Topic: How common is....

Hello,

I'm too very interested, how common it is?

I had IDC 4sm, IDC 8MM, DCIS, and one  tumor in  lump node -1sm.

I had 2 lumpectomy's because  second tumor (8mm)

was found after  first surgery.

Doctor told me that difference  between lumpectomy and mastectomy only 2%.

BethNY, thank you.

One study from back in 2005 showed about 10% of women were found to have had multi-focal or multi-centric tumors.  The study pointed out though, that it may be higher, but with Lumpectomies, one wouldn't know if there were other tumors that weren't seen till a later date.

The study also said that they felt in many cases using the entire tumor load would place those women at a higher risk for metasteses and thus, the tx they were receiving was possible undertreatment as a result of using only one foci rather than the aggregate tumor load.  That didn't fare well with me in the report and I'm left wondering why more studies aren't done on this aspect of breast cancer.

For instance, the oncotype test is done on ONLY the largest tumor, not both, so the ILC w/ LCIS was not even considered in the RS.  Seems like that is ommitting pertinent information to me, but no one seems concerned.  I still am.

Here is what the study concluded: 

CONCLUSION: The tendency of breast tumors to metastasize is a reflection of the total tumor load. Failure to measure the additional tumor burden provided by multiple small foci may understage a woman's disease. This may deny patients the opportunity of adjuvant therapies if the contribution of the smaller foci to the incidence of node positivity and survival is ignored.

This is a fascinating conversation.  I, too, had a lumpectomy, in which the surgeon bisected another smaller tumor which we didn't even know existed.  I was recommended for a re-excision, but opted to have a mast instead.  The final path report also showed DCIS.  So, I had multiple areas in the breast that were affected, but it didn't seem to concern my surgeon as much as it did me.  Perhaps they are used to treating much more aggressive cancers, so when they see a stage 1, grade 1, neg lymphnode cancer, they're happy.  I, however, decided to aggressively attack what I had, get the mast, and though my oncotype was 14, 2 oncologists felt that it would be wise to do chemo as well.  I'm also pre-menopausal (36 yrs old), so that factored into the decision.

That study info is interesting, wishiwere.  I've also read that in the recent past, tumor stage was based on the aggregate size of all tumors involved.  Nowadays, they only count the largest one. 

I wonder how this has affected recurrences, distant metastises, and overall survival?

That's what concerns me too, Patrice.  I had the 2 in different quadrants with the larger IDC/DCIS at noon high on the chest wall, and the other just about under the nipple and was ILC/LCIS.  With the tx and all, they only considered the IDC even though the ILC was over 1cm without the LCIS involvement.  Now, they aren't even doing mammo's every 6 months, but annually.  The Mammo and the U/S did NOT find this ILC, only on the MRI, so yes, I'm very uncomfortable with this R breast and it's follow up. There just doesn't seem to be enough study or consistency when it comes to the treatment of mult-centric, multi-focal BC and follow either.  Makes one wonder who to trust, who to go to and what the heck...everything, you know?

No thanks needed guys, this is one of the sites i've saved, b/c it's bothered me ever since I found way back in january.  But of course, my onco can't understand me when I ask questions, and doesn't 'normally' deal with BC pts, so what good would it do to bring it up either :(

So, Kimbly, did you have a mast or lump?  I know that they say complete response to the neochemo is a great sign!  Sounds excellent hey? 

Hi ladies....

I initially had a diagnosis of low grade dcis (found by calcifications on my first mammogram)...after i had the first lumpectomy to remove that..lo and behold they found a 1mm idc and a 4mm idc both low grade and no lymph nodes......i had a second lumpectomy to clear margins...then i did radiation treatment and tamoxifin....

i was lucky both of those were so small....

a client/friend of mine just turned 40 and was just diagnosed with 2 very large tumors in her breast,, she is doing the whole works, chemo, bilat, radiation...and probably hormonals after....she is doing great and remaining very strong, positive and hopeful.....

hugs to all of us...

kosh