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Oct 16, 2012 12:26PM
stayinhappy
wrote:
I had a segmental mastectomy last Thursday. Needing help from some of you more informed sisters about the path report. Excerpts below. Due to the fact that the lumpectomy was done after 4 rounds of chemo (T/C) and while on Tamoxifen since May, I am inclined to have both breasts removed. Would love insight and information from some of you as I make this very difficult decision. I note that the positive 1.2mm micrometastasis in the node is ductal carcinoma, not mucinous. That is a larger factor in me making this decision. Many thanks!!
Micinous carcinoma - the tumor described grossly is residual mucinous carcinoma
Nodes: 1.2 mm micrometastasis in the sentinel node (1 of 6 nodes tested) - It is metastatic ductal carcinoma
DCIS .5 mm from the inked medical margin - several foci present; solid type, low-grade.
Tall columnar cell atypia
From section "Microscopic" - In the "left segmental mastectomy", the tumor described grossly is residual mucinous carcinoma. Centrally, aggregates of mucin are mostly devoid of neoplastic cells. Viable tumor cells are mostly around the periphery of this mass. The tumor cells form small and slightly larger cohesive groups with some tubule formation. A small focus of adjacent ductal carcinoma is present adjacent to a suture, indicating the true deep
margin. Stromal fibrosis and scattered foci of columnar atypia are appreciated, which focally involves papilloma. Columnar atypia is 0.5 mm from the inked medial margin. Also appreciated are foci of ductal carcinoma in-situ,
mostly solid type, low grade. DCIS is also 0.5 mm from the inked medial margin. Retraction artifact is present. Definitive lymphovascular invasion is not appreciated. In the "sentinel node #1 and #2", two lymph nodes are
identified microscopically. One of these contains a 1.2 mm maximum diameter metastatic ductal carcinoma. Mucinous features are not identified. This focus is verified by immunoperoxidase stain for pankeratin. The other node is negative for metastatic carcinoma and cytokeratin stain is negative. Three "sentinel node #3 and #4" are examined microscopically and no metastatic carcinoma is identified. Levels and immunoperoxidase stains for cytokeratin are negative. Sections of the "nonsentinel node" show one lymph node with no metastatic carcinoma
identified.
Mucinous Carcinoma 3.5 cm and DCIS (scattered areas), 100% ER, 98% PR, Her2 2+ (Neutral/Equivocal), OnctoypeDX 20, 43 years old, premenopausal
Dx
5/2/2012, 1cm, Stage I, Grade 1, 1/8 nodes, ER+/PR+
Chemotherapy
7/17/2012 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Surgery
11/8/2012 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Mastectomy: Left, Right