Ask an Expert: View a Question
 
 
 
 

Ask an Expert is a free question-and-answer service about breast cancer and breast health that is available on weekends. If you'd like to ask a question or comment, please visit us again on Saturday or Sunday. In the meantime, please search the existing topics using the search tool at the top of the page. It's quite possible that one of our many existing topics already addresses your question.

If you would like a consultation with a breast specialist at the Johns Hopkins Avon Foundation Breast Center, call 443-997-8282. It is possible to get an appointment for a second opinion within a few days of contacting us.

We hope you find the information helpful!

ForumQuestionsAsk a Question
Facts and Myths about Breast Cancer
Questions on the facts and myths of breast cancer.
1,034 Ask a Question

AskedPublicly Submitted Question
12/2/2017My question was:
How high the recurrence risk for people old than 60 with negative margins but no radiation and anti hormone medicine treatment?
Your answer was:
it depends on the grade, Ki67, ER,PR and HER2 receptor status. how large the tumor was and what kind of breast cancer it was.

Here is the information except no Ki67 test:
Report from 1st surgery:
ER +, PR+, HER2-,
BREAST, LEFT, LUMPECTOMY:
-INVASIVE CRIBRIFORM ADENOCARCINOMA, BSR GRADE 2, 2.3 CM IN MAXIMAL
DIMENSION, ASSOCIATED WITH INTRACYSTIC PAPILLARY ADENOCARCINOMA + DCIS OF INTERMEDIATE GRADE + CRIBRIFORM TYPE.
-DCIS INVOLVES ANTERIOR, INFERIOR, + POSTERIOR SURGICAL MARGINS.

The result from re-excision surgery:

A. BREAST, LEFT NEW INFERIOR MARGIN, EXCISION:
MICROSCOPIC RESIDUAL HIGH-GRADE DUCTAL CARCINOMA IN SITU, SOLID TYPE.
There is a 2 mm focus of DCIS (block A2) near the edge of the tissue, where the blue ink (true margin) and black ink (cut surface opposite true margin) come together. This focus is 1 mm from the true margin (blue ink).

B. BREAST, LEFT NEW DEEP MARGIN, EXCISION:
FIBROSIS.
C. BREAST, LEFT NEW ANTERIOR MARGIN, EXCISION:
FIBROSIS.

Would you please answer my question again?
RepliedJHU's Breast Center Reply
12/2/2017First, there is a question whether there is still a margin issue at the inferior margin so confirm that they have at least 2 mms of free margin for all 6 sides of the DCIS. the stage is stage 2. request oncotypeDX test be done to formally calculate your risk without chemo and without hormonal therapy. your risk may be as high as 30% or more without hormonal therapy. radiation is to prevent local recurrence and right now there sounds like there may still be a margin problem. you will want WIDE margins if you aren't doing radiation. it is important to note that when someone agrees to doing lumpectomy they are automatically signing on for radiation too. the only way to avoid it in your case is with doing a mastectomy.

Please note: This service is not intended to provide primary medical advice concerning specific medical care or treatment. Ask an Expert is a free service operated by health care professionals at the Johns Hopkins Avon Foundation Breast Center. Due to the volume of questions and their complexity, there are times when medical oncologists, surgeons, radiation oncologists or oncology nurses are consulted for their input. These individuals volunteer their time for this service and will respond as soon as they are able. Please do not post or send the same question to us in multiple locations or categories.

The contents of this portion of the website cannot be used as a substitute for a consultation with your doctor or other healthcare provider. It also may not represent the opinions of other Johns Hopkins professionals. It is a free service performed on volunteer time and intended to provide feedback to questions posted by consumers however should not be used as a directive or instructions to now follow. Seeing your own medical provider is always important in getting your needs and questions addressed. In the majority of cases, a clinical examination, review of pathology slides and xrays, along with other medical information is needed to truly provide a consultative service. If you wish to receive a formal consultation with our physicians please call 443-997-8282 for surgical appointments and 410-955-8964 for medical or radiation oncology appts. For breast imaging, call 410-955-4100.

 
 
 
 
 

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System, All rights reserved.