what stage am I???

[sunny Lisa]

Hi all, I had a 9 cm x 3cm tumor of DCIS removed. Positive margins after mastectomy(has anyone heard of that?) 6 nodes removed all neg and no micro invasion found.
What stage is this? Has anyone been treated with Herceptin or other chemo with a similar diagnosis? I am ER and PR neg. Her2+++,grade 3 with necrosis. Thanks, Lisa

[atdec05]

Hi Lisa,

it sounds like you have extensive DCIS. If you don't have IDC and your nodes are negative, I believe you're stage 0.

Your pathology report should say where the margins weren't clean, e.g., was it near the chest wall?

I would think that radiation would be recommended (depending on where the unclean margins were).

What did your surgeon say? Do you require more surgery?

- Anna

[Catherine]

Hi,

I would call your doctor and ask what stage you are. Ask them for a copy of the pathology report. I thought staging had something to do with the size of the tumor. I thought margins were either clean or not clean. Definitely get a complete diagnosis and explanation from your doctor. My surgeon had a hand out that she filled in "my numbers." It was actually a little booklet that described size, node involvment,er,pr, her2.

All the best, Catherine in Oregon

[tousled1]

Lisa,

You should ask your oncologist or surgeon for a copy of your pathology report. A good website that shows how to read your pathology report and about staging is www.breastcancer.org

[Debra]

Lisa -

Did they tell you 9 centimeters or was it 9 millimeters? I was told that I was automatically in the Stage II category (prior to node testing etc), just because my largest tumor was greater then 2 cm. (it was 3.8 cm with an additional tumor measuring .9 mm)

[skeetur]

If it was all DCIS, then you are considered stage 0.

I was initially dxed with DCIS (not sure of total size) but once they did my pathology they found small spots of IDC so I'm now considered stage I.

Skeetur

[mts]

Hello!

Take a peek at the link to see more about staging. I also wanted to ask if your tumor was 9cm or 9mm ? BIG difference! Either way, the breast has been removed and if you had "dirty" margins -you will likely have rads.

Whatever Stage you are; it NEVER hurts to get a second opinion. Many of us on this board have had multiple opinions because there is so much info to absorb and in the end it will be up to you to decide.

http://www.breastcancer.org/dia_pict_staging.html

Maria (MTS)

[sunny Lisa]

Hi, Yes it was 9cm which I know is huge. Total size was larger since the lateral margin was still positive. It was smashed to 3cm by 9cm because it was draped around my breast Augmentation implant. Does the size play a role in staging. Long story...but my doctor is no longer taking my calls and the new onc. is close to impossible to reach. I have to make an appt.,day off work and long drive to see her. I ask questions here because the knowledge shared here is sound and much faster! Thanks for all the replys. Lisa

[skeetur]

For DCIS, I do not think that size matters in staging. DCIS is always labelled stage 0, which is good! Really!

Size plays a roll in staging if it is invasive cancer but not in DCIS.

I had quite a bit of DCIS in there (do not know size) but because I had 2 very small areas of IDC (invasive ductal carcinoma) the largest of which was .3 cm (3 mm) - I'm considered stage I.

Good luck, Skeetur

[mts]

Hmmm... your Doc is "no longer taking your calls?" WHAT ???!!! So what's the treatment plan for you? It would be nice for you to get the plan going so you can make the most informed decision. All I can say is that I went to 5 different onc's before I decided what route to take. I know that sounds excessive, but this website was not on my radar at the time and therefore the benefit of this board's knowledge and experience was not available either.

If you were to stage your tumor based on its size, you would be a Stage IIIA. I had three small tumors that combined added up to more than 2 cm and therefore I was upgraded to Stage II. I am 15% ER+ and PR-, no nodes and had lumpectomy.

Just be sure you have an onc (preferably one that returns your calls) that respects your concerns and is willing to help you ease your mind. Half the battle is being able to put your life in someone elses hands and if that person is not willing or able to find the time, then move on until you find one that does. I too travel a lengthy drive to my current oncs office. But he's worth every drop of gas.

Keep us posted on what is next with you!

Maria (MTS)

[Karen Weixel]

As far as I know, DCIS is considered stage 0, therefore, size does not matter. If it is too extensive, that is where a mastectomy comes into play with DCIS.

For instance, I had 4cm of DCIS removed and right above that was 1.3cm of IDC which put me at stage 1, because of the invasive disease.

Hope this helps.

Karen

[CLTann]

Your nodes involvement would put you at least in stage 2. It is the spread and the size that define the stage. The dirty margin indicates that cancer has spread through the lymph system to nodes. I would guess that your treatment plan will include radiation and chemo. It is true that if all your cancer cells are in-situ, you could be stage 0. But the fact that your cancer cells are no longer limited to the inside of the milk ducts, the classification got to be 2 or greater.

Sorry to be so straight forward.

[skeetur]

My first lumpectomy didn't yield clean margins of DCIS. Within my DCIS, was 2 tiny bits of invasive cancer. The fact that my margins aren't clear hasn't changed my staging at all but the path isn't back yet. I just went for a re-excision this week to hopefully remove the rest of the DCIS. If the margins are now clear and no more invasive cancer is found in what they just took out and it was just more DCIS... I'll still remain at stage one since the largest of the 2 small bits of the invasive component (IDC) was .3 cm.

Skeetur

[skeetur]

Lisa,

They need to go back in and get clear margins on the DCIS. I just had this done on Tuesday. I'm hoping for clear margins this time around.

Good luck!

Skeetur