Help me make sense of this

Racquel

I wasn't sure where to post this but I'm thoroughly confused.

When they measured the cancerous growth during the mammo and ultrasound they had it figured around 1 1/2 to 2 CM.  The radiologist pulled 5 core samples from this whole area and all came back positive for cancer.  I get the path rpt from mastectomy and it reads that it was 2 MM.  ??? I went for a second opinion from another highly recommended onc and he said it makes no sense except that maybe they pulled some of the cancer out during the biopsy.  He said that is very unlikely though and is not sure what to make of it.  He's the only one of 3 docs that noticed this and said to be on the safe side we'll be doing chemo.  I start that Tuesday.  Could this have been a big typo saying it was only 2 MM when they had it marked originally as 2 CM?

The first report from biopsy shows ER pos & PR pos.  The path report states ER pos & PR neg.  First onc kept saying both were pos.  Second opinion doc said PR neg is not a good thing but didn't really explain why.

The other thing that doesn't make sense is that first onc said it was a very slow growing IDC but my path report reads "infiltrating ductal carcinoma and ductal carcinoma in situ grade 2, margins uninvolved".  What does this mean?

As much as I didn't want the chemo and am not looking forward to it I'm glad I went for a second opinion with a doc who actually answered my questions instead of blowing me off.  He said he's baffled by the discrepancy and is not sure what to make of it as he's never seen that before.

Hopeful-1

Hello Racquel,

I also notice inconstencies in my pathology report.  They weren't too inconsistent, but mostly from the mascectomy pathology report.  Did you have an MRI on your breasts?  I did and that confirmed the location of the cancer.  It was only in my left and in situ which means the 1cm by 2cm mass that was identified in the mammo, ultrasound and then I had the needle biopsy.  I'm glad I'm taking chemo becuase I received a Nottingham score of 3 (high grade tumor) from my needle biopsy.  Your second doctor should seek clarification from the pathologists.

Your diagnosis sounds very similar to mine.  I just started chemo yesterday.  If you click on my name you can see some of my previous posts which outlined my options and treatment.  Everything so far indicates my cancer was caught early which makes me lucky.  The type I have typically can spread fast to the liver, lungs, brain and bones, but all MRIs and scans came out clean and showed no signs of cancer has spread.

 I think too many women are getting breast cancer and the pathologists and doctors are so busy that they could make mistakes.  I hope some group or someone finds out how to prevent this awful illness which seems to be increasing.  I'm in CT and I was told 1 of 8 women in CT get BC.

I wish you all the best and hope for your speedy recovery.  If you want to keep in touch and share experiences and tips, feel free to send me private messages.  In my short time in these forums, I've met some really nice, helpful, caring women.

 Connie

Racquel

Connie -- I too wish they'd find something to prevent this.  I'd not wish it on my worst enemy.  Oddly enough, when I was diagnosed there were 3 other women in our town also diagnosed with BC at the same time.  This is a town of 1200!

No MRI, just the mammo (1st and last) and the ultrasound at the same time to confirm location and size.

My first onc basically said "all's good, take this tamoxifen for the next 5 years".  From what I'm reading, tamoxifen isn't the best choice when one is ER+/PR- but I'm sure my new doc will tell me what's best.  I'm HER2- also so guess that's good.

NatureGrrl

I'm not as experienced as some of the women here but here's my 2 cents:

There's a huge difference between 2 CM and 2 MM, as you know -- so I'd guess it was a typo (for lack of any better ideas!) -- which certainly doesn't give much faith in the medical transcriptionists (although to their credit, it could well have been the dr. who dictated something incorrectly).

Being + for ER, PR, HER, gives you more treatment options, so that's probably why the dr. said the PR- wasn't good.  I'm not sure I'd call it "bad," either, just means fewer treatment options, but I may not know everything about it.  Hopefully someone else will chime in if they know something more.

IDC is Invasive or Infiltrating Ductal Carcinoma.  The grade indicates how aggressive it is -- 1 being least and 3 being most.  So if you're a 2 you're in the middle.

Staging is different than grading but I noticed you didn't mention that so hopefully that's not a question. 

Best of luck... chemo isn't much fun, of course, but for me it's worth it (in spite of all my rants about it!)   I have too many years of kickin' left in me!

Take care and keep posting...