Topic: Confused about post surgery pathology

Forum: IDC (Invasive Ductal Carcinoma) — Just diagnosed, in treatment, or finished treatment for IDC.

Posted on: Jan 11, 2022 10:03AM - edited Jan 11, 2022 10:17AM by hippmark

Posted on: Jan 11, 2022 10:03AM - edited Jan 11, 2022 10:17AM by hippmark

hippmark wrote:

I received my post lumpectomy pathology report yesterday. It is worse than I hoped for and I am confused about what to do. Should I seek a second Onc. opinion? The biopsy showed a 1.8 CM Grade 2, Stage 1 tumor. From what I can read, the IDC is 2.2 mm with embedded DCIS " of equal value." I assume meaning it is 50/50? Both MRI's and the surgeon felt confident it had not spread to my lymph nodes. The results came back as a 2.2 CM DCIS Comedo Grade 3 and IDC Grade 2 tumor with one positive lymph node. However, the surgeon only took out 1 sentinal lymph node. When they placed the dye in the tumor before surgery, it would not migrate to lymph nodes. I was told they would use a probe instead. After surgery, the surgeon said that the one node he took was soft and did not look at all cancerous. Guess it was. I have not spoken with my surgeon yet. Why would he not take out more nodes? Because the others also did not "look" cancerous? How would he know unless he took more?

I am confused and disheartened. So how many more could there be? As well, I happened to see my Oncologist yesterday too. I had to print him a copy because he is at a different hospital. He was in a rush as he was the only Oncologist there that day. He ordered the Oncotype test. He is very caring, but seems to put a "too much" (at least for me) positive spin on things. He scheduled me for chemo starting in 3 weeks with T/C, 4 rounds every 3 weeks. Does this seem the appropriate chemo for a node (or nodes postive) path? As I left he said "no problem, we'll get this wiped out and you'll be alive 20-30 years from now." He doesn't know that! I don't want to be overtreated or undertreated, that's for certain. I am planning radiation and AI following chemo.

No one may have the answers to this, but like many others, I have a sick feeling in my stomach not knowing what to think now.



DX 10/29/21, DCIS/IDC, R 1.8 CM, Grade 2, ER+, PR-, HER2- Surgery 12/23/21 Lumpectomy DX 1/10/22 DCIS/IDC Grade 2, 2.2 cm, Stage 2B ,1/1 node Chemo: Taxotere/Cytoxen x4
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Jan 12, 2022 12:58PM nns121317 wrote:

I had similar concerns after a similar pathology surprise - my post is here:

https://community.breastcancer.org/forum/96/topics...

My Oncotype score was 25. My MO, who describes my cancer as "persistent" if not objectively aggressive, recommended AC+T but also offered TC (4x, biweekly). Knowing my family history, I went with AC+T.

I'm still bothered that I don't know if I have more positive nodes lurking around, but have resigned myself to the notion that radiation will get them, even if I'll never have proof of this. Can't see myself signing up for the potential SEs of an ALND right now.

Surgery 10/1/2021 Lymph node removal (Left): Sentinel; Mastectomy (Left): Skin Sparing; Mastectomy (Right): Skin Sparing; Reconstruction (Left): Silicone implant, Silicone textured implant; Reconstruction (Right): Silicone implant, Silicone textured implant Chemotherapy 11/19/2021 AC + T (Taxol) Radiation Therapy 5/9/2022 Whole breast: Chest wall, Lymph nodes, Left breast Surgery 6/1/2022 Hormonal Therapy 6/1/2022 Arimidex (anastrozole)
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Jan 12, 2022 03:15PM hippmark wrote:

I think my MO did not offer AC+T or similar because I told him I did not want to be on Adriamycin. We have heart problems in my family, not to mention just how tough that chemo is and I live alone. Is T+C strong. Yes. Is it strong enough for me? I don't know. But I an positive my Oncotype Score will come back high. So I guess it will be what it is and I hope I am making thr right choice. No one knows.

For others that have responded to this thread, my surgeon did call today. And while I don't understand everything he said, I feel I have enough information now. He explained that some of the dye did migrate to some nodes (although I was told pre-surgery it did not). He also used a probe which I understand now shows radioactivity in nodes. He did say that the one node he took showed radioactivity and that is why he took that one. The others tested with the probe did not (I guess) show radioactivity so that is why he did not take them. He said he was also surprised to find the node was cancerous. But, he feels like it was the only one.

He confirmed was Beesie said, that they would treat it with radiation to the lymph nodes, so no more surgery needed. I was just completely unprepared for even one to be positive and no one thought it would be.

I want to thank everyone so much for their guidance. I'm not sure what I would do without this board!




DX 10/29/21, DCIS/IDC, R 1.8 CM, Grade 2, ER+, PR-, HER2- Surgery 12/23/21 Lumpectomy DX 1/10/22 DCIS/IDC Grade 2, 2.2 cm, Stage 2B ,1/1 node Chemo: Taxotere/Cytoxen x4

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