micrometastases of bone marrow

ittybittyme

I was diagnosed ILC Stage IIA last May. No lymph nodes involved. Went thru intensive, dose dense chemo and just finished that Dec. 10, 2008. Had lumpectomy to left breast July 1 and started the chemo July 28, 2008. The doctor downplayed the micrometastases and I just found out from my surgeon that that is what the intensive chemo was for and now he is talking masectomy with reconstruction. I can't seem to find any good info. about micro mets and I am really getting scared at what little info I have found. My aunt had ductal cancer and radical masectomy w/reconstruction and has been invaluable with good info., but micro mets seem to be rare and I would appreciate any info or personal experiences. I am scared because I don't have info. and I do much better if I know my enemy. Thanks!

nash

How did they diagnose the micro mets to the bone marrow? I've heard of micro mets to the lymph nodes, but not to the bone marrow (although I've heard of mets to the bone marrow, but that would make you Stage IV). Can you elaborate on how the bone marrow issue was diagnosed? If you can give more info, that would help us figure out where to direct you for more info.

Also, why is the doc recommending a mast at this point? Did they not get clean margins with the lumpectomy?  

Congrats on finishing chemo, BTW. That's a big hurdle.

ittybittyme

bone mets were diagnosed from a marrow draw during lumpectomy surgery. The margins were not clean after microscopic exam and he needs to clean the margins. I have what I call negative A sized breasts. An A cup does not fit me unless there is padding in the bra (I cry when I bra shop), so because my breasts are small and I have an increased risk of recurrence due to several factors (ILC,2.7 cm tumor, micro mets, PR/ER +,and only 43 yrs old, pre-menopause, family history). I dont know for sure if they are removing both breasts or just the left, I see the plastic surgeon as soon as they get me an appt. and have another MRI to get as well before surgery is schedualed at end of this month or early Feb. I hope this helps.

nash

Wow, I had no idea they took bone marrow draws during lumpectomies--what prompted them to do that? Is it something your surgeon does routinely, or was there something specific to your case that called for it?

I'm sorry you have to go through all this--I have no experience with micromets to the bone marrow. Not to completely freak you out, but if you go over to the Recurrence and Mets board, there are girls over there with bone marrow mets who might know something about micromets.  I think it's good news that the doc downplayed them, b/c if they felt they were true bone marrow mets, they would have staged you Stage IV. The whole thing is probably along the lines of micromets to the lymph nodes--the docs don't get too excited, but the patient does. They probably figured the DD chemo would eradicate the micromets.

You and I have very similar stats--my tumor was also 2.7 cm, and I was 38, almost 39, at diagnosis. I'm 40 now. Also have a strong family history, including my Stage IV bc mom who just passed away in Feb 2008 and my dad who died of pancreatic cancer (they thought I'd be BRCA2 b/c of that, but I wasn't). Anyhow, just wanted to let you know I understand your concerns.

I did find one article comparing bone marrow micromets with lymph node status--don't know how helpful it will be, but here it is--sorry I can't post live links with my browser:

http://www.springerlink.com/content/e86136140tw21l67/

nash

Here's another article--a word of caution, though, it's not very positive about micromets.

http://www.bio-medicine.org/medicine-news/Measuring-disseminated-cancer-cells-in-bone-marrow---valuable-tool-for-detecting-early-breast-cancer-metastasis-5334-1/