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Psychological Support
Questions about support for the mental aspects of breast cancer & treatement.
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AskedPublicly Submitted Question
8/7/2017Hi Lillie,

In June I was diagnosed with breast cancer and had a lumpectomy. I'm pre-menopausal (I'll be 47 next week.) BRACA 1 & 2 negative

Path report: IDC stage 1 grade 2 (tubule formation: 2 nuclear grade:2 mitotic index: 2
1.2 cm
ER+(100%) PR+ (90%) Her2- (1+)
Ki67 5%
lvi present focally
SNB 0/2
Oncotype 17 (11% chance distant recurrence with tamoxifen)

Med onc and surg onc said no chemo - yes to radiation and tamoxifen (and eventually an AI) for probably 10 years

I'm extremely concerned about the focally present lvi, as I know this is a very bad prognostic factor. I'm trying to stay positive but I can't help but think the tumor has already traveled. I really want to live to see my daughters grow up.

Do you think I have a good chance of dying from old age and not cancer? Or does the lvi pretty much guarantee that the cancer will or has already spread?

Thank you for your help.
RepliedJHU's Breast Center Reply
8/7/2017Prognostic factors include more than just lymphatic and vascular invasion. Other factors such as number of positive axillary nodes, tumor size, tumor grade (histologic or nuclear), proliferation markers, and ER/PR status must be taken into consideration. Some studies have shown the most significant prognostic indicator for patients with early-stage breast cancer is the presence or absence of axillary lymph node involvement. Furthermore, there is a direct relationship between the number of involved axillary nodes and the risk for distant recurrence. Try to focus on all the positive prognostic indicators you listed in your pathology report (tumor size 1.2 cm, ER/PR+, Her2 negative, Ki67 5%, SNB 0/2).

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