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Topic: Need Pathology Report Help Please....

Forum: Just Diagnosed With a Recurrence or Metastasis —

Meet others who are just facing the diagnosis of a recurrence of breast cancer or metastatic (advanced) disease. You are NOT alone.

Posted on: Sep 26, 2019 07:43AM

Marel wrote:

Hello,

I am new to this site and would like to know if someone could please narrow this patholgy report down to where I understand it before I go for my onocolgy appt this coming Friday. My BC was back in 2005, 6 chemo, 27 rads, tamoxifin then arimadex 6 years. Mams every year, last one 4/19, all clear! All this was discovered after a ColoGuard test, then colonoscopy with 7 polyps removed. Just really exasperated right now. (Pardon Spelling, please)

Diagnosis: 1. Sigmoid colon polyps, biopsy: Positive for invasive poorly differentiated adenocarcinoma with signet ring cells. See comment.

2. Transverse colon polyps, biopsy: Tubular adenoma.

3. Cecal polyps, biopsy: Tubular adenoma.

4. Ascending colon polyp, biopsy: Positive for invasive poorly differentiated adenocarcinoma with signet ring cells. See comment.

5. Rectal polyp, biopsy: Positive for invasive poorly differentiated adenocarcinoma with signet ring cells; small hyperplastic polyp. See comment.

Comment: The morphologic impression of probably metastatic carcinoma in 1, 4 and 5 was discussed with Dr. Alexander Weick 8/30/19 a.m. Dr. Weick reports a history of breast carcinoma. Previous breast pathology is not available in Munson files. Immunohistochemistry is performed on block 4, subsequently on block 5, as little carcinoma remains in immunohistochemical stains applied to block 4. In block 5, carcinoma is positive for cytokeratin CK7 and shows nuclear positivity GATA-3 and estrogen receptor. Morphology and immunohistochemical profile are compatible with metastatic breast carcinoma. Carcinoma is negative for cytokeratin CK20 and CDX-2, making intestinal primary unlikely. Special stains: On 4 and 5, CDX-2, CK7, CK20, ER, GATA-3

Thank you so much for your time.

Sincerely,

Marel K

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Sep 26, 2019 01:28PM LoriCA wrote:

Marel welcome to BCO. I'm so sorry but unless I'm mistaken it reads to me as if your breast cancer has metastasized to your colon. Your profile doesn't say, but I'm going to take a wild guess that you had lobular breast cancer (ILC) based on where your mets first appeared? Lobular often tends to metastasize in different places than ductal (IDC) does. I'm surprised they would give you the pathology report before telling you in person, that's a horrible way to find out and you certainly shouldn't hear it from someone on the internet, so I feel absolutely terrible about saying it and I had to give it some thought before responding, but I figured that the report uses the words "positive" and "metastatic" enough times that you've probably already guessed.

They will likely have you do a PET and/or other scans to see if it has spread anywhere else before discussing your treatment options. It's a big shock and it takes some time to digest, but please know that there are many women here who are living full lives for many years at Stage IV.

You'll find a world of knowledge and support in the Stage IV forum and I hope you join us there. Hugs!

IBC Stage IV de novo - mets throughout skeleton (bones & now bone marrow), liver, dozens of distant nodes, chest wall/pec muscle, skin, tumor in brachial nerves, thyroid, polycythemia from bone marrow involvement Dx 9/8/2017, IBC, Right, Stage IV, metastasized to bone/liver/other, Grade 3, ER+/PR-, HER2+ (IHC) Chemotherapy 9/26/2017 Taxol (paclitaxel) Targeted Therapy 2/6/2018 Perjeta (pertuzumab) Targeted Therapy 2/6/2018 Herceptin (trastuzumab) Chemotherapy 11/26/2018 Taxol (paclitaxel) Radiation Therapy 1/30/2019 Whole-breast: Breast, Lymph nodes, Chest wall Targeted Therapy Kadcyla (T-DM1, ado-trastuzumab)
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Sep 26, 2019 03:19PM KBeee wrote:

I agree with what Lori said both in terms of interpretation, and advice, though obviously a medical professional is the only one who can make that determination. I am so sorry you are dealing with this. (((HUGS))) Definitely use these boards to help you navigate this. Hoping you have answers and a plan in place soon.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/26/2013 Mastectomy: Left, Right Chemotherapy 9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/23/2014 Reconstruction (left); Reconstruction (right) Surgery 1/29/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Surgery 2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Chemotherapy 3/31/2015 AC + T (Taxol) Radiation Therapy 8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Sep 26, 2019 04:08PM KBL wrote:

I had a similar type of report, only it was my GI tract. My diagnosis was de novo, as I had not been diagnosed with breast cancer before. It said the same words, adenocarcinoma and positive CK7 and GATA3. I am Stage IV. I’m sorry.

I had a mammogram, ultrasound, and Breast MRI, and they could not find it. It was in my stomach in two areas

I had a PET scan, but with lobular it may not show anything. Mine said uptake to the stomach within normal limits, whatever that means.

I’ve been on Ibrance and Letrozole since June with one break in between on the Ibrance for three weeks because my neutrophils dropped too low.

I’m going to have my first CT scans next Friday since I’ve been on treatment for three months now.

My tumor markers were very high, in the 220 and 400 range. They’ve come down on the medications but only 30 and 60 points so far.

Please keep us posted.

Dx 5/1/2019, ILC, Stage IV, metastasized to other, ER+/PR+, HER2- (FISH) Targeted Therapy 6/23/2019 Ibrance (palbociclib) Hormonal Therapy 6/24/2019 Femara (letrozole)
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May 12, 2020 12:55PM comingtoterms wrote:

Hi Marel,

How are you doing? I had a positive Cologard and a resulting colonoscopy this morning, which found a large polyp in my rectum that will have to be surgically removed. I am waiting for biopsy results.

Your situation seems similar to mine. Neither breast cancer nor (potential) rectal cancer run in my family.

I am praying for you now.

Tammy

Dx 1/9/2009, DCIS/IDC/IDC: Tubular/IDC: Mucinous/IDC: Cribriform, Left, 2cm, Stage IIB, Grade 2, 1/27 nodes, ER+/PR+, HER2-
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May 12, 2020 07:21PM MinusTwo wrote:

Tammy - Marel only posted the one time in Sept 2019 so we have no follow up information. Hope your biopsy results are better.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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May 25, 2020 03:18AM jcp wrote:

Hello Marel. I had mine in 2005 also. Did lumpectomy, 4 AC chemo 30 rads and 10.5 years on estrogen blockers


I still haven't had a colonoscopy yet scared as anything bc in my family in the men, paternal grandfather and paternal cousin probable for it. Long story. Anyway, I wish I could help you understand this. I know about br ca due to my Mom and me, but not much about this. I'm so sorry. I would like to help. I can tell you my grandfather lived w colon ca for probably 30 years and this was a long time ago and he wasn't diagnosed very early I don't think. But I know this is looking not like colon ca but breast ca. Let us know how your appointment goes and good luck. I will keep you in my prayers. Susan JCP

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