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Question:
#1171
8/14/2005
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I had an excisional biopsy performed 7/1/05. diagnosis: foci of lobular neoplasia. proliferative breast disease,characterized by stromal fibrosis, apocrine metaplasia, cyst formation, sclerosing adenosis and moderate ductal epithelial hyperplasia of usual type. Is this breast cancer? Surgeon suggests drug chemo or annual mamogram. What is best course of action. |
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its not a deion of breast cancer. not sure what you mean by drug chemo. chemotherapy is given for cancer only. |
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Question:
#1172
8/14/2005
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My pathology report came back stating that keratin positive cells were artifactual, linear alomg the outer report of the capsule. It was staged as pN0 thus I did not receive chemo but I am on Tamoxifen. My question is, I know this was not a true metasteses but is there a chance some cells got into the lymph node if they were on the outer capsule? I keep thinking I should of gone ahead and gotten the chemo. Thanks in advance for you reply. |
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there are no guarantees in life. even women with totally negative nodes can still have cells travel if they are dealing with invasive disease to start with. that said, you are actively doing something to prevent recurrence-- hormonal therapy. |
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Question:
#1173
8/14/2005
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I'm 44 years old and have had yearly mammograms since 40. Two years ago, my 48 year old sister was diagnosed with infiltrating ductal carcinoma. She had both breast removed and chemotherapy. I was diagnosed this week with two different types of cancer. The first tumor, infiltrating ductal carcinoma. Tumor size: 1.8 cm, greatest diameter (invasive component, measured on slide.Tumor grade: Well differentiated, Nottingham score 5/9. Nuclear grade:2/3,Tubule score 1/3, Mitotic index: 2/3 99mf/10hpf)
Surgical margins: Infiltrating ductal carcinoma involves the margin in one focus measuring about 3mm in width, and is close tothe margin in other areas.DCIS does not involve the margin. Tumor #2 (smaller lesion present in grossly normal breast tissue). Infiltrating lobular carcinoma. Size:.5 cm.greatest diameter (measured on slide).
Grade: Well differentiated, Nottingham score 5/9. Nuclear grade:1/3, tubule score 3/3, Mitotic indes 1/3. Both estrogen and progesterone positive. I'm not sure what all this means. I'm thinking lumpectomy with radiation. I don't want chemotherapy. What do you think?
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probably good candidate for lumpectomy with sentinel node biopsy. think more about chemo though...at least talk it through with the medical oncologst. no one "wants it" but you need to know and be informed of what benefit if may provide you long term. |
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Question:
#1174
8/14/2005
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I was diagnosed on August4,2005 with breast cancer. My report states that the biopsy shows a high grade ductal carcinoma is present associated the microcalcifications. the lesion shows solid and comedo patterns. The overall extent of the lesion is approximately 1 cm. Additionally,3 foci of microinvasive carcinoma are present, up to 0.5 mm. Elements of ductal carcinoma in-situ are identified 0.3mm from the surgical margin. Lymphvascular invasion is not observed. Please explain what this means and suggestion on what steps I should take. Thank you in advance for your attention to this request. |
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a very early stage breast cancer. stage 1. tiny for invasive component. next step is lumpectomy with sentinel node biopsy. if you want to come to us just call 443-287-2778. |
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Question:
#1175
8/14/2005
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My girlfriend is 51...she had a marble-size malignant tumor removed from her breasr as well as the removal of her lymph nodes for that side. 6 were positive. All her scans--PET,MRI,CAT-- were clear as she started chemo. She has now completed 8 weeks of Adramycin (sp?) and then Taxol, as well as Herceptin...she continues receiving Herceptin and radiation. During chemo,her CA 27, 29 markers were way up to the mid-eighties, but has now stabilized at the mid-fifties. The tumor markers are a big concern to her, but don't seem to be alarming to her oncologist. She is considered stage IIB. Can you advise on "Tumor Markers"? Thanks so much.
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tumor markers are very imperfect tests and not something that doctors hang their hat on today. scans and how the patient feels are considered better measuring methods. |
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Question:
#1176
8/14/2005
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I had mammo and US for a suddenly appearing large mass at 3 o'clock, left breast. Core bx was done because even though it was a cyst, it was complex (irregular borders, mixed echogenicity)and did not resolve after FNA. The mass was 34mmx30mmx40mm and was not painful. The pathology report came back as "atypical cells" with the following comment: "dense fibrous breast tissue with a chronic-actie inflammatory infiltrate with abundant eosinophils and reactive stromal changes. The atypical cells within the stroma are negative for panctokeratin, arguing against invasive carcinoma. We favor these to represent reactive stromal cells." They thought it was an abscess but my white count was normal, I haven't had any fever, pain, redness or any other infection type of symptoms. No one has been able to provide me with any explanation as to this "inflammation." I am 49 and am not lactating (last breastfed 9 years ago). I am concerned about the "chronic-active" inflammatory component and the atypical cells. They've recommended another ultrasound in 6 months, but considering that this mass came up very suddenly, I'm worried about what could happen in 6 months. Am I just overreacting/worrying too much? And, does this put me in a higher risk category for breast cancer, due to the combination of dense breast tissue and inflammatory changes? Thank you. |
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consider another formal second opinion with a breast surgical oncologist.if you want to come to us just call 443-287-2778. |
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Question:
#1177
8/14/2005
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mY PATHOLOGY REPORT CAME BACK SAYING THEY COULD NOT DIFFERIATE BETWEEN A FIBERABONMA OR A PHYLLODES TUMOR. I HAD THE SECTION TAKEN OUT ON MONDAY(8/8). I AM NOW WAITING FOR THE PATHOLOGY REPORTS TO COME BACK AS TO WHAT IT IS. IF IT IS A PHYLLODES TUMOR WHAT WOULD BE MY NEXT STEP.... |
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surgery. if you wish to come our way just call 443-287-2778. we can also re-review the pathology for you. |
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Question:
#1178
8/14/2005
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I had an MRI and results stated the size of my tumor as 3.8 x 2.7 x 2.6 cm lobulated enhancing mass. Ultrasound showed 2 side by side masses but MRI showed a single mass. Nottingham Grade III, Tubule Formation:3, nuclear pleomorphism:3, mitotic rate: 2.
What stage of breast cancer is this and what does the above mean? |
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stage 2 at this point. additional information though needed about your nodes. if you want to come our way just call 443-287-2778. we like to do ultrasound of the axillae to see if there is any evidence of nodal involvement. grade is 3-- aggressive. oftentimes chemo is given first and surgery done second with the goal to shrink down the tumor. |
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Question:
#1179
8/14/2005
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Hello
I am 34 years old and have completed neoadjuvant chemo (dose dense AC and TAC). I just had a modified radical mastectomy and am confused by the report. Gross: Roughly centrally and laterally there is an ill defined area of firmness and probably sclerosis within some white breast tissue located 3cm from the closest margin. This area is ill defined (approx 6.5 x 3.5 cm). Diagnosis: Residual, grade 3 of 3 infiltrating carcinoma, predomintely ductal within a 6.5 x 3.5 cm area of sclerotic breast tissue. Lymphatic and vascular invasion present. 1) Does this mean that tumor is scattered through this 6.5 x 3.5 area, or that the tumor is the whole size listed or what. Even the surgeon was confused by the way it as written "within". 2)would path report mantion dermal invasion if it was inflammatory?
Thanks |
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1. it sounds like the original tumor size was 6.5cm X 3.5 cm and the chemo has killed sections of the tumor, leaving it scattered now in this original mass. 2. yes, there would have been mention of dermal lymphatics if that had been seen. |
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Question:
#1180
8/14/2005
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Hi, I just had my first mammogram because I was having swelling in my left breast. The doctor called me in and only told me that the results showed Category 5 in the right breast and highly suspicious. He is scheduling a biopsy for next week. Does this mean cancer, and what is the percentage that Cat 5 ends up being cancer? Thank you for your website, it is very imformative. |
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for category 5, the risk of it being breast cancer is 80%. hopefully the biopsy can be done as a core biopsy with results back in 24 hours. if you want to come our way just call 443-287-2778. |
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Question:
#1181
8/11/2005
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I've submitted a question before, but am still concerned about my husband's breast cancer. He had a 1.4mm lump removed from directly under his nipple in March 2005. 3 lymph nodes positive with the senntinel node "extra-nodal with cancer cells grossly present". I gather that means they could see them. Also angiolymphatic invasion; er/pr positive; heur negative, moderately differintiated cells. He has had four rounds of AC now starting 4 rounds of Taxol, then docs recommend radiation, which he does not want (he had a modified mastectomy). About the time of the mastectomy and more since, he has been having pain in his ankles, arms, and now hips. Bone scan showed a couple of spots on both hips, that they thought might be arthritis. How often does bc with lymph involvement spread to bones? I asked for a CAT scan and another bone scan, they've been ordered but am I overreacting? He is 52 and otherwise in excellent health, withstanding the chemo well, but balks about radiation. Any input about prognosis, radiation, mets, etc. and prognosis, will be greatly appreciated. He had the lump about 9 months before removal after it turned his nipple white. |
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anytime there is nodal involvement or presence of angiolymphatic invasion there is risk of disease going onto other organs. would suspect he is taking tamoxifen now?? since hormone receptor positive. don't know if his bone pain is related to mets or not. only a trained eye of a radiologist can determine this right now. |
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Question:
#1182
8/11/2005
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I was diagnosed with Infiltrating tubulolobular carcinoma with prominent ductal carcinoma in-situ and had a skin-saving mastectomy/reconstruction in 2/05. The tumor size was 1.2; ER + (80%) and PR+ (40%); HER.2 - (1%) . No nodes were involved and the margins were clear within 1 cm. The K1-6 ratio was 9%; S phase factor 5% and Histologic Grade of 2. My total Nottingham score was 6 and the Ocotype test indicated a low range (but in the high/low area) of reoccurrence. As a result, chemo was not recommended and I have been on Tamoxifen for 3 months. Is this aggressive enough to prevent reoccurrance? Recent CT/MRI and blood work (after 6 months since diagnosis) showed no signs of metastasis. Thank you very much for your help. |
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not sure why scans and blood work were done. that isn't standard of care anymore to do for your early diagnosis. stage 1 breast cancer. great prognostic factors. and you are doing something to prevent return of the disease. feel good about your decisions. |
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Question:
#1183
8/11/2005
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I was diagnosed with extensive, high grade DSIS, cribbiform type with central necrosis, calcifications and extensive lobular involvement in my left breast in April 2005. I had a S/C mastectomy later that month and have recovered well. The sentinel node was negative and the post surgery path. report was negative any microinvasive cancer evidence. The report did specify the DCIS was ER positve however, I have elected not to take Tamoxifen. My maternal grandmother died in 1962 from BC. My mother had a hysterectomy at the age of 41 (1977) after "precancerous" cells were found in her pap smear. I am 41 yrs. old. I am awaiting results of my BRCA test which should be released later this month. My questions are the following:
How does having had DCIS affect my overall life expectancy?
Does my type of DCIS put me at greater risk for a new primary on the other side or for any other types of cancers? |
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DCIS as you know is stage 0 breast cancer and shouldn't impact your life expectancy since it is noninvasive disease and now is gone. no matter what type of breast cancer you have had though, it increases risk for the other side, somewhat higher than the average population of women would have. tamoxifen is designed to prevent that from happening. if you test gene positive then the risk for the remaining breast is quite high and most women opt to do prophylactic mastectomy. |
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Question:
#1184
8/11/2005
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My mother was operated from invasive ductal carcinoma grade 3b last year. She underwent radical mastectomy, chemotherapy (doxetacel and the like) and was implanted an expansor (for later breast reconstruction), and radiotherapy. 1 year after diagnostic and treatment, and just one month after radiotherapy ended (and all tests performed went very OK, cancer markers and the like) a hematoma-like thing appeared on her sick breast. It began to grow quite rapidly, and in just one month it got to the size of the breast, with an appearance like a punch on the breast, skin infection, psoriasis... doctors were confused. Biopsy results came today, and they say Lymphangitis carcinomatosa. She feels well, good breathing ability, no side effects at all save a feeling of heat of the operated breast, but the "hematoma" grows daily and visibly, and dark red. Ecography shows nothing, X-Rays, nothing. I am very worried. What is the prognosis and treatment for her? |
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sorry to hear this... then this isn't a hematoma but is cancer. request that her case be presented to their breast cancer tumor board where a team discussion can take place with surgical oncologists, medical oncologists and radiation oncologist, pathologists and radiologists to discuss her situation and create a plan of care for her. stay near her. |
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Question:
#1185
8/11/2005
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when results indicate fatty lumps in breast were seen, what does that mean? Is that something to be concerned about. The term used in the report was fatty parenchymas pattern. thank you |
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no, normal findings. fatty lumps are exactly that. breast fat. |
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Question:
#1186
8/10/2005
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I recently recieved the DNA section of my pathology report. I am 35 years of age. pT1cpNXpMX, IDC,Grade II, EN Score 7. Node free. MDR-1 0+, HER2,1+, Estrogen Receptor 280, Progestror 150, p53 Gene Product 0+, Thrombospondin1 31, Ki-67 10%, EGFR 0+, BCL-2 3+, CD117 1+, Angiogenesis/CD31 30/200X field, and VEGF 2. What does all this mean?
I recently completed 4 rounds of AC and will be 30 treatment of radiation. Just want an idea of what I am dealing with. Thanks! |
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actually it was a garden variety stage 1 invasive ductal cancer. not especially worrisome or unusual. |
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Question:
#1187
8/10/2005
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Macroscopy: A:Pot 1: definite daldifications Multiple cores of cream. yellow & Haemorrhagic tissue, from 0.2cm to 3cm, multiple in one. B. Pot 2 no calcifications Multiple cores of cream, yellow & haemorrhagic tissue, from 0.4cm to 1.8c m, multiple in one,
Microscopy Breast right side needle core biopsies A multiple foci of high grade dcis, solid with necrosis & calcification no definite invasion seen. B Breast tissue showing focal epithelial hyperplasia there is no evidence of dcis. I am having a mastecoctomy and a central node removed I am very worried as I have a twelve year old daughter |
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don't worry. first of all, the pathology report thus far shows this to be stage 0 breast cancer. noninvasive disease. |
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Question:
#1188
8/10/2005
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I had a baseline mammo, BIRADS 4, mass found. I then had a mammotome biopsy. I am happy that the results are benign, but would like to understand more about the particulars of my report, and if what they found could predispose me to future malignancy, or be suspect for anything else. In particular, I wanted to understand what "fibromyxoid to sclerotic stroma" means. Here is my path report:
H&E slides consist of level sections of core biopsies that show fibroadenoma-like proliferation of ducts surrounded by stroma that ranges from fibromyxoid to more sclerotic. Some of the ducts show mild-moderate epithelial hyperplasia. Non-lesional breast samples show focal mammary fibrosis and minimal fibrocystic changes.
Thank you so much, and I so love and appreciate your website, and your service to all of us out here. |
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in a nut shell, the ducts inside the breast in that area were enlarged due to a benign mass. a fibroadenoma. congrats. |
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Question:
#1189
8/10/2005
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My pathology report lists that I have both ER/PR positive receptors. Also that HER-2/Neu report as positive (score 3+). Further lists the invasive tumor type as ductal adenocarcinoma NOS, Other type(s) with lobular component. The in situ portion was cribriform,soild representing 30% of the tumor. Lastly that fibrodenoma, FCD in the non-neoplastic breast tissue. Fibrocystic changes with ductal epithelial hyperplasia and sclerosing adenosis. How normal or non normal is it for this to be in a person with no family history of breast cancer. I am 44 years old. My margins were all clear and no lymph node involvement. It seems like I had a lot going on in one breast. Thank you! |
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VERy normal. and remember that only 12% of women diagnosed with breast cancer have any family history. |
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Question:
#1190
8/10/2005
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I recently had a mammogram. My results were ok. There is one sentence I need clarified. What does it mean that I have "fibrofatty parenchymal pattern present? thank you |
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fatty lumps in breast seen. |
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Question:
#1191
8/10/2005
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Hello! My mother recently had a mastectomy performed. She has been waiting for pathology results for around 3 weeks, and was just informed that further testing needed to be done. Before surgery she was told that she had stage 1 infiltrating ductal and after surgery it was confirmed that no lymph nodes were affected. Should she be concerned anyway, because of the delay/further testing? Thanks. |
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a bit strange it is taking so long but suspect they are waiting for "full pathology" which includes her hormone receptors and Her2neu receptor results to be back before reviewing all the information with her. |
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Question:
#1192
8/9/2005
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Thank you so much for answering my question #6 on 8/8/05
I have just one more question. What is your opinion or
assurance that everything will work. Thank you so much
I am really do appreciate it. I am very concerned |
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hhhmm. I don't have a way to go back and see previous entries when in this section and the messages come in anonymously. so email me your question privately at this point with your original Q&A in it. shockli@jhmi.edu |
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Question:
#1193
8/9/2005
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Thank you for telling be to ask about the margins. The macroscopic deion is described below:
My pathology report also says "The specimen consists of breast biopsy tissue with localizing wire attahed. It measures 5 x 4 x 35 cm. The external surface shows yellowish-white fibrofatty breast tissue. The margins are linked before dissection. Cut sections reveal whitish-yellow birofatty tissue with firm to rubbery consistency throughout. Multiple representative sections are submitted. Seven cassettes."
It does not mention anything of margins. But it does say that this is not the full report. The full report is under separate cover. "Please see the complete A.F.I.P. Report, Accession #2984387, which is reported under separate cover."
How do I get a full copy of my report? Would that tell me what the margins are?
I'm also in a higher risk to develop colon cancer because I've had ulcerative colotis for over 22 years. On occasions I have had polyps but the were benign. Other family members have had different types of cancers and have died from their diseases. As much advance warning that I can get will help me tremendously. Any advice you have for me would be greatly appreciated.
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call the pathology dept (number should be on the report) and give them your pathology history number and request that the ENTIRE report be faxed to you so you can see the status of the margins. |
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Question:
#1194
8/9/2005
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i got my pathology report like you suggested.could you please help me understand what it means? "sclerosing adenosis" focal ductal hyperplasia,usual type;microcalcifications;small cysts formation" i also had a fibroadenoma removed in the same breast 2 years ago should i be concernd about breast cancer since my grandmother on my mothers side died from breast cancer? |
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benign findings so celebrate. |
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Question:
#1195
8/8/2005
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Report says Diagnosis - Biopsies, tumor at L1-Metastatic Adenocarcinoma
1. Tumor cells are CK7 positive, CK20 negative
2. Lung and breast are favored primary
3. Clinical history correlation may be decisive
What does this mean? My sister had breast cancer 6 years ago. she had back pain for 6 months until the pain sent her to the er. They opperated and took out a tumor and put in 2 rods. |
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it means that she has cancer in her lower spine and they are trying to determine if the primary cancer came from her breast or possibly from her lungs. |
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Question:
#1196
8/8/2005
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Hello I recenty had a biopsy. I received by Pathology report. This is what it said:
Multifocal atypical ductal hyperplasia (ADH)
Focal lobular intraepithelial neoplasia, grade 2 (LIN2, ALH)
Small papillomas
Fibrocystic and fibroadenomatoid changes
Intraluminal microcalcifications
Doctor's accessment:
Sections exhibit fibrocystic changes, small peripheral papillomas, focal LIN 2 (e.g., slide 1), and multiple foci of ADH. Some of the foci of ADH show more uniform, rounded population of cells with areas of rigid epitbelial cell bridging, secondary lumens, and micropapillae formation. Like you, we believe these fetures are worrisome for low grade DCIS. However, we prefer to label these changes as ADH because there is only partial duct involvement, and the archtectural changes are not as well developed as we would expect in typical low grade DCIS. Correlation with clinical findings and close follow-up are suggested.
Can anyone explain to me what this means? My doctor says that I do not have cancer but that I have a 1 in 11 chance of getting cancer sometime over the span of my life. I'm 42 now. Soon to be 43 in another couple of weeks. My mother developed breast cancer when she was approximatley 60 - 65. She has since passed from her fight with this disease. I want to be sure that I'm okay. Any advice that I can get would be greatly appreciated. I grew concerned about the "partial duct involvement".
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the stats since you have ADH for sure and 2st degree family relative who was diagnosed would be probably higher than 1 in 11. get yourself into the hands of a specialist. ask about the margins too on this specimen. |
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Question:
#1197
8/8/2005
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I was given a Grade 1 with the Bloom Richardson Scale; Tubule 2, Nuclear 2, Mitosis 1.
We sent my slides to MD Anderson and I was given a Nuclear Grade 2 Modified Black's.
Am I a Grade 1 or 2? |
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don't know where the first pathology results were done but MD Anderson is a good place for having them reviewed. don't get hung up on the grade too... focus more on size and nodal status. |
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Question:
#1198
8/8/2005
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I recently had lumpectomy and a sentinel node biopsy
The lymph node was negative for tumor. The histologic type: In situ and infiltrating ductual carcinoma with micripapillary features. Extensive extension of dcis into lobules. The tumor measured 3.0 cm grossly. The elston grade of infiltrating component: III if III. Mitotic Rate of infiltrating component: intermediate. The lymph node
was negative for tumor. margins was negative. Addenum:
Block : 2s, Her2neu overexpression : 0/1+ Estrogen & Progesterone receptor analysis estrogen receptor positive tumor cells 90% ?Staining intesity: Moderate Interpetion
Postive, Progesterone receptor Positive tumor cells 90%
stining intensity: strong Interpetion: positive
KI-67 proliferation index 20%. I understand the tumor was removed all margins were negative. I confused about the
estrogen receptors and progesterone receptors results.
He recommed I needed radiation and chemo.Also taking medication for the next five years. He said my chances of
the cancer not coming back would be 90 %. I am told by my doctor my cup is almost full. I just need to do the above to make a full cup. I am very nervous I need some assurance. What are your comments. |
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the tumor cells are stimulated to grow by estrogen and progesteron so they are recommending hormonal therapy to prevent hormones from reaching the cells in the future thus making it difficult for them to survive. recommendation of chemo, radiation and hormonal therapy seems logical. |
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Question:
#1199
8/8/2005
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My pathology report states that I have infiltrating duct carcinoma (grade 3, 1.5 cm) with lymphvascular invasion and major component of ductal carcinoma in situ (nuclear grade 3, without necrosis, cribriform pattern). Among other things it also states that they identified angiolymphatic invasion and perineural invasion. What does that mean? My sentinel node was negative for metastatic malignancy. I'm very concerned about the possibility of chemo because i am 32 and have not yet had any children. I do not yet know whether the cancer is hormone receptive yet. |
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chemo is your friend and not your enemy. though the sentinel node was negative there was evidence in the actual tumor itself that it contained blood vessels and lymphatic vessels enabling it to help the cancer to travel... and the mission is for you to die of old age. you are just 32. consider chemo an insurance plan for ensuring your longevity. in most cases, menstruation resumes for women your age following chemo. hang in there... also think about genetics evaluation. |
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Question:
#1200
8/8/2005
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Just to follow up on the question I submitted yesterday. I am trying to understand what "proliferation" refers to, and what the difference is between being in the "low range" for the proliferation marker MIB-1 staining, versus having Grade 3 active cells. |
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proliferation is the rate the cell is multiplying and subdividing. a grade 3 is fast, rapidly growing cells. |
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