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Topic: Newly diagnosed IDC

Forum: Just Diagnosed — Discuss next steps, options, and resources.

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Posted on: Jun 13, 2022 10:11PM

Posted on: Jun 13, 2022 10:11PM

dani_p wrote:

My story starts in March, just before I turned 50. I had a biopsy for microcalcifications. They found an intradermal papilloma, and I was referred to a breast surgeon. I saw the surgeon mid-May, and because of a couple of lumps she felt on physical exam, she wanted an ultrasound of the left breast to make sure she knew what was going on before she scheduled surgery for the papilloma. She also wanted a bilateral MRI as I have extremely dense breasts. So, I have the ultrasound, and the radiologist finds 3 spots that need biopsy. Last week, I had my MRI and the biopsies later the same afternoon. When I came back for the biopsies, I was told that not only did my left side light up like a Christmas tree on MRI, but something on my right side did as well. The radiologist tried to find something with ultrasound that correlated to the spot on the MRI, but couldn't. She said that depending on what shows up with the left sided biopsies, they may need to do a MRI guided biopsy on the right.

...........which leads me to the phone call I just received. 2 of the spots biopsied were ok, but one was IDC. ER+/PR+, don't know HER2 yet. She said it was small, and my lymph nodes looked good on the MRI. I asked her to fax me all the imaging/pathology reports as her office doesn't have an online portal. I need to be able to see this to be able to process it. Because of the IDC, she wants to do the MRI guided biopsy on the right.

I'm a bit in shock. I was thinking, I think because of the papilloma, that if anything, it would be DCIS. I was not really prepared for IDC.

Invasive Ductal Carcinoma (IDC) Left 11 o'clock, Grade 2, ER+, PR+, HER2- Invasive Ductal Carcinoma (IDC) Left 12 o'clock, Grade 1, ER+, PR+, HER2-
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Jun 14, 2022 02:28AM rah2464 wrote:

Dani P sorry you got that news. I am really thankful you have such a thorough group working with you. One thing I can tell you about getting breast cancer - what you think will happen can always change on you. My biopsy result was DCIS but I was upgraded at final pathology to IDC. I had developed this magnificent plan to avoid hormone therapy and radiation ( I avoided the radiation at least) but the universe had other plans. The earliest days can be the hardest until you have all your information and a treatment plan in place.

I hope the biopsy on the right is benign. My best to you.


Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 6/26/2018 Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 14, 2022 12:29PM - edited Jun 14, 2022 06:07PM by dani_p

I got my pathology report which I'm hoping I can get some help with:

Left breast at 11 o'clock, core biopsy:

-Invasive ductal carcinoma (no specific type)

-Predicted Nottingham histologic score:

-Glandular (acinar)/tubular differentiation score 3 of 3

-Nuclear pleomorphism score: 2 of 3

-Mitotic rate score: 1 of 3

-Overall grade: II/III (total score 6/9)

-Longest confluent tumor focus: 7.5 mm

-Lymph-vascular invasion: not identified

-Associated in situ component: Present, cribiform, nuclear grade 2, without central necrosis

-Microcalcification: not identified

-Estrogen receptor: Positive

-100% of tumor cells with strong average intensity

-Progesterone recepto: Postive

-78% of tumor cells with strong average intensity

-Breast biomarkers: HER2 by IHC pending, to be reported by addendum

The addendum was also included, which said:

HER-2 protein by IHC, left breast at 11 o'clock:

-Equivocal, IHC score 2+

Addendum comment: In view of the equivocal IHC result, reflex testing for HER-2 amplification by FISH has been ordered and will be reported by addendum


I also found out that they are going to do a MRI guided biopsy not only on the right side, but on a different spot on the left side as well. This is scheduled for next Wednesday.

Thanks for any information/help/advice you can offer! I really appreciate it!

Danica

Invasive Ductal Carcinoma (IDC) Left 11 o'clock, Grade 2, ER+, PR+, HER2- Invasive Ductal Carcinoma (IDC) Left 12 o'clock, Grade 1, ER+, PR+, HER2-
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Jun 14, 2022 06:43PM obsolete wrote:

Hi Dani, sorry you ended up here, but it's a great place for info & support. Just take baby steps in your thought process as you settle in. I promise you will eventually feel better, once you're over this hurdle.

Your final path report after surgery may differ slightly (tumor size, etc), but this preliminary path tells you that it's LOW mitosis WITHOUT LVI, which are favorable characteristics for your conventional IDC lesions. Middle of the road differentiation is average for a strong average Grade-II (like me who's been fine for 8+ years).

Your ER at 100% is perfectly awesome for hormonal treatment with a high PR % is a fairly nice balance. It sometimes happens that HER2 needs further testing, so nothing to be alarmed about at this point.

Please stay in touch and let us know how you're doing. Best wishes & hugs!

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Jun 22, 2022 03:20PM - edited Jun 22, 2022 03:21PM by dani_p

Had my MRI guided biopsies today. Of all my biopsies so far, this was the most uncomfortable. They gave me Xanax, at their recommendation, to make sure I was calm and stayed completely still. For whatever reason, the right side didn't numb up all the way so that part of the procedure wasn't the best. At least it's over. I meet with the surgeon next Tuesday to figure out next steps. Still waiting on HER2 results

Invasive Ductal Carcinoma (IDC) Left 11 o'clock, Grade 2, ER+, PR+, HER2- Invasive Ductal Carcinoma (IDC) Left 12 o'clock, Grade 1, ER+, PR+, HER2-
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Jun 22, 2022 09:57PM obsolete wrote:

Good going, Dani, you're a trooper! Another hurdle is now behind you. I don't know why certain areas don't numb as easily as others (like our gums in the dentist's chair).

Fingers crossed for a benign or another favorable biopsy pathology. Best wishes!

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Jun 23, 2022 09:04AM odyssey305 wrote:

Hi Dani. Anytime I read a newly diagnosed post my heart drops a little because I know the worry and stress of the early days of diagnosis. Everyone in this community can relate, so I’m glad you’ve found your way here for support, you’re in good company. At my first appointment with my surgeon she told me that the next few months would really suck going through treatment, but I would get through it and wind up on the other side, hopefully sharing my stories and supporting others. And here I am. After 6 months, even with a few unpleasant surprises and setbacks, I’m finally done with active treatment. And I can honestly say that it hasn’t been all bad, I’ve managed to live a basically normal life through it all - worked, went on vacation, planted a garden, fostered dogs,started a new exercise routine, ubered my teens 😂. You’ll be on the other side of this too soon. Hang in there. My best advice would be to find a good team (breast surgeon, medical oncologist, radiation oncologist if needed) and don’t hesitate to get a second opinion or third if you need it for peace of mind. Having a nurse navigator can also be helpful for keeping track of all the moving parts. But most important is to lean in to support and try to find joy everyday, it will help keep you balanced.

Good luck on next steps, keep us posted!

Dx 12/2021, IDC, Right, 1cm, Stage IB, Grade 1, 1/5 nodes, ER+/PR+, HER2-, FISHISHCISH Surgery 1/1/2022 Lumpectomy (Right); Lymph node removal (Right): Sentinel Surgery 1/29/2022 Lumpectomy; Lumpectomy (Right); Lymph node removal Hormonal Therapy 2/1/2022 Radiation Therapy 3/3/2022 Whole breast: Right breast Surgery 4/1/2022 Surgery Radiation Therapy Whole breast: Breast, Lymph nodes Hormonal Therapy Femara (letrozole), Zoladex (goserelin) Hormonal Therapy
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Jun 29, 2022 12:46PM dani_p wrote:

I had my appointment with the breast surgeon last night. The result of the biopsy on the right was benign, but my left side is all sorts of messy and decided to throw another IDC into the mix. The 2 spots are pretty close (first biopsy was at the 11 o'clock position, second biopsy at the 12 o'clock position), so she isn't sure if the new IDC is a separate tumor or part of a larger one. This spot was Grade 1, with DCIS present (the DCIS was intermediate grade, cribiform and solid type, with central necrosis). Microcalcifications were present in both the IDC and DCIS. It is ER/PR positive (both 100%) and HER2 negative. Anyway, with these results, lumpectomy is basically off the table. I'm not sure I would have gone that way, anyway, but it was almost a relief to at least have that decision made for me! And, just with the history, risk, etc., I'm going to do a bilateral mastectomy and save myself a future this worry every 6 months. So now, I wait for the plastics consult. Everything is "hurry up and wait," which is frustrating. She said once we get path from the mastectomy and lymph nodes, she'll contact MO and probably send thing off for Oncotyping.

Invasive Ductal Carcinoma (IDC) Left 11 o'clock, Grade 2, ER+, PR+, HER2- Invasive Ductal Carcinoma (IDC) Left 12 o'clock, Grade 1, ER+, PR+, HER2-

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