimeter, which should place you as Stage 1b, N0 (no positive nodes). As for the grade of your mucinous component (the IBC) I am guessing it is a low grade, most mucinous cancer is. As I told you previously, mucinous cancer makes up only approx. 2% of all breast cancers. It tends to be less aggressive, and is usually not Her2 positive. Having the bilateral mastectomy was a good move. Are you having reconstruction? It is so worth the effort.

All in all, you could be in a much worse position. My guess is with chemo and Herceptin you will have a very favorable prognosis.
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Dx'd w/multifocal DCIS/IDS 3/08
7mm invasive component
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Old 11-01-2010, 08:12 PM   #5
chrisy
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Re: Help needed in understanding my pathology report

Good answers laurel as always. I read a couple of things differently.

First I would not call the intraductal component IBC as that is typically the acronym for inflammatory bc. Intraductal carcinoma is generally referred to as IDC. Picky picky I know but they are two very different things and it gets confusing.

Not sure the phrase ending in "chronic inflammation" referred to cancer. because I didn't know the words before for sure but the word fibrosis seems to usually not be cancer. So definitely needs to be explained.

I did note residual foci of mucinous carcinoma which to me means that there was still some present. But I do agree mucinous is generally less aggressive

You've just learned the downside of getting lab reports on your own. So get on the horn with your oncologist first thing tomorrow.

Also just be aware that not everything mentioned on a path report is bad news but the words can sound scary anyway.

You will feel much better after discussing with your onc, getting your questions answered, and getting a plan of action

I read residual
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June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 11-02-2010, 05:55 AM   #6
meglove
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Re: Help needed in understanding my pathology report

Thank you guys very much.
Just edited my signature. The mucinous tumor is 3*2.8*2.5 cm. So that put me in stage IIa.
I live in Canada right now.It seems BC with triple positive starts with FEC, followed by TH in Canada, but I read in the United States Her2+ has TCH to start with and has become a new standard now. I live very close to the border to the states. Am thinking if it is wise to cross the border to get TCH. Will try to talk to the onc about TCH but kind of certain he will follow Canadian standard. If TCH works well for triple positive, I am hoping to avoid other drugs in chemo if my assumption is correct. I will have medical insurance in Jan from husband's work.
Any suggestion is appreciated. Best wishes to everybody.
__________________
Aug. 5 2010 See family dr for bloody discharge from right breast (age 38)
Aug. 8 mammo and us, suspicious tumor (tumor has been there since 15 ys old, B9 in 2001 by fine needle biopsy)
Sep 13 lumpectomy and SNB (SNB is clear but margin in breast found DCIS)
Oct 8 abdomen US: clear (fibroid in uterus which was there bf)
Oct 12 whole body scan: clear
Oct 18 BMX: multifocal mucinous (margin 1cm, tumor size 3*2.8*2.5 cm) and multifocal DCIS (margin 0.7 mm, one is 1.7cm) in right breast, left breast found benign lumps
Oct 28 told tumor is triple positive
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