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Types and Stages of Breast Cancer
Questions about the different types and stages of breast cancer.
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AskedPublicly Submitted Question
9/17/2011I am writing this question for a friend age 45 and premenopausal who has been diagnosed with Breast cancer and has had bilateral mastectomies. The breast cancer was only in the left breast and was 25 mm in size, well differentiated infiltrating duct carcinoma, Nottingham Grade 1, no lymphatic or vascular invasion, infiltrating margin extends to within 1 mm of inked superficial margin, receptor studies HER2 negative, also in the left breast has extensive duct carcinoma in situ-tumor volume exceeds that of infiltrating component tumor extends over the same field measurement as invasive component tumor abuts on superficial margin, surrounding breast tissue contains foci of flat epithelial atypia and duct hyperplasia without atypia,sentinel axillary node negative for tumour. She has had bilateral breast reconstruction done and is wondering whether she would benefit from chemotherapy. She was told that she would be started on Tamoxifen as well in the future.Her question is that with the type grade and extension of the tumor and the DCIS to the margins whether she should be looking at chemotherapy before starting the Tamoxifen. Thanks for your help in this matter.
RepliedJHU's Breast Center Reply
9/18/2011Thank you for turning to the Johns Hopkins Breast Center with your questions, and for being a caring and supportive friend. So tumor in breast 2.5 cm, bilateral mastectomy, low grade, negative nodes. Assuming ER positive since to start on tamoxifen. Immediate concern is your mention of close to positive margins, and what has been done for these...re-excision, radiation?? Chemo question secondary with positive margins...they need to be addressed first. She actually has very favorable prognostic factors, save for the positive margins. In terms of chemo question however, Oncotype Dx assay could help here. She should be consulting with her breast surgical oncologist and medical oncologist as well. Hope this helps, and best wishes.

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