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Stage II w/Lymph Node Involvement

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Comments

  • bdavis
    bdavis Member Posts: 3,192
    edited April 2011

    bump

  • proudmom_wife
    proudmom_wife Member Posts: 176
    edited May 2011

    bump

  • Fearless_One
    Fearless_One Member Posts: 905
    edited May 2011

    bump

  • Charley
    Charley Member Posts: 10
    edited May 2011

    Thank Fearless for bumping .. Great article!  That information was pretty much what my oncologist told me although since I do have lymph node involvement I think I may always have a nagging fear of reoccurrence.  Hopefully the TCx6 that I had last year totally obliterated any of the cancer cells that may have remained after BMX.  My aunt who turned 81 this year was diagnosed back in the early 70s.  No chemo then, but she did have MX + rads and had no problems since.  It will be interesting to see what the next few years will bring in regards to research and treatment. 

    Charley

  • Warrior517
    Warrior517 Member Posts: 240
    edited June 2011

    Hi girls.....just checking in. I am pre menopausal and on tamoxifen. For the third time, I have a Thick uterine lining. Another d&c is ahead of me...ugh. There is talk now about a hysterectomy. I am now 43 now. Feel like too young for full blown menopause and heard the a.i drugs have tough side effects.......any thoughts warriors! ?!?! I am negative fore genes.....

  • toomuch
    toomuch Member Posts: 254
    edited June 2011

    Warrior-I was premenapausal and 48yo when I was diagnosed. I've had uterine biopsies in the past and didn't want to deal with the worry of uterine ca and tamoxifen. While still in chemopause I had an oophorectomy. I've been on AI's for 4 months.I have had relatively few side effects. The biggest thing has been in the way my skin looks and feels, much drier all over and that includes places you can't see! I've had a few warm flashes but no problem with pain. These decisions are never easy.

  • coraleliz
    coraleliz Member Posts: 158
    edited June 2011

    Just found this thread. I'm posting even though I only read the 1st & last 2pages. I will go thru the other pages soon. I have bilateral IDC & had MBX in early April. Could someone help further define a micro metastis. My smaller tidy tumor had 2 positive sentinal nodes, 2mm & 3mm. My more invasive tumor had a node that was positive by "staining". Is this what micro metastis means or are all of my tumors micro.....Both of my tumors are grade I, the tumor with the 2 positive nodes is stage2. My tumor w/the 2 nodes was 1.3cm & the other 1.6(smaller than expected). As for RADs, I will probably have it. I had a blip light upon a PET scan after surgery. Can't say for sure it's a positive node. Also the positive nodes. My other option was ALND & that side healed slower than the other & I fear another surgery & drain. As for Chemo, I'm awaiting my oncotype's. The MO didn't want to run this test. He said there is little data on how to interpret them in bilateral disease. I've read other posts & talked to oncotype company & it is being done on such patients. So I ask my MO again about the test & he agreed. I'm leaning away from Chemo, but will have it for a intermediate or high score.

    I also recently came across an article saying lymph nodes don't matter & that it's all about adjuctive therapy being tailored to the individual. If I find it again, I'll post it here.

  • saralmom
    saralmom Member Posts: 216
    edited June 2011

    Hi Warrior!  I had a complete hysterectomy (LAVH) in January - very easy recovery btw.  I am still on Tamoxifen.  My onc says as long as Tamox is working there is no need to jump right into AI's.  Tamoxifen is for pre and post, AI's are just for post.

  • bdavis
    bdavis Member Posts: 3,192
    edited June 2011

    Coral... I had a micromet, and it is defined as being larger than .2mm but no larger than 2mm... Mine was .38mm.. so no, yours are not micromets, they are full-fledged positive nodes... had mine been .18mm smaller it would have been considered negative.... Mine was nonetheless there and positive and so I had extra chemo doses...

    My one tumor was 1.9cm and just one micromet, and my MO said to have 6 tx of chemo and didn't even give the oncotype test... Positive nodes does mean you should have chemo... the chemo will hopefully zap any rogue cells that may have escaped past the nodes... I wouldn't want to take the chance that it had spread so I am glad I had chemo... I am skipping rads though but having a MX instead... I do not need both. If I had had more node involvement, then I would have needed both.. so you may need both chemo and rads.... better to be safe.

  • coraleliz
    coraleliz Member Posts: 158
    edited June 2011

    bdavis, to further confuse myself, I went to the oncotype website & found a link to a clinical trial.

    http://www.swog.org/Visitors/ViewProtocolDetails.asp?ProtocolID=2197    It's called th RxPonder Trial.  It is for women with 1-3 positive nodes. ER+PR+ Her2- . They must also have a low to intermediate oncotype score. If i understand it correctly, half of the women will be assigned randomly to get chemo & half won't. There is obviously some thought that node-positive patients may not need chemo. I have also heard from other women whose were node-positive, with low oncotpye scores, that were told they didn't need chemo. My MO told me he didn't want his bias's to get in the way of my decision but that he didn't think 10years was a long enough time for "no reoccurrence". So, I guess he recommends it but not strongly.

  • bdavis
    bdavis Member Posts: 3,192
    edited June 2011

    Maybe you need a second opinion... My MO knew that I wanted to do the BEST treatment, meaning whatever it took, I was not afraid, and wanted to achieve the best odds of no recurrance... and there was no doubt in his mind that chemo was in store for me... the simple fact that the cancer travelled AT ALL to the nodes means it could have escaped and gone somewhere else... the ONLY medicine to kill those cells is chemo... and if it lands on in your lungs, bones, liver etc then there is no cure... That was not something I wanted to fiddle around with... chemo was not a big deal, lasted for me Jan-May... small price to pay for a lifetime of hope.

  • pejkug3
    pejkug3 Member Posts: 277
    edited June 2011

    BDAVIS - I couldn't agree with you more.  I wrapped up chemo yesterday.  When I started in February, I certainly couldn't see June.  The entire process was scary and seemed SO LONG.

    But one day I was fretting and being fearful over the thought of CHEMO.  Seriously?!  I'm going to let someone poison me for 4 long months?!  Ugh.  My husband looked over at me from the hotel bed when we were at the Mayo clinic for a second opinion and he said, "Is there any other way?  I mean, I know you've read all the research..."  I thought for a second and said, "No, I guess there really isn't."

    And that sealed the deal.  I knew there was no way I was willing to forgo chemo.  Hairloss, fatigue and general hatred for chemo was overshadowed by my desire to NEVER DO THIS AGAIN.  And chemo gave me my best chance at that.

    Now onto rads...and, once again, I'm searching for a way out.  But I know I have to do this...

  • christine47
    christine47 Member Posts: 846
    edited June 2011

    pejkug3-- felt the same way when I started my chemo, so wonderfully and simply stated by your husband.  Now that I have completed chemo, I am so happy I went all the way.  Fortunately with the mastectomy and chemo I do get to skip Rads, but if indicated I would be there too.

    Now on to growing some hair and living a great long life.

  • bdavis
    bdavis Member Posts: 3,192
    edited June 2011

    pejkug3... like Christine, I don't need rads because I have chosen MX instead, BUT had even one doctor (and I saw 4) said I needed both I would seriously consider it... but luckily all doctors agreed that if I have MX, no rads, ... of course they all thought rads was all I needed and no MX, but my goal again is never be here again... So MX and DIEP in July.

  • Jamie30
    Jamie30 Member Posts: 17
    edited June 2011

    Hi.  I am stage II also.  I was diagnosed on April 11 2011 with multifocal invasice ductal carcinoma.  I had my bmx on may 26th and I decided to go with TE.  I have had one fill right now and will find out on Thursday next week if the onc wants to go ahead with chemo.  They are on the fence because what was in my node was small.  They are leaning towards chemo but want to wait for my oncotype test to come back in.  I just wanted to stop in and say hi. 

  • bdavis
    bdavis Member Posts: 3,192
    edited June 2011

    Hi Jamie. Just wanted to tell you (briefly) my story... Diagnosed in November... tumor was IDC 1.9cm, clean margins and one micromet in SN .38mm... so very very small. My MO decided the 1.9cm tumor warranted some chemo and the micromet made him decide to give me 6 tx instead of 4... I think my age of 48 also played a role... had I been 75, he may have chosen differently... He also decided with a positive node, there was no reason to do the Oncotype test as he wanted me to have chemo regardless... I do not regret that decision at all... Yes, I lost my hair, but I have the peace of mind to know that I have done whatever I could to avoid a systemic recurrance... and even though the node involvement was microscopic, it did indeed travel over to the node and that cancer transportation was enough reason for me to zap it before it travelled to my liver, bones, lungs etc.

    Good luck with your treatment...whichever route they choose for you.

  • rachel5738
    rachel5738 Member Posts: 658
    edited June 2011

    I have similar situation to bdavis--IDC--tumour was under 2cm and had evidence of cancer in my one sentinel node--Doc suggested chemo and he said that at my age (39 when diagnosed), pull out the big guns and not leave anything on the table. I agreed and it was a rough few months--but I am on the other side.

    From reading on this site and meeting many BC patients...you have to choose the best treatment for you and will give you comfort. Take care. xo

  • Snoopy73
    Snoopy73 Member Posts: 118
    edited June 2011

    Hi ladies, I am a Stage IIB also:-) my lump was 2.2cm (the BUGGER) had sentinel biopsy and 1 node was "slightly" positive:-( I was told the node was doing its job responding to the lump... I am also ER/PR positive and HER2 negative. I will be starting cehmo, 4-6 TC cycles in july, dont know the exact dates yet, hoping for the 2nd week of july so i cna celebrate my bday and my son's bday weekend of july 4th:-) I am so glad i found this thread. Thank you for reading:-)

  • Snoopy73
    Snoopy73 Member Posts: 118
    edited June 2011

    Hi ladies - my diagnosis is abit similar to bdavis - diagnosed on 4/27/11 with IDC; I am almost 38yrs with 2 small kids (under the age of 5yrs); had a lumpectomy on 5/24 with sentinel node biopsy; results were clear margins, removed 6 nodes 1 came back slightly positive (same as bdavis .32mm). I did the oncotype before surgery and the results were negative (meaning that I may not have to go through chemo) but after my surgery adn the 1 positive node and my age:-) my MO & BS highly recommended i do chemo. So now, I will be starting chemo in july, hopefully 2nd week of july, 4-6 TC cycles, then 6 wks of Rads then Tamoxifen.. wish me luck :-) :-)

    Thanks for reading.

  • rachel5738
    rachel5738 Member Posts: 658
    edited June 2011

    Snoopy--Good luck with chemo....you will get through it. Make sure to let your Docs know if anything is bothering you--they can help with almost all the SE you may experience. I started my chemo the 2nd week of August last year...seems like a distant memory now! Take care, Rachel

  • Snoopy73
    Snoopy73 Member Posts: 118
    edited June 2011

    Thank you Rachel:-)

  • bdavis
    bdavis Member Posts: 3,192
    edited June 2011

    Snoopy... As I said I did 6tx of TC and started in jan and finished in May... I worked full time, went on a vacation to St John right in the middle and mostly had a normal life... just a day or two per cycle that were not great days... I am thru it now and was also slated for rads and tamox, but have since decided to not do rads but instead have MX and recon... just a personal choice... I had a left - sided cancer and didn't want to radiate my heart (or even risk it) but also I have other reasons like peace of mind, not wanting future biopsies, already needing a pappilomma taken out on left side and watching a birad 3 on right side... etc.

    Anyway... don't worry about the chemo... you will be fine... check out my thread TAXOTERE TOOLBOX where I and others make suggestions to get thru chemo as unscathed as possible.

  • Chrys23
    Chrys23 Member Posts: 43
    edited June 2011

    Hi everyone!

    I just met with my BS today to go over my pathology report (I posted this info in the "Newly Diagnosed" section as well, so sorry if you are reading this in duplicate):

    I just had a lumpectomy on June 9th (have a stupid old, sore hematoma and seroma from it!!! Undecided)

    My tumor was originally listed as 1.5cm during the biopsy, but on the path report it is listed as 2cm from end to end.

    Also, while they got the all of the tumor out and the margins were pretty 'clean' for that - on the median border of the tumor cavity were DCIS cells!!! (listed as <0.1 cm from the inked resection margin).

    I also have lymphovascular involvment along with 1/6 lymph nodes positive. (booo!). Surprised

    My case has to go up to the tumor board because there may be a concencous to take more nodes (I hope not) to see how the med oncologist is going to treat me. The tumor board meeting is July 11th and I will hear the results on July 12th.  I do have a medical onc meeting (first consult) on July 5th.  Hopefully, the 2nd lumpectomy will be sometime during the last 2 weeks in July.

    I guess Chemo is in my future, but I will discuss that with the med onc on 7/5 as well as him sending out my sample for the Oncotype testing too.  

    Has anyone else had lymphovascular invasion? That kinda freaks me out....If I have to have chemo, so be it, I just hope they can get everything.

    Also, is it better to have a BMX since I have some semblence of DCIS in my right breast?

    Many thanks!

    Chrys

  • coraleliz
    coraleliz Member Posts: 158
    edited June 2011

    Chrys23, My case went before the tumor board & no consensus was reached. It's the largest hospital within a 2 hour drive but not a major teaching hospital. I had a BMX & still need RADs because of  lymph node + status. The MO thought a disection was in order but the BS & the RO disagreed. I'm siding with the BS & RO on this one. They talked of concerns of my overall lifetime risk for LE. I will have RADs. As for the oncotype, the MO talked me out of it twice. I was leaning away from chemo anyway & the only way I was going to do it was a high or maybe intermediate oncotype score. It was finally done & came back "4". My MO doesn't seem to be onboard with the oncotype testing. I also have an appt with a large medical center in July just to run my decision not to have chemo by them.

  • Snoopy73
    Snoopy73 Member Posts: 118
    edited June 2011

    Bdavis - Thank you, its so encouraging to hear that you continue wrking and went on vaction while doing chemo. I was thinking of taking my kids to a short vacation this summer but not sure exactly when until i start chemo. I am attending an edcative session today with my Med Onco today & the nurse practitioner, feeling abit nervous and anxious:-(

  • NAD
    NAD Member Posts: 44
    edited June 2011

    Hello new friends.  I am waiting for the DX results due in 6 days.  Moments before going into surgery, my surgeon told me that the node biopsy came back positive.  He said that he would remove several nodes, I would have chemo and would most likely lose my hair.  I said "I do not want to have lymphodema."  He said "then we will leave it" and that was the last I remember.  The next appt. with him he finished his sentence "....we will have chemo first and then radiation".  I still am very anxious about lymphederma.  I have seen it and have heard the awfulness of it.  I don't know how many affected nodes I have.    I go for second and third opinions on the 5th and 11th and then I will have to decide with whom I will spend the rest of my life.  I live in Atlanta so I have many good choices.   Any wisdom from you war horses?

  • claire_in_seattle
    claire_in_seattle Member Posts: 2,793
    edited June 2011

    NAD......

    Do the arm exercises.  Very important as keep range of motion and keep the lymphatic system working normal.

    My own take on lymphedema is that I will worry about it if and when I need to.  There is treatment out there.  But I don't go nuts or let the worry prev ent me from doing anything.  So I lift weights, cycle, and x-country ski.

    I am just fine.  5 days ago, I wiped out cycling, and landed on that side.  I have a skinned hand and sore shoulder but I am still fine.

    I do watch to make sure I stay fine.  Right now, it's my ankle that is the problem.

    So you really don't know.  Everyminute does have lymphedema and she runs marathons and is doing all sorts of cool things with her life.  So it really can be managed.

    I would worry about getting through treatment.  The important thing was to get the cancer out of your body.  Congrats on being past that step!!! - Claire

  • coraleliz
    coraleliz Member Posts: 158
    edited June 2011

    NAD, positve lympn nodes doesn't mean automatic chemo. You didn't mention what grade your tumor was. Be sure & ask. It can be confusing getting different %'s from different MO's. I'm not sure throwing the kitchen sink at all cancers is correct especially if the cancer is low grade. Be sure & write everything down. The oncodx test maybe helpful if your tumor i low grade. As for the LE risk,I was told it was a"lifetime risk". But I'm glad I know the extent of my cancer.

  • Madismommy719
    Madismommy719 Member Posts: 377
    edited June 2011

    Hi everyone, I'm still very confused regarding the lymph node involvement determining treatment course.



    I had a BMX in mid-June and just got my path report this past week. I had 3 nodes taken out while on the table and all 3 tested negative (that flash freeze test) while I was laying there.



    Now, this past Tuesday at my follow up I got the news with my full report that one node came back positive, actually TWO did but the oncologist told me the micromet didn't count because it was .1 cm in greatest dimension, the other one says .5 cm in greatest and is listed as a "macro met" Is there a big difference and what is it??? And how did these two test negative and than end up positive, is that a normal occrance???? BS is recommending an axiliary dissection next but my oncologist has told me to hold off a week or so until I can meet with her and the BS on her team.



    Very confusing as to how the nodes all fall into play????? Or is every case different???

  • claire_in_seattle
    claire_in_seattle Member Posts: 2,793
    edited June 2011

    Sorry about the news update Madismommy.  I suspect they biopsied during surgery.  So there was no cancer in the sample they took.  For the final pathology, they sliced and diced these lymph nodes.  Then they found the tumor.

    The final pathology is what determines your final diagnosis. This is why they take lymph nodes BTW.  What they found tells them you may need different treatment, than was thought originally. - Claire

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