pathology or clinical staging?

[LAURIE]

I have been going though all of this craziness with 2 conflicting stagings. I knew as soon as I got my pathology report I was considered stage III (with the 10 positive nodes and 3 cm tumor) Actually I thought Iwas IIIC, to be technical. I talked to my oncologist about this and he insists I am Stage II. I know it should not make a difference, (since treatment is the same) but for insurance reasons for the future I wanted to know, plus I wanted to answer correctly when people asked. My radiation Oncologist explained it to me as this. My oncologist is looking at the clinical staging and I was looking at the pathological staging. I am not really sure which staging is used for what situation, and think that all records at my oncologists office say stage II. I insist I am stage IIIc and the normal BC world goes off of pathology rather than clinical. I guess I am different in that I fall between the two thoughts of staging.

[skeetur]

If you look at this page from NCCN (.org), it says that pathological staging is usually more important because it includes lymph nodes whose status can only be determined microscopically.

http://www.nccn.org/patients/patient...t/4_stages.asp

Hope this helps.

Kathy

[dlaxague]

If you look at the staging guidelines, you're clearly stage III. I think clinical staging is relevant only until pathology becomes available and then clinical staging defers to the more accurate information. This is a long PDF document but on page 52 the staging guidelines and discussion begin:

http://www.nccn.org/professionals/ph...PDF/breast.pdf

These guidelines came out a few years ago - maybe your oncologist is not using the new ones yet? The new guidelines have much more to say about micromets to lymph nodes, and they also changed staging considerably depending upon number of positive nodes.

Debbie Laxague

[LAURIE]

Thank You, I have been questioning my doctor a lot lately, I have found out that things that he has been saying lately are outdated, I feel bad questioning him but I am in contol of my treatment.

[Karen Weixel]

Don't feel bad questioning him. A second opinion is a good idea, too.

Karen

[lkc Gumby]

Hi Laurie,

When my onc first examined me his clinical exam was " probably stage 1" ,
the following week I had the first of my surgeries , and wound up with stage IIIC, which did freak me out, as I was diligent with SBE and mamos. ( I found my lump too)
Anyway that was back May 05, and Herceptin was just being discussed for non metastatic BC.
Wahooo, I was able to go on and am still on Herceptin( Its been 18 mos ) My onc down here is awaiting the results of the 2yr study.
I am NED and remember well being wheeled into surgery reading the frontpage article in Newsweek aboutthe success of Herceptin.
I get it every 3 weeks and aside from a runny nose, I haven't had any problems.
Although HER pos tumors are aggressive and fast growing the arsenal available now is amazing.
Please continue to be your own advocate and question everything. If you don't feel comfortable asking questions, please consider a second opnion.
I wish you well.
God Bless,
Linda

[Jean]

Dear Laurie,

Never feel bad to ask questions....you should and it is advisable that you do.
Ditto on the 2nd opinion......

All good wishes to you.
Jean