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Question:
#61
2/14/2009
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42 years old, Right breast diagnosed with DCIS in May 2007 had lumpectomy, radiation and tamoxifen. Recently tested for BRCA 2 gene positive, had bilateral mastectomy 4 weeks ago.
Pathology report says, 1. Right breast mastectomy: residual intraductal carcinoma, microscopic, away from the biopsy site, 2 mm from the inked deep margin, no invasion seen.
2.Right breast, additional inferior margin, excision: focal fatty mammary tissue with rare intraductal carcinoma 0.9 cm to the new surgical margin. My questions are, 1.what does rare intraductal carcinoma mean? a serious type of cancer?
2. Do I have recurrence of cancer?
Thank you very much for your time. |
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not sure what is meant by the pathologist using the word "rare". never seen that in a report regarding DCIS before. the answer to the question about recurrence is yes. and they found several areas of it in the breast so it just wasn't one spot. good you did this surgery. a question still remains though. sounds like the margins may have had dcis literally "at them." if that is the case a discussion with a radiation oncologist may be needed to ensure that you don't need any chest wall radiation. usually you don't but in some "rare" situations they do. so ask about this. hope your next surgical stop is to get ovaries out. LS |
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Question:
#62
2/14/2009
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had high grade dcis comedo type.from 1st biospy. after partial mastectomy. post surgery pathology report. stated benign findings. could you please tell me if i did have dcis.what the surgerical report would of possibly shown. also now after 3 weeks.the lab is doing a dna on my biospy. can you tell me what this might be for. thank you |
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i'm not familiar with doing DNA on the biopsy?? if there was invasive breast cancer and it was hormone receptor positive then i could see doing oncotypeDX perhaps. not sure what is meant by the DNA test though. to ensure they sampled the right area, a wire should have been placed to bulleye the area where the 1stt biopsy was done. then after the operation the specimen should have been taken to radiology to be xrayed before going over to pathology. this way they have assurance that the correct area was biopsied. so normally on a surgical specimen you would see the measurements of the specimen, mention of the wire, mention of a clip inside the specimen (which should have been placed there when 1st bx done) and then a deion of the pathology cell findings, for which usually you would see mention again of DCIS and what each of the 2 margins looked like. grade would also be listed. LS |
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Question:
#63
2/14/2009
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I had breast cancer four years ago, with lymph node involvement...lumpectomy, chemo, radiation and feamra ( still taking ) recently do to left hip pain, MRi was done and lesion was seen on hip, original path report says they do not think it is bone mets, but sent biopsy to the top guns down in Sf.for further testing, i ask doc, so it''s not cancer , and he says...didn''t say that, we just have to wait. ALso to note: under my left arm pit.....swollen what seems to be lymph, has enlarged in the last month when i first noticed it. To get a hold of my docs sometimes is very frustrating....what do i do? |
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the lymph node needs to be checked, preferably with ultrasound and a fine needle biopsy done of it to determine its cause. it may be local recurrence given you had nodal involvement originally. sounds like a bone biopsy was also done. very smart. its either going to be arthritis or cancer. hope you get results soon to get you out of limbo. LS |
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Question:
#64
2/9/2009
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Breast pathology report states Pathologic Stage:T2 NO(i+) and under Sentinel Nodes(Step Section and Cytokeratin Immunohistochemistry), Number of Sentinel Nodes: 2, Number of Sentinel Nodes Positive For Metastasis: 0 (A Single Lymph Node Shows Isolated Tumor Cells, 0.53 MM), Final Lymph Node Count(Positive/Total): 0/2 I am confused as to what this all means. The surgeon says this is lymph node negative while the medical oncologist says the isolated tumor cells, along with Stage II due to tumor size, is reason for chemotherapy. What does the (i+) status mean for determining risk and weighing treatment options? The Oncotype DX test is being done and results should come in a week or so.
Thank you so much for being there and for offering help.
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The pathologist found isolated tumor cells, not large enough to consider the lymph node positive requiring a full nodal disection. It is impacting your medical oncologists decision but more importantly, the size of tumor and stage will lead him/her to suggest chemotherapy as well. The Oncotype DX is an appropriate test for helping make decision for chemotherapy. ds |
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Question:
#65
2/8/2009
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I am a bit confused by reading some of the questions and answers regarding KI-67. Some of the responses lend me to believe that KI67 results correlate with risk of recurrence but other responses make me think the test has nothing to do with risk of recurrence. I was diagnosed over 3 years ago with stage IIb 2.1 cm tumor with one sentinel node positive. My tumor was strongly positive for both ER and PR and her2 was negative by FISH. I had bi-lateral mastectomy with reconstruction, dose dense chemo AC plus Taxol and radiation. I also had my ovaries removed and am taking Femara. My biopsy showed a high KI67 at 30% but my final pathology after surgery showed a grade 1 tumor with low miotic count. How reliable is the KI67 on a biopsy and does having a grade 1 tumor indicate a less aggressive cancer? The high KI67 haunts me and I am worried about my risk of recurrence and wish I could have had the oncotypeDX test done but in 2005 they would not run the test with a positive node. My tests were all done at Johns Hopkins so I know the lab was good. |
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biopsy is merely a sampling and doesn't necessarily represent the entire pattern of the tumor. some spots can be faster growning that others. grade on the final pathology is the most reliable since it represents sampling of the entire tumor. try to feel less haunted. you had favorable prognostic factors. you were very aggressive with your treatment too. rest easier. i would. LS |
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Question:
#66
2/7/2009
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In 2/06 I had bi-lateral synchronis dcis (comedo type with necrosis) and had lumpectomies and radiation. Now 3 years later I have Atypical Ductal Hyperplasia in one breast. Is there a protocol for this situation? |
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if ADH was found on a core biopsy then the protocol is to have a wire localization open excisional biopsy done to determine if any early stage breast cancer is present. 30% of the time dcis will be there. if only ADH, then nothing further is done. |
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Question:
#67
2/1/2009
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Hi Lillie, I am 38, dx with bc, stage II, grade 3, er/pr+ her2+. had lymph node biopsy that was also +. doing 6 months of chemo( did 4 Taxol, now half way through 4 cytoxan, epirubicin, 5FU with Herceptin weekly), then probably bilateral mast. My 1st ? is about the ki-67 test. Mine was 80% unfavorable. Does this mean my chance for recurrence is 80%?! If so, is the bilateral mast. my best option and does that greatly reduce my chance for recurrence? My 2nd ? is about alkalining your body. A few of my friends are really into this and even think drinking this kangan water will rid my body of cancer or at least help with side effects of chemo. Sounds like weird science to me, but i have been so sick with the chemo recently that I would try about anything as long as it doesn''t interfere with the chemo doing its job. Thanks for your time and consideration! |
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mastectomy reduces risk of local recurrence in the effected breast but doesn't do anything about risk of distant recurrence. removal of the other breast doesn't impact recurrence either. doing chemo is smart. very smart. and doing herceptin and hormonal therapy would be wise. these prevent recurrence. i personally would not embark on alkalining your body. now the 80% question. this is a prognostic factor and tells us that your cancer cells are rapidly multiplying and subdividing. and the good news is that chemotherapy works best with such a proliferation rate. it has nothing do to with risk of recurrence. hang in... LS |
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Question:
#68
1/31/2009
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I had a FNAB which says mildly atypical cells however the cromatine pattern does not look malignant. Nipple ulcer with signs of subareolar papillomatosis.
All other exams which I did came normal such as U/S, mamo, blood tests and physical examination. I was asking since I have a pinkish nipple with some soreness could this mean nipple adenoma which mimic paget''s disease?
My 2nd question is: can paget''s disease stay for long (years) without causing any changes or harm in the nipple. Are there any reaserches that proof paget''s can live long without causing symptoms that deveop or worsen the patient''s situation? |
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no studies to show how long pagets remains localized to the nipple/areola complex. same applies for dcis-- how long before it progresses to invasive disease isn't know either. that said, what you are describing is worrisome. atypical cells on an FNA has a 30% risk of cancer being present when more tissue is sampled and more tissue does need to be sampled. nipple sounds like pagets at a minimum. can you come to us? 443-287-2778. LS |
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Question:
#69
1/24/2009
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I have a couple of questions which seem to cross subject lines. Just completed lumpectomy, am in middle of mammosite radiation and need to move on to hormonal therapy which has not been addressed since the pathology report became available. Pathology report was: DCIS, solid type, intermediate nuclear grade with focal necrosis. Only two small foci of residual carcinoma in situ are present, the larger measuring .3cm. Tumor extends to within .4cm of the closest soft tissue margin, which is located medially. No invasive carcinoma present. Adjacent breast tissue with proliferative fibrocystic changes with focal atypical ductal hyperplasia, ductal hyperplasia of the usual type, scelerosing adenosis, apocrine metaplasia, and stromal fibrosis. Previous core needle biopsy site with cictrization. 1. The part starting with "Adjacent breast tissue" says what and has what implications for reoccurance or new cancer developing? That seems like alot going on. 2. Would I would benefit from seeking additional opinions on the hormone therapy beyond "take tamoxifin for five years" ie. is there more out there that might be more targeted to me? Or am I hitting an ant with a sledge hammer. 3. Can/will my existing oncology team work with a second opinion provider? I am 55, post menopausal, with this my first health issue of any kind beyond taking actenel for osteopenia. Thank you for this service and your response. |
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Very early diagnosis. good for you! margins are fine. wide margins actually. tamoxifen is appropriate if the DCIS was estrogen receptor positive. no other hormonal therapy for dcis treatment. it works well for prevention. risk of recurrence after lumpectomy and radiation and hormonal therapy is small based on size of cancer you had and size of margins. less than 5%. celebrate rather than fret!LS |
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Question:
#70
1/24/2009
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I had a bilateral breast u/s on July 2008 that show a small cyst noted at the 4 o''clock position of the right breast, 2 cm from the nipple measuring 7mm without mammographic correlate. The surgeon just told me is normal at my age (39) and just see in 1 year if dissapears or if becomes larger. Is this ok? It doesn''t hurt or anything, I don''t even feel it.
I''m also planning to have breast implants can I have it done if I have that cyst? |
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benign cysts are very very common and no treatment is needed unless they are causing pain. what he described is standard of care. augmentation is fine to do with breast cysts. LS |
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Question:
#71
1/23/2009
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Hi, What is the percent that your pathology lab uses for KI-67 (mib1) being labled low vs. high? My report staes ki-67 5%/strong. |
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it doesn't matter how often a pathology dept labels something low or high. all that matters is what your personal score is. low is better than high. if yours is only 5% celebrate. |
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Question:
#72
1/18/2009
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Lillie, the only measurements I have are from a Macroscopic Deion: From ultrasound guided core biopsy - multiple white firm fibrous fragments and multiple yellow soft adipose tissue measuring in aggregate 1.7cm x 0.2cm x0.2cm
And macroscopic deion from stereo guided biopsy: consists of multiple fibrofatty, rubbery fragments measuring in aggregate 1.7cm x o.2cm x0.2cm. The doctor seems to think that we caught this early enough. Surgery for lumpectomy is scheduled for Feb 27th. Sentinel node plus one or two others will be checked then as well. He said I would need radiotherapy afterwards. Prognosis was 90-95% for this surgery. He also asked if I had my ovaries (hysterectomy done at age 40, I''m now 50)and I do. Does this change anything? Should I have them removed? If so, would that mean I could forego the hormone therapy? I know that ILC sometimes occurs in both breasts and I''m scared that I have it in the other breast but it''s not showing on a mammo yet. Would you suggest bi-lateral mastectomy at this stage? |
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so sounds like this is a stage 1, assuming lymph node is negative. that's good news. even if ovaries were out hormonal therapy would still be recommended. he was probably asking to determine if you would be placed on tamoxifen(for premenopausal women) or on an aromatase inhibitor (for post menopausal women). so all sounds good.... be well dear! LS |
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Question:
#73
1/18/2009
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I just received the results from my biopsy (right breast)which was done 2 ways. I''d like your opinion on the severity of this type of cancer and if prognosis is good. Thanks for your help.
First ultrasound guided core biopsy and then stereo guided. Under ultrasound guided results were: invasive mammary carcinoma, columnar changes and microcalcifications in stroma and benign skeletal muscle. The stereo guided biopsy results were invasive mammary carcinoma (E-Cadherin weakly immuno - positive, nuclear grade 1-2/3, in situ (see note) note: immunostain for p63 has also been obtained in eval of this material. The overall impression is that of lobular carcinoma in situ and invasive. The e-cadherin immunostaining varies from none to weak in the in situ and mostly weak in the invasive. Then it says, + ER (moderate staining in 100% of invasive cancer cells) and +PR (moderate to strong in 100% of invasive cancer cells. Negative for HER2/Neu overexpression score =0
What does all this mean? Thank you for your time. |
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they didn't provide a measurement of the invasive portion of the tumor. that is important. what is the measurement of the invasive lobular/mammary cancer cells. you do have favorable prognostic factors of it being hormone receptor positive and her2neu negative. that's good. so go back and ask them for the measurement. sentinel node needs to be done to complete the staging information process. |
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Question:
#74
1/18/2009
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I was diagnoised with stage 2a breast cancer in October of 2006. Stage 2a due to microscopic involvement in one sentinal node out of 7 removed. Had multifocal [ 3 tumors, small] all grade one. Had 4 TC treatments, bilateral mastectomy and am taking Arimidex. Dr. says I am in low recurrance catagory. ER,pr positive, her2 neg.
My question is I read grade 1 tumors have a lower recurrance rate, but instead of the 2 year mark being the biggest threat for the time of recurrance, it can go to ten years due to the fact the grade of tumor is so slow growing. I was very excited to have passed the two year mark and now this is concerning. Any truth to this? I have written to you before and you have been very kind and encourging with your answers. I took your advice and tried Effexor to help my anxiety and it has helped a great deal. Thank you for all you do for all of us. I never thought I could go to that chemo room again, but a friend has had a recurrance and I have been taking her to treatments. I got this courage from reading your advice. I felt if you can do what you do everyday, then so can I. Thank you so much. |
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no, the grade doesn't result in your milestone being 10 years instead of 2 years. so start celebrating! glad effexor is helping too. LS |
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Question:
#75
1/18/2009
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Hi, Iam 37 years old and was just recently diagnosed wth dcis, solid form, grade 2, 3mm single focus seen on 1 slide along with florid hyperplasia and papilloma, margins were clear (2mm). Had a normal mammo & this was found on sono appearing very benign. Had fna which revealed atypical cells which lead to excisional bx. My question is regarding the er/pr. The report states er undetermined due to lack of dcis on the slide, pr states <5% Ihad another pathologist review the slides and they confirmed the dx of dcis but were unable to attain an er reading. Is this common? I have opted to do RT and Tamoxifen has been offered to me even without an er reading. What are your thoughts? |
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not being able to determine hormone receptor status is odd. you might want to have slides and tumor block sent to us to figure this out for you. call 443-287-2778 and sheila can explain to you how to do this. |
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Question:
#76
1/11/2009
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Happy New Year! I was diagnosed with a 3.5 cm tumor (grade 1) and a 1 cm tumor (grade 2), both er/pr + her2 negative. I had a double mastectomy with reconstruction. One sentinal node and micro mets in one axillary node our of 24. Also, a minute amount of extra-nodal extension in one node. Wide margins. I took six TAC chemos and radiation and am now on tomoxofen. My original diagnosis was 12/07. When I was diagnosed I asked for oncotype testing even though I was node positive because I wanted to get a sense of how my chances were for recurrance. I was told, in 12/07, that they absolutely could not do oncotype on node positive, even if I offered to pay for the test. NOW, a year later, I find that they are oncotyping some node positive women. I asked for my tissue samples to now be tested so I could know whay the score was. My oncologist flat out said that there was absolutely no benefit and that it can''t be done. Is this true? Would peace of mind be a benefit...or possibly the knowledge that it is not good news and I could then be very pro-active. Am I crazy? |
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It sounds like you have been proactive to do all you can to reduce risk-- bilateral mastectomy, chemotherapy. The oncotype DX is helpful in the decision making process for certain cancer types. It was part of trial which is why there were standards of who could be tested. That trial is changing. Your doctor is right that the test would not benefit you now that you introduced the treatment that has reduced your risk. The test is not for you at this time. ds |
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Question:
#77
1/11/2009
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Hello. I''m a 42 yr old and I just had a radical modified mastectomy of the right breast. Getting ready for chemo in the next week. My pathology report stated the following:invasive ductal carcinoma, margins of excision free of malignancy. Notthing grade 9pts Path stage IIA, Carcinoma in situ is not present.
Estrogen Receptor 0% unfavorable Progesterone Receptor 0 unfavorable ki-67 52% unfavorable
p53 0% favarobale Her-2/neu by IHC 0 by Fish non-amplified Her-2/neu: cen 17ratio = 1.3 What does that mean? My lymph nodes were negative all 33 of them and no cancer found in my organs. What does all this mean? I assumed it was the cancer was all taken out. I was told I had aggressive cancer and had a high risk or it returning. Any other advise would be greatly appreciated. |
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Your cancer is stage 2, hormone receptor negative, her2neu negative. The lymph nodes are negative and you have no sign of disease elsewhere which is very good. Now you are going to have chemotherapy to treat your whole body which will reduce the risk of recurrence of breast cancer. Think of this as a treatable cancer. ds |
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Question:
#78
1/12/2009
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I am 50 years old dxd with Left medial breast cancer late aug 2008 by screeing mammogram. Initial bx done by ultrasound. Also ahd a MRI which showed 2 additional small areas of uptake one on the left different quadrant and one on the right. A second look ultrasound showed these to have appearance of benign normal lymph nodes. I had a lumpectomy on 9/3/2008. Pathology cames back IDC 0.8 cm Grade 3 ER pos, PR pos, HEr 3pos. DCIS grade 3 with extension away from invasive tumor consistent with extensive intraductal component ( solid, micropapillary and comedocarcinoma types. The margins were all read separately and were clear but ADH was seen at 2mm short of the margin on the superior and deep margin. The base margin also included a 1 mm terminal duct lobular unit expanded by ductal cells with nuclear enlargement and irregularity most consistent with adh. 4 sentinel nodes all negative, No lymphovascular invasion. I am currently undergoing Chemotherapy TCH every 3 weeks with herceptin weekly to be followed by herceptin every 3 weeks for the rest of the year. My question has to do with the most appropriate care for controlling local recurrence. I have met with the both radiation oncologist and plastic surgeon and breast surgeon. I am scheduled for whole breast radiation but am now wondering whether bilateral mastectomy with reconstruction is a better choice. Does my extensive DCIS and ADh changes but me in a category with higher local recurrence? I understand my systemic therapy is treating my risk of regional and distant recurrence. Are there local recurrence risks for a high grade Her 2 tumor published that are different from overall risks? Bcra tests were negative although I have some family hx. Thanks for your response. I still haven''t made up my mind. |
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Great questions!! My assumption is that you'll also be treated with hormone therapy given the ER/PR positivity. As far as the choice of surgeries, this is usually left up to a personal choice as it is generally believed that lumpectomy with radiation is equivalent to mastectomy for local control. However, I don't believe anyone knows the answer to your question ie are rates different for HER2 positive tumors. One would have to believe however,since the original studies didn't use these distinctions, that as a group, either surgical option would be okay.Many times these decisions are also influenced by the types of reconstruction options and how to get the best cosmetic results (ie with or without radiation can influence this). Hope that helped. |
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Question:
#79
1/4/2009
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My cousin just had an incisional breast biopsy with the following results: Tissue removed was 4.8 x 4 x 2.3 cm. Margins inked in blue. Serially sectioned to reveal a 1.8 x 1.8 x .8cm firm grey spiculated lesion abutting the surgical margin. Final diagnosis: High grade infiltrating lobular carcinoma at least 1.8 cm in greatest dimension. Nottingham score 3 of 3. Margins of resection are positive. Lymphatic space invasion is identified. There is no definitive evidence of large vascular space invasion. High grade duct carcinoma in situ with comedo necrosis present comprising less than 10% of tumor volume.
My questions are these: The doctor says this is slow growing but she describes "just waking up with this hardness" in her breast. You can feel hardness of her breast from about the 12 o''clock position to the 8 o''clock position and the ultrasound tech said she saw two areas of concern but the doctor refers to what she has as "a" tumor. What is the hardness then? If it is slow growing, why did it seem to come on so fast? She also has multiple (maybe 5) dimples in her breast within the hard area. There was no pathological stage info: pTX NX and MX. She is ER + (58%) PR+ (4%) HER2 equivocal (being sent for FISH) KI-67 9%. H&E poorly differentiated infiltrating carcinoma. The doctor told her the mass was too big for lumpectomy (we were agreeing because the area of hardness is so big), yet the tumor itself seems small compared to the felt hard area. She is scheduled to see a surgical oncologist on 1/12, to order PET scan. This seems to be moving way too slow. She had first needle biopsy on 12/11. Indeterminate. Second needle biopsy on 12/17, also indeterminate. Finally the incisional biopsy on 12/23.
What do these things mean? Why wasn''t the tumor staged based on size? Also, doctor told her not to worry about the margins because he took the sample from the middle... Is this right?
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Am a little befuddled why a PET scan is being done. premature right now for that. The staging cannot be done until the entier tumor is removed with clear margins and sentinel node checked and if positive then axillary node dissection done. diameter of infiltrating component in its entirty is needed to determine tumor size and nodal status needed for accurate staging. MRI of breast might be helpful. Infiltrating lobular has a reputation for sometimes being bigger than it appears. it grows like a star with points. some points are longer than others. measurement goes point to point at largest dimension. infilatrating ductal grows more uniformally. It is a high grade tumor so aggressive. however it probably took 5 years to get to where it is now. the body forms a wall of scar around breast cancers once it figures out that this is cancer and can do harm to the body. that wall of scar forms overnight. so that explains why one day she feels nothing and the next she feels something hard. good its sensitive to hormones. good prognostic factor. glad she is seeing a surgical oncologist (who i assume specializes in breast cancer.) if she wants to come to us just call 443-287-2778. the time frame is acceptable. as mentioned, this has been there for years. now that she knows its there it can make you feel like your hair is on fire but there is time to gather information and make good decisions. LS |
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Question:
#80
1/3/2009
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Hi
38 years old, 1.3cm IDC with no LVI, or PErineural invasion, grade 1, ER/PR + and Her-2 negative. Oncotype DX score 25. my question is given the pathology which is not so bad why is my oncotype dx score so high?
thanks
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if we could all predict that the oncotypeDX score was going to be by simply looking at the pathology report then there would be no reason to get the test done. that's the whole idea-- taking the guess work out of it. some are going to be higher and warrant chemo consideration. |
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Question:
#81
1/2/2009
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Hi...I sent you a message on 12/28...(I am a 34 year old woman, no family history of breast cancers..Real-time imaging reveals a hypoechoic nonvascular solid lesion in 9 o clock position in r breast 2cm from the nipple measuring .63 x .87 x .65cm. No other focal abnormalities. Implant noted.)...Today I had an excision biopsy performed in breast surgeon''s office. The mass was removed and the doctor said it does not ''look like anything bad''. He said we will get pathology results in a few days and he will call me, but if he thought it was a concern he would tell me (probably a fibroedenoma). I would like to know your thoughts on the probability of the mass not being cancer after the doctor''s advice. Also, the surgeon showed me the mass and explained that it was good that it was round and did not look like cancer looks. I came home with stitches and some minor bleeding and pain. This evening, I looked at the site and noticed three dimples in my breast just right of the area that had been worked on. I started to get worried because I read that dimpling is a symptom of cancer. Is that a normal thing unrelated to cancer after a biopsy, or should I report this to my doc right away and be worried? Thanks
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you've had surgery today so breast changes, such as dimpling and swelling are to be expected right now. dimpling is a sign of cancer when it is the presenting physical symptom that takes you to the doctor in the first place. deion sounds favorable that you will get good news. we will hope so. LS |
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Question:
#82
12/28/2008
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What is the difference between the terms "micrometasis" and "micrometastasis"? |
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there is no such term "micrometasis". the term "micrometastasis" is correct. |
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#83
12/28/2008
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I just read your post to my original question (I am a 34 year old woman, no family history of breast cancers...)
I realized that I should have left you the beginning of the report as well which includes the measurements. I was reading that if the mass is taller than itis wide,it is more likely cancer. Mine appears to be wider than it is tall, which could be a positive thing. Please tell me if this gives any new information you can tell me...Real-time imaging reveals a hypoechoic nonvascular solid lesion in 9 o clock position in r breast 2cm from the nipple measuring .63 x .87 x .65cm. No other focal abnormalities. Implant noted. |
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it's tiny. wider than it is tall is a very good sign and implies probably benign. |
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Question:
#84
12/27/2008
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I am a 34 year old woman, no family history of breast cancers. My maternal aunt had fibroadenoma at age 30 removed surgically. I gave birth at age 26 to a son and breast fed for 1.5 years. I recently discovered a bump in r breast and have implants. The breast seemed to be getting smaller than L breast. Surgeon said it was the valve of implant due to failure(they are 10 years old). Had a mamo and ultrasound 6 months ago and surgeon said it was the valve and replaced my implants. He also said he was 99.9999% sure not cancer or worry. Now, 6 moths later, I have a new lump in same breast. Surgeon says it is not related to old issue. The lump feels like a marble and moves(near nipple). Surgeon says probably a cyst or Fibroadenoma but I need another ultrasound to be sure. He says it feels like a cyst. I got the ultrasound done and got results back during time when surgeon''s office is closed for holiday. It seems clear to me this is not a cyst. I would like to know if you can tell me what this means. The imaging place says that if it were suspicious of cancer it would read so. Not sure if the MRI is recommended or just a ''possiblity'' due to the verbiage. Please help...Here is what the results/report says: .87 cm solid hypoechoic lesion in the 9 o clock position corresponding with the palpable findings. Follow-up MRI of the breast without and with gadolinium enhancement could be performed if further imaging is deemed clinically necessary. |
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the results are not clear-- they don't say that they think it is suspicious which is good. however they deem it is solid and not liquid, therefore not a cyst. since no mention of it having irregular edges, it may be a benign mass there. whatever it is, it is small. so now you have to wait for more information. i would suspect that more imaging will be done. also could be scar tissue from the implant exchange. LS |
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Question:
#85
12/21/2008
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Dear Lillie,
Do you know or how can I find out if there is any recent updates or the latest information about metaplastic breast cancer? I appreciate your help and I know everyone else does also.
Thank you |
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i personally haven't read anything new. you might check by googling san antonio breast cancer conference though. i didn't get to attend this year but if there is anything new it would have been presented there. LS |
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Question:
#86
12/21/2008
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my mother has had a lumpectomy one month ago and has started chemotherapy her pathology result has come:
ER Neg. PR Neg. P53 Pos.
Cerb-B2 Pos.(score2+) Ki67 Growth fraction 63%
IHC paraffin study/Tissue Block 58090
Avidin-Biotin method
It would be very kind of you to help us understand what it means and what we should do and how we should talk to the doctor
thanks so much
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Dear tabassom17,
This is Ben Park MD PhD and I got your question forwarded to me from Lillie Shockney at Hopkins. In general, there is too much to talk about in this forum. I highly recommend you speak with your doctors regarding this. Also, with a 2+ HER2, another test called FISH needs to be done, and until that test comes back, your mother's cancer cannot be completely assessed. There are other parameters that prevent me from telling you anything beyond this. If you'd like to discuss this, you can email me at bpark2@jhmi.edu. I will be away this week, but will be back next week to answer my emails. Best regards and happy holidays. Ben |
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#87
12/20/2008
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I was diagnosed four years ago (12/04) Had a double mastectomy. (elective)
Three tumors in right breast, (2.0, 1.3, .06), in 3 separate quads...Node negative. All Grade 1. Strongly Est. positive. Was strongly encouraged to do chemo, which I did. (four rounds of A/C) Tamoxifen for nearly four years.
When Oncatype testing came out, I pushed to have it done, even though I''d already had chemo. Of course, I wanted to know my rest factors. Test came back at 5%. Told I probably never needed to have chemo. (sigh) Now I have found out they only test the largest tumor in multi-focus disease. Now, because the tumors were in three different areas, I would like to have the other two tested--as we know that the tumors can be different. My oncologist says, "no way", even when I say that I will pay for the testing if my insurance refuses. This is all very frustrating, as I feel I''ve never felt particularly liberated in my treatment (thus, the chemo). Would like to know an opinion on whether I should push for this additional testing. Thank yo for any information or opinion you can offer...(Did not mention that I was dx at 44...Am now 48) |
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if the hormone receptors and her2neu results and type of breast cancer were all three the same then you can rely on the original oncotypeDX results you received on the largest of the three. |
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#88
11/30/2008
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My 25 year old daughter is coming to JH in 2 weeks for surgical consult. Question is can you tell from path report if mucinous cancer is pure or mixed: 4 specimens from L breast: L post with calc: core biopsy, invasive mucinous carcinoma, bodified Bloom and Richardson grade I of a possible III (nuclear grade I of 3, tubule formation < 10%, mitoses < 1/10 hpf), present on 2 of 3 submitted core biopsies, with maximal dimension of at least 0.2 cm. Ductal carcinoma in situ, nuclear grade 3, 2 foci, with maximal dimension of 0.2 cm. L breast posterior, all normal results. L breat enterior with calc, core biopsy, ductal carcinoma in situ, nuclear grade 3, 1 focus of 0.3 cm. No invasive carcinoma seen. L breast anterior no calc, core biopsy, DCIS, nuclear grade 3, 2 foci, with maximal dimension of 0.2 cm. No invasive carcinoma seen. Thank you so very much!! |
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if the pathology dept who did the path slides sends an adequate sampling of the slides to us then we should be able to tell, yes. Given she is 25, if genetics hasn't been yet discussed it might be time to also consider looking into that as well while with us. if you would personally like support, seek free services from Mothers Supporting Daughters with Breast Cancer. you can go to www.mothersdaughters.org or email msdbc@verizon.net (PS. We will take good care of her at Hopkins.) |
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#89
11/23/2008
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49 yr old woman with infiltrating ductal carcinoma, modified bloom-richardson grade III, ducatl carcinoma in-site situ,solid and cribriform types high nuclear grade,Fibrocystic changes.
Tumor measures 4.0 cm in greatest dimensions(T2 tumor)
ductal carcinoma in-situ in less 10% of tumor.
Mestatic carcinoma involving 1 of 14 lymph nodes
ER & PR by IHC 90%favorable
HER2 /Negative |
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so your provided the pathology report but i don't see a question?it has favorable prognostic factors. ask about oncotype DX |
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#90
11/17/2008
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Hello, I was diagnosed with T1mic,No,Mx high grade comedo necrosis breast cancer. The MRI showed suspicious linear and nodular enhancement anteriorly towards the nipple for a distance of 5.1 cm. The anterior aspect is located 3.1 cm deep. There is suspicious wispy enhancement extending to the 3 o''clock position where an additional 2.1 cm linear enhancement is present. The craniocaudal extent of the area measures 3.3 cm. A few scattered less than 5 mm areas of parenchymal enhancement are seen in superior breast. Because of the amount of DCIS the MRI showed, a sentinel lymph node bx was done. 1 non sentinel axillary node was also taken. The sentinel node path said multiple H&E levels and cytokeratin stains were performed and no malignant cells were seen. It also states that follicular hyperplasia was seen (immunostains CD10, bc12 and Ki67 performed). The sentinel node measured 1.4x0.9x0.7cm, whereas the nonsentinel node was 0.4x0.3x0.2cm. My question is, should I request a second opinion on the path report based off the follicular hyperplasia? I have read that that can indicate a "pre-cancerous" condition. Also they found one small area of invasion, less than 1 mm, and I have read that it is unusual for there to be only one area of invasion especially with the amount of disease there was. Is this true? Also, the path said it was not multifocal or multicentric, but doesn''t the MRI say it is? Thank you,
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A 2nd opinion path report may be beneficial. Contact David Page at Vanderbilt or path services at Johns Hopkins (Sheila can direct you at 443 287 2778)
The small area of invasion is not unusual.
The pathology report is your definitive diagnosis, not MRI. ds |
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