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IDC, Grade 3, maybe metaplastic?

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mimmin
mimmin Member Posts: 3
edited August 2022 in Just Diagnosed

Hello there!

I'm still in diagnostic process (MRI done yesterday, PET/CT tomorrow), but what I do know is that I have 6 tumours in my left breast, they are quite big (that wasn't written on my report), I am ER-, PR- and HER2 +. Grade 3, score 8.

I will do 6 rounds of chemo with antibody treatment, then surgery.

What is really confusing me is that on my report it says there is suspicion for metaplastic cells. My diagnosis was less than a week ago, so I'm still learning about what all this means, but so far, my understanding is that metaplastic cancer can only occur in tripple negative type? Does suspicion mean that there will be further tests to confirm this?

And another big topic for me right now is: I have a 2 year old and we did want to have another child, although right now it's seeming less important than just going through chemo and getting better without any delays! There were multiple options presented to us including: hormone injections to suppress ovarian activity, freezing ovarian tissue, freezing eggs. Since my tumours are pretty big, most likely spread to lymph nodes and growing quickly, I am eager to start my treatment and not delay it by 2 weeks to retrieve the eggs. I also just dread to have an operation to remove ovarian tissue just before going through chemo, so I'm leaning towards option nr. 1. Any experience with these procedures? I don't want to regret anything later, but I also love my son so very much and it seems 100% more important that I be there for him rather than plan a future child and jeopardise my treatment.

Ugh, these were the worst weeks of my life, but I'm slowly picking myself up and getting ready to face whatever comes my way! Thank you for any inputs and support!

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  • moderators
    moderators Posts: 8,069
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    Hi mimmin, and welcome to Breastcancer.org.

    We're so very sorry for the reasons that bring you here, but we're really glad you've found us. As you're sure to see, our Community is full of amazing members, always willing to offer advice, information, encouragement, and support -- we're all here for you!

    While you wait for the helpful responses of our members, you may be interested in this page from the main Breastcancer.org site on IDC, which defines metaplastic disesase as "usually" high grade and triple-negative, but it's possible that it could be HER2+. Do you know which test you had to determine your HER2 status -- IHC or FISH? You may want to ask your doctors for the opposite test to confirm.

    In addition, we have a helpful Metaplastic Breast Cancer forum here that you might want to check out. This thread on Metaplastic carcinoma also may be informative.

    Also, there's some helpful info on Alternatives to Ovary Removal, which explains ovarian suppression. And, the Fertility and Pregnancy Issues section has lots of good advice.

    We hope this helps and that you get some answers and advice here soon. Please let us know if we can help in any way!

    --The Mods


  • specialk
    specialk Member Posts: 9,226
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    mimmin - I found this link regarding metaplastic and Her2+. Also important to remember, breast tumors are often not homogenous - you can have differing receptors and Her2 arrangements in the same tumor, and tumors with differing arrangements in the same breast. The treatment choices will be determined by the combination of these factors.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896714/

    I have no experience to offer with the preservation of fertility, but have seen members here use OS to help protect it during chemo. I am so sorry that you are facing this set of choices along with worry that we all face in the early days of diagnosis and treatment planning. Wishing you the best.

  • mimmin
    mimmin Member Posts: 3
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    thank you for that information and link! I had no idea you could have different types of cancer within the same tumour!

    I finished my scans now and on Monday is the day when I find out about the exact plan for chemo. I also have to decide about fertility preservation on the same day… my husband is really opposed to egg freezing because he wants to start cancer treatment ASAP. And I’m not really sure! It seems like the most secure option and I don’t want to regret anything later. On the other hand, I most definitely don’t want to regret slowing down treatment… how much of a difference can 2 weeks make? I will ask my doctor on Monday of course… but if anyone had any experience with fertility preservation I would be really curious to hear what decisions they made! Thanks!

  • elainetherese
    elainetherese Member Posts: 1,627
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    Hi!

    My cancer was also HER2+ and Grade 3, and I ended up doing "the works" -- chemo, surgery, targeted therapy, radiation, ovulation suppression, and hormonal therapy. I honestly don't think that waiting a few weeks will have any impact on your prognosis. Cancer simply doesn't spread THAT quickly. I put off starting my chemo to visit my family for 10 days. Nevertheless, the chemo wiped out all of the active cancer in my breast and compromised lymph node. Chemo works best for Grade 3 cancer as it focuses particularly on destroying rapidly dividing cells.

    I am doing ovulation suppression but not to retain my fertility. I was 46 when diagnosed and still premenopausal. So, I'm doing ovulation suppression so I can take an aromatase inhibitor (Aromasin) instead of Tamoxifen.

    Good luck!

  • specialk
    specialk Member Posts: 9,226
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    I can't speak to the fertility preservation situation as I was surgically post-menopausal at diagnosis, but here is a link to the list of posts (yours included) on this forum that talk about fertility preservation. I think there is a mixture of ovarian suppression and retrieval folks, but these members have walked this walk.

    https://community.breastcancer.org/posts/search?utf8=%E2%9C%93&search_builder%5Bkeyword%5D=fertility+preservation&search_builder%5Bauthor%5D=&search_builder%5Bsource%5D=&search_builder%5Bdate_range%5D=&commit=Search

    Agree with ET above, unlikely that a two-week delay would have any measurable effect - but your head space around that delay is important too, I had adjuvent chemo, but was delayed from the initial surgery to chemo by 14 weeks due to four additional surgeries due to both complications from the bi-lateral mastectomy, and the need to remove additional positive nodes. Discuss this thoroughly with your MO so that you have a full understanding of any risk, or lack of - I think that will help going forward with whatever the choice is.

    A number of years ago I posted a link for someone whose insurance did not cover fertility preservation - I just checked and it does not appear that the site is functioning. Here is another link to some organizations that may help if that is a need for you. The links to organizations are toward the bottom of the page.

    https://www.cancercare.org/tagged/fertility