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Stage 1 , Grade 3,

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  • Doeface
    Doeface Member Posts: 1
    edited November 2008

    Hi Sandilee,

    I have a similar profile... my tumor however was larger 1.95cms with grade 2.

    My onco recommending chemo... was curious if that was recommended for you and that you chose not to or if they said it wouldn't be necessary... did you have the Oncotype DX test?

    Thanks! 

  • Sherry-41
    Sherry-41 Member Posts: 1
    edited October 2011

    Hello, 

    I am hoping others are still on this site.  I was just diagnosed with breast cancer stage 1 grade 3.  I had a mammogram July 19th then an ultrasound July 26 then a Biopsy on Aug. 1st The results were negative breast tissue.  My doctor and hospital agreed I should have an MRI because my mother had breast cancer at my same age 41.  I went to a different hospital and had the MRI and two nodules appeared one is one cm and the other one is 5mm.  So I had another ultrasound and biopsy on both nodules.  The results came back stage 1 cancer grade 3 on both. My doctor wants me to genetic testing done.  I am going on Wednesday.  The ultrasound did not show any growth in my lymph nodes.  I have been scared, confused, sick, tired, and emotional.  I am glad I read this site because I have no idea what these receptors mean PR,ER, HER and will definitely ask my doctor about it.  The only information I know right now is I could get the nodules removed have the lymph nodes checked and receive radiation and this would give me a 10/% chance of not getting it back ( I believe in same breast)?  or I could have a masmactomy on the left breast and get chemo or have a bi-lateral masmactomy.  I feel confused and not sure why I have to make the decision.  I thought there would be a recommendation.  I feel I need to schedule surgery right away before it spreads to my lymph nodes.  I am starting to feel I may need a bi-later masmactomy and chemo.  If there is anyone out there who can give me some feedback it would certainly help.

    Thanks,

    Sherry

  • kira1234
    kira1234 Member Posts: 754
    edited October 2011

    Sherry,

    Not sure how you found this thread, it's a really old one. I'm sorry you have to join the group no one wants to be a part of. At this point you really need more information before decisions like chemo,radiation, ect.

    In my case I had a lumpectomy. A test called the Oncotype test was done on the tumor which helped with the decision for me on chemo. You will want to find out of the tumor is ER/PR+ this  helps on the decisions you will need to make as well.

  • LisaEpstein
    LisaEpstein Member Posts: 3
    edited December 2011

    Just found out today after I had a lymsectomy that I am er position

    The tumor was an early stage 2 and was grade 3. Also Lyme nodes neg and clear margins. I go to oncologist next wk wonder what treatments I will need.

  • Ginnaree
    Ginnaree Member Posts: 1
    edited November 2013


    Dear chillicook,


    I have IDC stage 1, grade 3, and estrogen + breast cancer. I received 4 combo chemo treatments with1 every 3 weeks and 30 radiation treatments with 1 every weekday over 6 weeks. I just finished chemo ad radiation and will start estrogen blocker medication that I will take every day for 5 years. I try not to worry but the chance of reoccurance is in the back of my mind. The things you described doing are actually healthy because they give an outlet for your anger and fears. Being angry or fearful is normal because they are part of the grieving process. You are grieving for your health, safety, and your breasts. Just don't get stuck in this stage too long. Remember that " Life without Hope is not Living at all " .

  • Julrich
    Julrich Member Posts: 1
    edited January 2017

    I have IDC stage 1-2, triple negative and im scheduled for an MRI Friday. I was told chemo first then wait for genetic testing to make my decision which surgery route to g

  • coyote12
    coyote12 Member Posts: 1
    edited February 2017

    Hi, just diagnosed also... triple positive..Her2 low is all I have been told.Plan lumpectomy in 2 weeks.. probable chemo and definite radiation. My surgeon recommends a lumpectomy and also possible mammosite.. although not if I have chemo. I am postmenopausal... has anyone had experience with mammosite radiation.. and should I do a Masectomy instead given the HER2 + results

  • livelife2017
    livelife2017 Member Posts: 1
    edited March 2017

    I was diagnosed with Invasive Breast Carcinoma on 12/19/2016.  My first doctor suggested doing MRI, but then my insurance switch over to Kaiser in 2017. So had to wait and see Kaiser doctor in 1/2017. Had biopsy, stage 1c grade 3. er:93%, pr:29%, her2:+1.  I ask to have MRI but Kaiser doctor said it wasn't necessary.  Had lumpectomy on 1/26/2017 and just met with Oncology who suggested just do radiation, but she also says there is a slight chance cancer may have already spread.  My Ocotype is 19, intermediate.  So I am confused why did my surgeon not suggest do MRI or Pet scan and now Oncologist is not suggesting chemo, but she says it is up to me (which I guess is kind of good).  Am I just overly worried? Should I consider chemo since there is a slight chance cancer may have spread? Since these are Kaiser doctors I wonder are they making the best decisions for me or what may be most cost efficient for Kaiser?

    If anyone knows please tell me with these pathological reports staging should I be overly concern?  Should I consider chemo?  Does anyone have the same scenario that they can share if they did chemo or not?

  • Robin1234
    Robin1234 Member Posts: 38
    edited March 2017

    Hi livelife201 try posting your post on the triple positive group it's a active group.

  • moderators
    moderators Posts: 7,884
    edited March 2017

    Hi livelife, and welcome to Breastcancer.org,

    We're sorry for the confusion you're having, but you've come to the best place for support and advice.

    As Robin points out, you may want to join the Triple Positive Group; just click the link and say hi to those very helpful members!

    We look forward to hearing more from you. Please don't hesitate if you need anything at all!

    --The Mods

  • BarredOwl
    BarredOwl Member Posts: 261
    edited March 2017

    (1) The Triple-positive thread does not appear to be relevant to livelife2017

    If livelife2017 has "HER2-negative" invasive disease, then the "triple-positive" thread (for ER+ PR+ HER2+ members) is not relevant to her clinical situation.

    livelife2017 said: "Had biopsy, stage 1c grade 3. er:93%, pr:29%, her2:+1."

    The reference to "her2: +1" appears to be the result of an IHC test for HER2 status. If by validated IHC testing, then under ASCO guidelines, an IHC score of 1+ is HER2-negative:

    2013 ASCO/CAP HER2 testing guideline: http://ascopubs.org/doi/full/10.1200/jco.2013.50.9984

    She also appears to have received an Oncotype test for invasive disease. Such testing is indicated for hormone receptor-positive, HER2-negative disease. Of course, it would be best to obtain copies of the results of all ER, PR and HER2 testing performed to date (from all biopsies and surgeries) to ensure these assumptions are correct.


    (2) Factors affecting systemic therapy recommendations

    livelife2017:

    Do you have IDC? Was it node-negative or was any lymph node involvement identified?

    In addition to histology (ductal, lobular, other) and nodal status, the actual tumor size, ER, PR and HER2 status, along with grade, the presence of lymphovascular invasion, and Oncotype test results may be considered in connection with decisions regarding systemic adjuvant (post-surgical treatment) treatment. Clinical factors such as age and co-morbidities may also be considerations.

    With very early stage invasive breast cancer, quite often whole-body scans may not be recommended in the absence of symptoms of distant spread. Even when such scans are performed, unfortunately they are not capable of detecting "micrometastatic distant spread" and cannot exclude the possibility. The risk of current undetectable micrometastatic spread leading to overt recurrent metastatic disease at a later date is the rationale for systemic treatment(s) when recommended, as explained here:

    https://community.breastcancer.org/forum/105/topics/812929?page=49#post_4864077

    The Oncotype test is one way of assessing risk.

    The Oncotype test provides "prognostic" information about recurrence risk, assuming receipt of 5-years of tamoxifen. For example, in the node-negative ("N0") Oncotype report, prognostic information is provided about the 10-year risk of distant recurrence after 5-years of tamoxifen associated with your particular Recurrence Score (i.e., the risk of suffering a distant metastatic recurrence in 10 years). Your medical oncologist should have explained this to you. As part of the risk/benefit analysis, the medical oncologist should also have discussed what is known/unknown about the potential benefit of added chemotherapy with a standard intermediate Recurrence Score of 19. Any potential benefit should be weighed against the risk of severe adverse effects from any particular chemotherapy regimen under consideration. If she did not discuss these things, please do not hesitate to request a second appointment to review the content of the Oncotype report and its implications regarding recurrence risk, etcetera. This may help you to better understand the basis for why the oncologist is "not suggesting chemo, but she says it is up to me." With a better understanding of risk/benefit, you can decide what is right for you, in light of your personal risk tolerance.

    You may wish to inquire if there is a "tumor board" or multidisciplinary panel at your current treatment center that would consider your case.

    With an intermediate Recurrence Score, if feasible under your health plan, you may find a second opinion to be helpful. As part of the second opinion, (if you wish) you can seek a pathology review (actual pathology slides from biopsies and surgeries are sent for review), and additional consultations with a Medical Oncologist and Radiation Oncologist. You may benefit from another explanation of your diagnosis, the Oncotype test result, and how the Recurrence Score and associated risk information should be viewed in light of all other relevant clinical and pathologic findings in your case. A second opinion also provides an opportunity for you to ask more questions about the rationale for systemic treatment and to gain a better understanding about your risk/benefit profile with endocrine therapy alone (e.g., tamoxifen or an aromatase inhibitor) versus endocrine therapy plus chemotherapy.

    In connection with the question of added chemotherapy, the intermediate range is an area where a judgment call must be made in view of all relevant factors, as well as the personal risk tolerance of the patient. In some cases (but not always), a second multiparmeter test might be ordered (e.g., MammaPrint plus BluePrint, Prosigna), if under applicable criteria (including "Clinical Risk" for MammaPrint) such further testing may provide additional information of value to decision-making. You may wish to inquire about that.


    (3) Stage

    Your actual stage and definitive diagnosis are determined by the combined pathology findings from all surgeries and biopsies.

    By the way, there is no such thing as "Stage IC." As can be seen from the chart below, Stage I disease is either Stage IA or Stage IB. The next highest stage is Stage IIA. Note that the results of lymph node biopsy are necessary to determine actual "TNM" stage under AJCC staging criteria (7th Edition).

    AJCC Staging Summary (7th Edition): https://cancerstaging.org/references-tools/quickreferences/Documents/BreastMedium.pdf

    image

    Under AJCC staging criteria (see Summary link above), "T1c" is a reference to tumor size (not stage):

    T1 Tumor ≤ 20 mm in greatest dimension, includes any one of the following:

    T1mi Tumor ≤ 1 mm in greatest dimension

    T1a Tumor > 1 mm but ≤ 5 mm in greatest dimension

    T1b Tumor > 5 mm but ≤ 10 mm in greatest dimension

    T1c Tumor > 10 mm but ≤ 20 mm in greatest dimension

    Please confirm your lymph node status and actual stage with your team (and on your pathology report).


    (4) Additional information

    If you have Stage I disease, you may be interested in this thread in the Stage I Forum for those with intermediate Oncotype Recurrence Scores:

    https://community.breastcancer.org/forum/108/topics/763815?page=5#post_4914865

    If you have node-negative ("N0") disease and received a node-negative ("N0") Oncotype report, you may be interested in the following.

    It is appropriate to consider a variety of additional clinical and pathologic factors with a standard intermediate Recurrence Score of 18 to 30, as indicated on the Genomic Health website (scroll down to list of factors):

    Genomic Health: http://intermediate.oncotypedx.com/en-US/Using-The-Intermediate-Recurrence-Score/Integrating-The-Intermediate-Recurrence-Score.aspx

    With regard to the potential benefit of chemotherapy, it is possible that there may be differences within the intermediate range, such that chemotherapy benefit might differ by recurrence score or other factors. This is also discussed on the Genomic Health web site (scroll down):

    Genomic Health: http://intermediate.oncotypedx.com/en-US/The-Recurrence-Score-Result/How-An-Intermediate-Recurrence-Score.aspx

    For more discussion about the intermediate range based on node-negative studies, see this earlier post:

    https://community.breastcancer.org/forum/147/topics/842209?page=3#post_4768276

    All external information (in posts or from the Genomic Health website) should be discussed and confirmed with your medical oncologist to ensure receipt of relevant, accurate, current, case-specific expert professional medical advice.

    Best,

    BarredOwl

  • Piscean
    Piscean Member Posts: 11
    edited March 2017

    Barredowl, that is the most comprehensive and complete explanation I've read on this site.

    I'm not sure if I should feel happy or sad that you are so educated on the topic, but I am certainly grateful.

    Cheers,

    Piscean

  • TofAvila
    TofAvila Member Posts: 1
    edited March 2017

    It might be worth getting a second opinion at UCLA. Their oncology Dept is great, and they can better explain your test results. Dr John Glaspy is top notch.

  • Warriorsmum
    Warriorsmum Member Posts: 4
    edited October 2017

    dear Sandilea

    My 31 year old daughter has just been told she has grade 3 breast cancer but after the MRI - they think Stage 1 - thank the Lord - but they saw a bit of lightning up on the lymph so they will double check - she is devastated - understandably- like Daisy- her sisters and I are floored but ready to fight with her. Thanks so much for you and the other amazing women's comments - love to you al

  • Warriorsmum
    Warriorsmum Member Posts: 4
    edited October 2017

    thank you for all the information - what a wonderful informative site this is

  • Warriorsmum
    Warriorsmum Member Posts: 4
    edited October 2017

    love to you Sherry -