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04-28-2007, 08:07 AM
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#1
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Senior Member
Join Date: Dec 2006
Location: Massillon, Ohio
Posts: 247
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pathology or clinical staging?
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.
__________________
Laurie
Diagonsed 8/10/06 (found own lump)at 35
Her 2 +++, er-/pr-
4 A/C 8-29-06 to 11-06
Lumpectomy, node dissection- 11/30/06
Pathology report stage IIIC
1 tumor 3 cm
10 of 15 nodes +
12 Taxol 12/18/06-03/06/07
Herceptin 12/18/06- 12/11/2007 done!!! yeah!!!
33 rads started 3/22/07, done!! yeah!! 5/07/07
Lymphedema diagonsed 2/1/07
BRCA1/BRCA2 negative
port out 1/10/08
pregnant after 6 yeas of trying- due mid feb.
Ryder David Kessel Hunter born feb.6th 2009
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04-28-2007, 08:21 AM
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#2
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Senior Member
Join Date: Jan 2007
Posts: 72
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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
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12/01/2006 Initial Dx via stereotactic biopsy - DCIS, grade 3
12/27/2006 Lumpectomy w/ SNB: 2 foci of IDC (largest .3 cm, Grade 2, Notthingham score 6) amid large area of DCIS: No clear margins on the DCIS; re-excision recommended
ER+(55%)/PR+(60+)/HER2+ (2.8+ via IHC?)
01/23/2007 Re-excision Lumpectomy: No clear margins on the DCIS; mastectomy recommended
03/02/2007 Bilateral mastectomy w/ expander implant insertion
03/19/2007 Emergency surgery to fix broken blood vessel in left breast
03/30/2007 Met w/ oncologist; oncologist checking on HER2 status with pathologist and doing some consulting on my case - no treatments for now!
05/02/2007 Next appointment w/ oncologist
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04-28-2007, 08:33 AM
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#3
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Senior Member
Join Date: May 2006
Posts: 221
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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
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04-28-2007, 08:36 AM
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#4
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Senior Member
Join Date: Dec 2006
Location: Massillon, Ohio
Posts: 247
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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.
__________________
Laurie
Diagonsed 8/10/06 (found own lump)at 35
Her 2 +++, er-/pr-
4 A/C 8-29-06 to 11-06
Lumpectomy, node dissection- 11/30/06
Pathology report stage IIIC
1 tumor 3 cm
10 of 15 nodes +
12 Taxol 12/18/06-03/06/07
Herceptin 12/18/06- 12/11/2007 done!!! yeah!!!
33 rads started 3/22/07, done!! yeah!! 5/07/07
Lymphedema diagonsed 2/1/07
BRCA1/BRCA2 negative
port out 1/10/08
pregnant after 6 yeas of trying- due mid feb.
Ryder David Kessel Hunter born feb.6th 2009
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04-28-2007, 10:21 AM
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#5
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Senior Member
Join Date: Jan 2007
Posts: 138
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Don't feel bad questioning him. A second opinion is a good idea, too.
Karen
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04-28-2007, 03:51 PM
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#6
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Senior Member
Join Date: Feb 2006
Posts: 437
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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
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Linda
Dxed Stage IIIC May 05, 12 pos nodes
er/pr -neg,Her -pos
LVI
Right partial mast & partial axillary dissection-June14,2005
Right modified mast-no clear margins- June 30, 2005
DD AC x4
Taxotere X4 with Herceptin
Rads x 35( 5 fields )
Left prophylactive mast( atypia & hyperplasia found ),
put on Tamoxifen x 1 yr; D/ced due to endometrial thickening
bilateral recon (saline implants)May 06
Nipple recon July 06
metformin 2010
removal of implants due to severe encapsulation, insertion of gummies 2013
Reclast Q yr
NED!!!
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04-29-2007, 02:47 AM
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#7
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Senior Member
Join Date: Oct 2005
Location: New Jersey
Posts: 3,154
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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
__________________
Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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