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|Types and Stages of Breast Cancer
Questions about the different types and stages of breast cancer.
|Asked||Publicly Submitted Question|
|6/22/2006||Had bilateral simple mastectomy 5/30/2006 for DCIS (modified USC/VNPI score = 7) & LCIS in left breast. Pathology report for left breast indicated DCIS with associated papillomatosis, nuclear grade I/III with cribriform pattern, DCIS focally came within 1- 2 mm of inked surgical margin. Had 3 biopsies (all non-malignant) previously in right breast, but had no suspicion of cancer in that breast prior to the mastectomy. Right breast mastectomy pathology report found: infiltrating ductal carcinoma, mucinous type; focal DCIS, cribriform pattern; infiltrating carcinoma grade I (Nottingham); DCIS nuclear grade I; tumor size 1.0 cm; deep margin negative; vascular/lymphatic invasion not present; ER+(100%) PR+(99%); KI-67 8%; P53 7%; HER2/neu non-amplified via FISH (HER2/neu / Cen 17 Ratio = 1.07; pathologic TNM stage: pT1b, pNX, pMX. Since we were not aware of the tumor in the right breast before surgery, sentinel biopsy was not considered and no nodes were removed during surgery. I am 54 pre-menopausal and in excellent health, but am concerned about now having axillary node surgery because risk of lymphedma may impact career (musician). We are waiting for the results of oncotype DX, to provide information about the tumor itself even though at this point we donít know node status. Weíve discussed several scenarios for treatment with the oncologist based on 0 node involvement and hypothetical 1-3 nodes involved. From what Iíve been reading, it seems node dissection is highly recommended for creating a treatment plan, but can it be avoided if the oncotype dx score is low? Are there any non-invasive methods of assessing lymph node involvement?|
|Replied||JHU's Breast Center Reply|
|6/22/2006||nodal status is usually assessed by surgical removal to determine the number of nodes involved. have your case presented to their weekly tumor board. that would be good for input from radiation oncology to see if they would consider radiating the nodes vs removal, realizing that both cause increased risk of lymphedema.|
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