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Question:
#2041
01/13/2003
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I am 37 years old and have just had an excisional biopsy with no lymph nodes tested yet. The biopsy report is as follows: Infiltating Ductal Carcinoma. Grade II. Tumor measures 2cm max in diameter. Surgical margins of resection are focally positive for tumor. Lymphatic invasion is identified. Multifocal Ductal Carcinoma in Situ ( Cribriform and solid type). Remaining breast tissue parenchyma with fibrocystic changes. E- cadherin immunostain shows tumor cells to be imunoreactive. Prognostic markers are pending.
Can you tell me what your opinion is on this as far as treatment. Surgeon has recommended masectomy due to chance of reoccurence with multifocal ductal carcinoma with possible chemo depending on lymph node results. He does not believe sentinel node biopsy is as accurate as taking all the lumph nodes. Also, i am very large breasted,and wonder if it would be better to go ahead with bilateral masectomy with reconstruction after possible chemo, due to the difference there will be in the breast size and the possibility of occurrence of this cancer in the unaffected breast later on. I have a positive attitude and good support system, but of course am very scared about all of this. Please let me know your opinion as i have not seen an oncologist yet. Thank you. |
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You would benefit from a formal second opinion consultation. Depending on the extent of disease, how far apart the multifocal areas are, your breast volume which you mentioned, and some other factors, would determine if you can skate by with a large lumpectomy vs mastectomy. So seek a formal consultation before proceeding with surgery so that you can feel confident in the decisions that are made with you and for you. Usually chemo is given for women with invasive tumors larger than 1.5 cms whether nodes are positive or not, unless the patient is elderly and has other health problems. Also hormonal receptor positive patients may have other options too.Lastly, sentinel node biopsy is controversial among surgeons when it comes to multifocal disease-- we have done them here in cases similar to cases to your own so again, explore that option further. You are always welcome to come here for surgical evaluation and actual treatment if you like-- many women do. |
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Question:
#2042
01/14/2003
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We are with the Veteran's Administration (VA) Hospital in Providence, RI and have received a request for BRCA-1 & 2 testing on a male who is positive for HER-2-Neu. Does your Lab do this testing? If not, what would you suggest?
Thank you. |
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Our lab does not do this test here. You may want to contact Dr. Deborah Armstrong here in medical oncology as she is our expert regarding this area. You can email me at shockli@jhmi.edu to get her number and email. |
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Question:
#2043
01/21/2003
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Regarding testing for Her2/NU - what is the best lab test and what is the percentage of false negatives using: Immunohistochemistry and FISH?
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The Her-2/neu gene encodes a growth factor receptor that is expressed at low levels in normal breast epithelium. Her-2/neu protein is overexpressed in approximately 25-30% of invasive breast carcinomas. Her-2/neu protein overexpression almost always results from amplification (having more copies) of its DNA (gene). Her-2/neu overexpression is significant because it is
1. an adverse prognostic factor, especially in patients with node negative disease.
2. a predictive factor, predicting response to anthracycline chemotherapy.
3. a therapeutic target, since patients whose tumors overexpress Her-2/neu may be treated with a humanized monoclonal antibody against Her-2/neu (Herceptin, trastuzamab).
There are two established and FDA-approved methods of assessing Her-2/neu status in breast cancer: fluorescence in situ hybridization (FISH), which measures DNA amplification, and immunohistochemistry (IHC), which measures the actual protein produced. Each method has its own advantages and disadvantages. Immunohistochemistry has the advantage of measuring the actual Her-2/neu protein that mediates the above effects, and in theory can detect rare cases where Her-2/neu protein is overexpressed by methods other than gene amplification. However, a major disadvantage is that immunohistochemistry is difficult to standardize across laboratories, mainly because fixation of breast tissue is very difficult to standardize across laboratories. Hence, there is significant potential for false positives and false negatives. FISH has the advantage of being less dependent upon fixation since DNA is preserved better than protein. However, FISH does not measure the actual Her-2/neu protein that mediates its effects. Additionally, since FISH is a newer technique, there is less experience with it in breast cancer. Along these lines, we are now beginning to see cases of borderline FISH amplification, the significance of which is not clear.
Overall, it is not absolutely clear which method of assessing Her-2/neu is best for determining its prognostic, predictive, and therapeutic implications, though many oncologists now favor the newer FISH technique.
In general, FISH and IHC correlate very well when the IHC is strongly positive (3+ score) or negative (0,1+ score). However, when IHC is weak positive (2+), only 20% of tumors have amplified Her-2/neu. Hence, many laboratories (JHH included) perform FISH whenever the IHC is a 2+.
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Question:
#2044
01/07/2003
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I received my pathology report, and it lists a diagnosis-- benign breast tissue with calcifications-- and there is a Gross Deion but no Microscopic Deion. Is there no Microscopic Deion because it was benign and therefore not necessary to include that? I guess I assumed that all pathology reports would have a Microscopic Deion, whether it is benign or malignant. Thanks. |
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hhhmm. usually there is a microscopic deion too--- consider having the slides re-reviewed elsewhere to ensure your peace of mind... |
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Question:
#2045
01/07/2003
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please, in as much detail as possible, could you tell me what my pathology report means. i had a partial mastectomy because of sudden cysts and tumors after taking breast enhancing herbs. i also have a strong family history of breast cancer on both sides of my family.
my report: fibroadenomatoid lobular hyperplasia, adenosis, rare foci of duct hyperplasia.
i am very interested in knowing what "rare foci" means. i cannot find any info on "rare foci"
if you could answer in detail please.
thank you very much
ps: i also had another tumor biopsy that reads: sclerosing adenosis with focal infarction, papillary duct hyperplasia and inflammation.
i was told these results make my future risk for breast cancer increased. is this true?
please keep in mind i am very interested in knowing in detail what "rare foci"of duct hyperplasia is.
again, thanks so much |
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rare foci means that there was a tiny isolated spot--- just a spot of cells that showed duct hyperplasia--- it didn't say atypical duct hyperplasia so rest easy... it is only the atypical ones that we worry about being a sign of possibly increasing ones risk of cancer in the future. your report is okay. for more information on path go to our home page and click on pathology- www.hopkinsmedicine.org/breastcenter |
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Question:
#2046
01/01/2003
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my wifes yearly mammogram was abnormal and the radiologists opinion was dcis pleomorphic.i would like her to have a lumpectomy for the complete removal in one piece for the pathologist to view the margins as i am concerned that useng the mammotome could cause cells to spread to the lymphatics and blood |
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The only way TO ensure clear margins is to do a lumpectomy.Mammatome is for diagnosis only-- not treatment, so you are correct about that. However, if the findings are DCIS don't be fretting about lymph nodes and blood vessels... this is noninvasive disease-- the earliest stage of breast cancer, which is the good news. Seek a surgeon now to do the lumpectomy procedure. |
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Question:
#2047
12/30/2002
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Oct 11th 2002, I had a lump removed from the left breast that I had found myself the week before.My mammos from July 2002, showed nothing.The Doctor said he was 99.9% sure it was just a cyst. Well it wasn't.Pathologic diagnosis read, Invasive carcinoma, with both ductal and lobular patterns, grade 11/111. The tumor was 3cm. The antibody tests read as follows. ER by IHC, negative. PR by IHC, negative. Ki67, 40%. DNA Index/Ploidy 1.46 Aneuploid. S-Phase 24.2%. Next to all of these it said "Unfavorable". To date no one seems to want to tell me what all this means.Could you please enlighten me. 2 weeks after the lumpectomy I had a sentinal node biopsy. 5 nodes were removed and all were said to be negative. Since then a new mammo of the right breast showed hundreds of microcalcifications that were not there in the July mammo. So I had a Stereotactic biopsy done that also came back negative. The opinions vary from double mastectomy to just chemo and radiation on the left side and keep a close watch on the right side.Someone said I should have a bone scan in case some cells have spread.Is this a good idea. One Doctor started me on Tamoxofin right away, and another said I shouldn't take it with ER and PR negatives, so then I stopped. I am very confused with all of this, and would greatly appreciate any info you could pass on to me. Thank you. |
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you need a formal second opinion from a medical oncologist who specializes in breast cancer as you are clearly getting conflicting information and advice. Tamoxifen is only beneficial for women who are hormone receptor positive and yours was negative. The tumor was fairly large and yes a bone scan and cat scan should be done before chemogets underway. You also will be advised to do radiation since you have more than 4 nodes positive. So get an appointment at another facility than from where you currently being treated so that you can get more information and hopefully better clarification of your treatment needs. You are stage 3. It's not a death sentence, but does require a lot of treatment to help ensure that this disease is gotten into control so you can get on with your life once again. |
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Question:
#2048
12/19/2002
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I had my breast done in november 13 2002 and I had to see a specialist about them my left breast has clusters behind the aerola lots of clusters grouped all together.I have an appointment in Jan.8 2003 for that.I'm getting a needle bio-something done cant spell it correctly. Should I be worried. |
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What they are focusing on is that the calcifications are in a cluster--- sometimes when this is seen it is an early stage of breast cancer. Don't worry yet... take this a step at a time. If the results do come back as breast cancer (often times as noninvasive disease which is the earliest possible stage and easiest to treat), then get 2 opinions about your surgical options... but for now, focus on the holidays and not on your breast health. Even it bad news, things have been identified early |
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Question:
#2049
12/04/2002
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Can you please tell me what adenocarcinoma insitu is???
Surgeons said it is cancer, stage 2 and I had to have a node dissection, neg.
and radiation following???? |
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hhhmmm. insitu means that it isn't invasive so this is a bit confusing... take a look at our pathology section on our website: www.hopkinsmedicine.org/breastcenter for more information on path terms. if necessary, send an email to Dr. Argani for more assistance: pargani@jhmi.edu He is our lead pathologist on breast cancer. |
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Question:
#2050
11/30/2002
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i recently had two stereotactic biopsies of the same breast. the nurse called to say that the pathology is precancerous... but in the next sentence she said that they call it dcis... isn't that cancer? is it possible to have both areas removed with lumpectomies rather than a mastectomy?
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you are right- DCIS is cancer-- the earliest stage of breast cancer-- also known as noninvasive breast cancer. Some people call it precancer but that is really understating what it is... If the DCIS is in two different areas of the breast doing 2 lumpectomies would probably result in the loss of the majority of the breast giving a bad cosmetic outcome unless you are very large busted. Multifocal disease, having cancer in more than one area of the breast at the same time, is usually a ticket for mastectomy. But reconstruction works well in such cases because you'd be a good candidate for skin sparing mastectomy with reconstruction. So explore that possibility. The most popular form of reconstruction today is DIEP flap-- taking your tummy tissue and fat and NO MUSCLE at all, and literally cutting it free from your tummy area and tranplanting it up to your chest, just having an incision around the edge of the areola of of the nipple. When all is said and done there is no evidence a surgeon was ever there. amazing... If the DCIS is far away from the nipple, sometimes nipple sparing can also be achieved- truly the best of both worlds. Something to think about... you have time to make this decision too, since it is DCIS and not invasive disease so take your time in selecting your surgical oncologist and if interested, your plastic surgeon. |
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Question:
#2051
11/29/2002
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My wife's Non-GYN Cytology Report Findings are: Proteinaceous material and scattered foam cells are present. Rare ductal cells are also seen. No malignant cells are identified.
What does this mean? This is from fluid expressed from my wife's left breast. It was done because of bloody discharge from a single duct on this breast. Can you explain? |
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these are normal findings for fluid expressed from the breast. apparently at the time there as no bloody discharge as there is no mention of blood in the specimen either. I trust that she has had a mammogram and ultrasound as part of her evaluation for bloody nipple discharge? if not, she should get scheduled for this soon to be properly evaluated and not rely solely on nipple aspiration fluid path results. |
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Question:
#2052
11/28/2002
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my mom went for a breast exam and she recently got a letter back from her exam and it stated that your most recent breast exam has been reviewed and shows a finding which requires further evaluation so i called and they told me it shows something on her left breast and 8 out of 10 are benign i'm worried i dont want her to have cancer she's going to have further exrays but i wish to god she has nothing |
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it is very common for women to be called back for more xrays after a screening mammogram and the majority of the time it is nothing to worry about. So don't you worry needlessly either. she will have some spot films done and probably an ultrasound and hopefully get a good report. |
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Question:
#2053
11/26/2002
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What is 7mm asymetrical cyst? I have one found in my left breast that has been there since 96 with no significant changes. I just went through surgery and radiation for DCIS in the right and am presently taking Tamoxifen. Do I need to be worried? |
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The term "asymmetrical" means that it is an unusual shape that isn't perfectly round as cysts usually are. To definitively ensure it is a cyst a radiologist could aspirate the fluid from it in a breast imaging setting. cysts and cancer aren't biologically connected. it is a good sign that it hasn't changed in its appearance |
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Question:
#2054
11/26/2002
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My lump was 1.3X 1.2 infiltrating, no nodes, her2neu neg, ratio 6 out of 9 and 8 out of 9 from 2 different labs in level of aggressiveness at 2 different hospitals, clean margins, CT scan & bone scans. Dr. recommends CA over CMF. I am pre-menopausal @ 46. 2nd opinion suggested I was a candidate for CMF but if they were me, they'd have CA. How do I know if the 2% kicker CA is supposed to give helps the Stage 1 candidate with poorly differentiated cells such as me or is too aggressive? Scheduled for CA 1st week of December. Trying to hold onto my conviction that CA is worth the risk. Many thanks! |
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it's tough to say... first, its good that you had a nice small tumor...you should do well. It also is nice to have options. Consider a third opinion as a way of reassuring yourself of what you want to choose. CA is pretty standard these days... also takes less time than CMF, but nice to have choice once again.You are young so it makes sense to be aggressive. |
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Question:
#2055
11/24/2002
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Family history of breast cancer. I am 32 and second mammogram report states, dystrophic calcification behind the right nipple. This is new compared to my last mammogram. Impression: Small calcification appears benign. Benign, Birads, category 2. A one year mammogram was requested. Is this anything to worry about? I didn't like the word,"appears." Either it is or it isn't benign. Also, what does the 'catagory 2' mean? |
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the deion is not troublesome. The word "appears" is used because the only way to prove what it is would be to go in and biopsy it, thus removing it. you are always welcome to get a second opinion reading with another radiologist who specializes in breast imaging though to give you peace of mind. |
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Question:
#2056
11/20/2002
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Would you please explain the difference between atypical hyperlasia and LCIS. |
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Take a look at our pathology section on our home page for more information: www.hopkinsmedicine.org/breastcenter as well as visit www.breastcancer.org for explanations regarding pathology terms that may help you. |
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Question:
#2057
11/20/2002
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i had dcis high grade with foci of microinvasion. had mastectomy. test came back estrogen positive and also very positive for her2neu. is my prognosis very bad now. please help. |
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No it is not. rest easy. Focus on the fact that you only had microinvasion-- that's good news. you are barely a stage 1 then, just bumped up slightly from a stage 0!! and ER positive is great news. Don't worry about the her2neu with such a good stage of disease... enjoy the holiday and hundreds of them afterwards! |
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Question:
#2058
11/17/2002
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My wife was recently diagosed on stereotactic biopsy to have Ductal hyperplasia with atypical cells. She then went on to have an excisional biopsy wich was read out have LCIS on 7 of 15 slides. The neoplasia extended to the ducts. The Lcis extended to the margin. Does the number of slides this is found on and the fact that it extents to the ducts have any influence on whether she should choose prophlactic bilateral mastectomies. And does the finding on the Stereotactic biopsy play a role in her decision. Different doctors tell her different things and we are confused. |
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A diagnosis of LCIS and the extent of LCIS present doesn't warrant prophylactic mastectomy. This is a marker for risk and not a diagnosis of breast cancer. She should enroll in a high risk breast cancer program where she can be properly evaluated for her risk and put on a plan that can help to further reduce her risk which does not have to include mastectomy unless she wants it to |
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Question:
#2059
11/17/2002
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Had a wire localization biopsy due to 'a group of clusters of indeterminate microcalcs' and the results are as follows: variably dilated ducts, ductules, adenosis, sclerosing adenosis, apocrine metaplasia, inter and intralobular fibrosis. Intraductal papillomatosis and prominent micro and macrocaclification seen. If atypical cells were found would they be included in the report? Also, would I need close monitoring due to the intraductal papillomatosis? my surgeon said to have a mammo within a year and no further followup is necessary. |
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If ADH or anything more worrisome were found it would have been stated in the report. your doctor's recommendation seems logical. |
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Question:
#2060
11/17/2002
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Had a small DCIS lumpectomy many years ago - with little chance of recurrence. Months ago, a surgeon said he "felt something" in the same breast site. I had a lumpectomy and the path report defines it as ADH and only .04mm and says it is not cancer.
Either he is Houdini with magical powers or should explain how on earth he could feel something so small....
Should this considered cured by excision with monitoring and followup and did I have this surgery for nothing??
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he may have felt scar tissue or a thickening that worried him and thus felt it appropriate as most doctors would to explore it further. usually a diagnostic evaluation would be done - mammography, spot films and ultrasound, to see if the abnormality is something warranting biopsy. If so, then biopsy is done. Once a breast makes breast cancer once it is capable of doing it again, so he was airing on the side of caution. you are right that it would be impossible to actually feel something the size of .04mm but he may have felt density there that signaled something |
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Question:
#2061
11/17/2002
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Here's one for you, thank you for your answer.
I have breast implants, was diagnosed
with 1.7cm cancerous tumor, Dr. gave only 1 option lumpectomy with sentinel
node biopsy, lymphs were clear, but field of margins came back not clean, now they are reccomending I go back soon and have mastectomy, shouldn't my doctor
have done only 1 surgery and if he wasn't informed about proper procedure for breast implants shouldn't he have inquired for my sake???? |
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hhmm. what is curious is the lumpectomy requires radiation with it and implants and radiation don't mix. (implants don't tolerate radiation well and will become hard and capsulitis is common). Talk with your surgeon about how the choices of surgical options were determined and if you wish get another opinion from a surgical oncologist who specializes in breast breast. you need to ensure you are confident with your surgeon and his expertise in this field and if he isn't expert, move onto someone who is |
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Question:
#2062
11/17/2002
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First, I would like to say thank you for your outstanding, patient and superlative services here. God bless and keep you for all the "sleepless in stress" people who dearly need your help..........
I asked previously about getting a re-cut addendumized by requesting my original tissue block- You encouraged me to do so and I was successful.
With a little shorthand, The following is the addendum / amendment to the re-cut report, which said 1.5mm,focus of atypical ducts -- an additional 0.3mm focus of atypical ducts .- Uncertainty of relationship of the 2 foci. If total sz of lesion were greater than 2.0 mm or represented a truly multifocal lesion, we would favor a diagnosis of low grade intracuctal carcinoma; while if the total sz of lesion were less than 2.0mm, then a diagnosis of ATDH would be favored. The primary diagnosis is thus changed from "ATDH" to "ATDH vs. low grade intraductal carcinoma" The remainder of the diagnosis is unchanged.
Well, now, I'm thinking -that is a ton of "if's" !! --- Is this an "upgrade" from the 1st report of ATDH? --- or just another way of saying we don't wish to rule out another dr. saying it's low grade DCIS (intraductal carcinoma appears to mean DCIS) How very confusing~
Thanks for your comments~ |
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interesting... it does appear to be an upgrade from your previous findings. The national expert on DCIS is David Page, a pathologist at Vanderbilt. You may wish to explore this with him for him to personally review your slides as well. When there is a question of ADH vs DCIS most breast surgeons would probably take the approach of aggressiveness and treat you as if you were confirmed with DCIS, thus ensuring that you get the treatment you need, even if that treatment in the long run ends up being overtreatment (ie, if the final findings were to be ADH only without DCIS.) You need to personally decide how aggressive you want to be too and how worried you are. More things to think about. |
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Question:
#2063
11/17/2002
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I am 43 female and recently my mammogram came back as suspicious. I had gone in for more views and the report said clustered punctate rounded to faint rounded amorphous calcifications some of which some have increased in size and numbers since last mammogram. there are also several hazy amorphous to rounded calcifications with vague suggestion of possible slight layering in two of the larger faint calcifications. There is heterogeneously dense parenchyma extending throughout the breast which decreases sensitivity to mammography. There is a small group of 3-4 loosely grouped calcifications more inferiorly as well as scattered punctate to faint amorphous calcification. Impression: Probably benign f/u 6 months. At this point should i get a biopsy or am I being given the best advice? thanks for your time. |
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To be confident, take your mammograms and have then re-read by another radiologist who specializes in breast imaging. with 2 opinions giving the same advice that its okay to watch and monitor you will sleep better. |
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Question:
#2064
11/10/2002
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My question is twofold. I found a lump between my neck and collar bone, had it biopsied and the doctors said it was related to breast cancer. I had a mammogram in March 2002, with no problems, and now this, it's November of 2002. I also am a kidney transplant patient for over 2 years, with excellent cbc counts. What kind of prognosis do I have as far as cancer and saving my new kidney. |
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there are certainly patients we have operated and treated at Hopkins for breast cancer who have had organ transplants, including kidney transplants and they've done okay. a key question is how far has this breast cancer spread? if the lymph nodes in your neck are breast cancer, then there is risk the disease has gone onto other organs like your lungs, liver or bone. Pursue this discussion with your medical oncologist who specializes I hope in breast cancer as it is time to get some scans and blood tests to investigate this further. you are obviously made of tough stuff, having survived a organ transplant already so hand in there dear... |
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Question:
#2065
11/15/2002
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Q: |
I am doing some research on pathology slides and over-reads or re-reads; specifically for breast cancer. Are there any standards or guidelines on what types of slides do or should get a second read? Does a slide that is read as negative for breast cancer automaticaly get a 2nd/confirmatory read? Does a new diagnosis of breast cancer get a second read? I am struggling to find literature on the subject of if and when pathology slides are to be over-read. |
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This is an excellent question. Our hospital’s recommendation is have patient’s pathology slides from other institutions reviewed here by our pathologists before treatment is begun. This is also the recommendation of the Association of Directors of Anatomic and Surgical Pathology. This policy has resulted in a small but significant number of changes in diagnoses which have resulted in major changes in treatment (See Cancer 1999;86: 2426-2435). Within a given hospital, there is no uniform policy as to second review of slides. At some hospitals, the policy is that any new cancer diagnosis should be reviewed by 2 pathologists. Negative biopsies may not be reviewed, however. At our hospital, 2 pathologists (a resident and an attending) review essentially every case. We have an additional daily quality assurance conference where any difficult cases are shown to the entire group here (including 8 attending surgical pathologists and others) for a second opinion. Most of our breast biopsy specimens are reviewed at this conference given how difficult to interpret they can be. |
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Question:
#2066
11/08/2002
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Q: |
Hi my q. what is breast tissue showing fibroadenoma /fibroadenomatoid changes and fibrocytic. disease with intraductal hyperplasia and apocrine metaplasia? |
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A: |
doesn't sound worrisome. fibroadenomas are of course benign masses. The majority of women today seem to be diagnosed with fibrocystic disease which makes it fairly common and not something that would be considered abnormal in general. you can read and learn more about hyperplasia and metaplasia by visiting www.breastcancer.org in their pathology section as well as our own at ww.hopkinsmedicine.org/breastcancer then click on pathology icon. |
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Question:
#2067
11/06/2002
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Q: |
I was diagnosed with DCIS in my left breast on 11/99 it was of a high grade and I had a lumpectomy and radiation. I was 46 at the time and premenopause. I did not take tamoxifen after. My mother died of breast cancer at the age of 36.
I discovered two lumps in my right breast on 6/01. The path reports states: fibroadenoma with extensive adenosis, fibrocystic disease with ductal hyperplasia. There were also microcalcifications noted. I am just doing follow up of yearly mammograms and wanted to know if this was enough? I am concerned since I have paternal and maternal relatives also with breast cancer. |
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there is no comment in this report of atypical cells. fibroadenomas are benign masses, which is good news. you should be followed however by a doctor who sees and treats women who are high risk since you have had the disease and have apparently extensive family history. annual mammography is wise, but clinical breast exam and putting together a plan to help additionally reduce risk (nutrition, exercise, staying away from smoke, etc) can be useful and a discussion about tamoxifen might be on your horizon now |
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Question:
#2068
11/06/2002
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I am sorry, I just sent a question regarding my sister who was diagnosed with focal amorphous breast calcification on the right breast near the breast wall. I forgot to mention that she is 55 and a heavy smoker. Is it possible that this spot is coming from somewhere else? |
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no calcifications don't come from another place in the body and then go to the breast- they start in the breast. It would be great for her to become a nonsmoker though, just because that is a way to reduce risk of breast cancer, reduce risk of heart disease, and reduce risk of lung disorders including of course lung cancer. |
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Question:
#2069
11/01/2002
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Q: |
I am 42 & had bilateral Mastectomies June 2000. My reports says : High grade invasive ductal breast carinoma,accompanied by high grade DCIS ,stage 11B,T2,N1 apparent MO, which is hormone receptor negative, and 3+ of Her-2 Neu on immunohistochemical testing. I had 4 cycles of Cytoxan,Adriamycin & 4 Taxol. I was also given advise in my home town of Boise to do 6 weeks of radiation since my tumor was 3 cent 2 nodes positive. I flew back to Ohio State University /James Cancer Hospital as I have family back there & wanted to go to a breast cancer specialist. There are none in Boise. Dr. Shapiro was my oncolgist at the James. He was very concerned about the Her 2 neu thing. He thought it would be to my benifit to do the Herceptin Trial but none were available out here. My question is...I saw on the internet last night that people with Her 2 neu have a ,
"POOR PROGNOSIS" & that it is a most aggressive breast cancer." I knew it was aggressive but not that I have a poor prognosis. Does this mean I am really not a stage 11B cancer? I have been upset about this Her 2 thing since I read my report 2 1/2 years ago. I want to know if it means my surivival chances are worse than other stage 2 ,2 node women & is Herceptin of any value now even though I show no signs of metastitis yet?
Worried In Boise |
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A: |
It is unfortunate that those treatment is done it is still haunting you but this is common among breast cancer patients...Her2neu is a prognostic factor and we certainly do prefer to see it negative than +++. It isn't a death sentence though and each woman's situation is unique unto itself. you have done the right thing in going ahead with chemotherapy as you did, with its mission to obliterate any possible cells lingering elsewhere. You didn't mention your hormone receptors but women with positive hormone receptors usually fair a better than those which are negative. Statistics are merely numbers-- there are people who fall on both sides of the curve. the stages are not broken down into who is her 2 neu positive vs negative, which tells us that this isn't something you should sweat over. See your doctor regularly, exercise, avoid smoking and alcohol and stay on top of the latest research in the field of this disease so that you are always an informed patient. Try to move forward and don't fret about one individual pathology finding. You ARE a survivor! |
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Question:
#2070
10/29/2002
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Q: |
I had stage 0 DCIS and had a lumpectomy, the Dr. would like to see me on tamoxifen, I can't be on that cause the side effects is blood clots and I am prone to blood clots, my dr. said that she would see me every six months, should I have a second opinion? Thank you so much |
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A: |
sure. a second opinion is a smart thing to do |
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