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Mar 6, 2020 12:04PM
JP47 I know it's frustrating, but yes, besides any genetic testing, you won't know more than what you know now, until surgery (besides any future scans looking for changes from chemo response or disease progression, if applicable). Scans are limited in what they can "see" and often can't detect smaller tumors (of a few mm) and cannot detect lymohovascular micromets (the vessels of blood and or lymph), and all of these things determine accurate staging and thus statistical odds of recurrence and death.
Being stage 1 wiith small tumors and no lymph involvement gives you really good odds, even without PcR. If it helps you to compare and contrast, my clinical staging was an estimated 3a, with an almost 6 cm main tumor and multiple palpable lymph nodes (the exact # unknown but 1 confirmed during biopsy, and my largest lymph node was larger than your largest main tumor). Every scan gave me a different tumor size or node #, at one point they said I had a 5 cm tumor with smaller satellite tumors around it. We'll never know exactly what was going on at that point because I had neoadjuvant TCHP, which gave me a response my MO called "very good", but not PcR. There was lots of cancer left in my opinion- my main IDC tumor still measured 4cm (but "was positive for signs of response"), with areas of DCIS and 2 positive nodes, which makes me pathological stage 2b. My MO said without Kadcycla I had 23% chance of recurrence within 3 years (aka 77% chance of disease free survival in 3 years), but a year of Kadcyla would shave those odds of recurrence in half. So (if I'm able to finish treatment, which I'll start once I'm done with radiation) I'm looking at a 88% of disease free survival, with a large tumor and positive nodes with no PcR.
My MO also said that being HER2+ means it's more likely to come back within the next several years, but LESS likely than hormone positive HER2 negative cancer to come back after that, at say, the 10 or 15 year point. Note that there is NO "cure"; nothing will make even the smallest case of DCIS 100% likely to never come back, and all we have are statistics for what is likely but not guaranteed in each case.
Diagnosed at age 43. Triple + luminal B regional spread to lymph nodes, pathological TNM stage llB after 6 sessions neoadjuvant TCHP (dropped perjeta after 4 doses), initial clinical stage lllA
5/24/2019, IDC, Left, 5cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (IHC)
8/1/2019 Perjeta (pertuzumab)
8/1/2019 Herceptin (trastuzumab)
8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel)
12/27/2019, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 2/8 nodes, ER+/PR+, HER2+ (IHC)
12/27/2019 Lymph node removal: Underarm/Axillary; Mastectomy: Left
3/4/2020 Whole-breast: Lymph nodes, Chest wall