What is "micromets"?

hlya · October 2009

I have a friend who developed IDC with 2mm in one lymph node, I saw somewhere says "1 micromet in lymph node = negative lymph node", may I know what is "micromet?" Is 2mm "micromet"?

lexislove · October 2009

Its a very small amount of active cancer cells. I believe, but not sure, it has to be under2mm to be considered a micromet, over would be node positive.

There are many woman on here who had that hopefully in the morning they will give you a better idea.

HelenaJ · October 2009

Hi LuA,

I have been trying to find a good link for you but the one I have printed out is no longer there. Anyway, here is a quick rundown for you.

"A micrometastasis is a tumor deposit that is between 0.2mm and 2mm in diameter. Such nodes are designated as pN1mi." It means some cells have broken away from the original tumor and made their way into the lymph node.

There is quite the debate at the moment regarding treatment for micromets and isolated tumor cells (I had two nodes with ITCs). Some regard them as lymph node negative but there is contraversy on whether this is indeed correct.

At 2mm your friend would just make it in that description but she really needs to speak to her oncologist about her treatment plan going forward. There is a great test called Oncotype DX which may assist her in making a treatment plan. Not knowing the rest of her diagnosis, her age etc. I'm not sure whether she will qualify but make sure she asks about it.

Sorry that you are both going through such a tough time. Hopefully you will get some more posts which might be able to explain better than I can.

soft hugs

Helena

London-Virginia · October 2009

Hi there -

I echo what the ladies above have said. It is a difficult topic because it is strongly debated and more research is being done all the time. Some of the tests that can be done to ascertain certain things are dependent on the hormone status of the disease, a;so pre or post menopuase and what sort of disease, so it is complex. Myself, I have two micromets in one node that are both under 1mm. There is a firece debate as to whether I should have afull axilla strip. I am currently doing chemo, and will do rads. Then I will go on to FEmara, an aromatase inhibitor.

I don't much fancy more surgery right now and I haven't made up my mind. I see the radiotherapy oncologist next week so I want to discuss having rads on the axilla. surgery or the rads could cause lymphodema.

A useful site is www.cancerfacts.com and www.cancermath.org

IT is one of those "there isn't a simple answer" things unfortunately. But very best of luck and good wishes to you and your friend

xxxxxx

hlya · October 2009

Hi, All,

Thank you it really helps. I will let her know.

Sukiann · October 2009

I had a micromet in my sentinel node. It was .5 mm enough for my onc to say I should do chemo. My tumor was 2.5 cm so that may have been a factor as well. He said the cut off for no chemo (I don't know if this is his cutoff) was .2 mm. Meaning that if the micromet is over .2 mm then chemo is for you. He said that it indicated the nature of the tumor - that is that the tumor was breaking off cells. I agreed with him. I felt that if the cells were on the move then I wanted them all dead. I wasn't comfortable with the fact that they may have seeded themselves somewhere other than in that sentinel node they found. Then my oncotype dx test came back that really made the decision. It was/is a 32 which is in the high category so it was chemo for me for sure. I checked off that I am node positive but technically I think I'm still node negative.

I wish you luck in you decision. It is a hard one for some but my onc made it for me so I was happy that I didn't have to make it myself. Chemo is hard but you can do it if you have to.

London-Virginia · October 2009

Sukian - just out of interest, did you have to have more nodes removed please? Or did your onc feel the chemo was suficient?

thanks for your help.

xxxxx

Sukiann · October 2009

Virginia (my Mom's name too but we call her Ginny),

yes, I had 9 nodes removed. They were all clear. The micromet was found after the second stain. The first stain said no cancer. The second one (I guess they do 2 stains to make sure) said .3 then they looked again and agreed it was .5 mm. I hope this helps.

London-Virginia · October 2009

Sukiann - thanks. I am doing chemo presently (FEC) and had one noe out of two with micromet of 1mm. I am not absolutely clear in my mind if the chemo will do the trick on its own with the mircomet; I really don;t fancy gpoing back for my surgerty on the axila - hence my rather cheeky question to you! The minute I was told there was a micromet I knew there was no argument to be had over chemo. My dilema atthe mo is, can rads do the trick for me?

Ah, this endless quiz....!

thanks so much for your reply -

xxxxxxx

unklezwifeonty · October 2009

LukA,

I had micromets (0.25mm) in 1 node. The surgeon removed 7 more nodes besides the 2 sentinel nodes. They were all -ve. This is considered T1mic and is right on the border of node +ve or -ve. She would most likely be given the choice of how aggressively to treat.

Sukiann · October 2009

Virginia,

Sorry, I didn't read back in the posts for your original question. So you are asking if you need to have more surgery to check for other nodes? No, I had the 9 nodes removed at the beginning, when they found the micromet. No more surgery. I had radiation, just finished a couple of weeks ago. I feel that the rads would kill the cancer in the other nodes that were not checked. That's what I'm banking on. The whole breast area is radiated including the node area under the arm. That plus the chemo I think should do the trick. Of course there are no guarantees. I'm more worried about mets at this point. I'm going through a kind of anxiety stage now that I'm done with treatment. I'm on arimidex and take lupron shots. Supposed to be very good at keeping cancer away but then again, no guarantees. With the arimidex you ache all over so how am I supposed to know if my bones ache when my bones ache from the arimidex (I think it's the arimidex??). Anyway, this is what I think we are going to go through from now on. The constant, what ifs, should I have had, etc. Gotta go to church now. I'm going to say a prayer for all of us.

London-Virginia · October 2009

Sukiann - thank you so much for taking the time to reply today.

I am just off for walk and will pass through a beautiful churchyard here on the river Thames and will think of you too. William Blake, the artist was married at this church. Oddly enough, Benedict Arnold is buried there!

hugs to you all -xxxxx

annadou · October 2009

Virginia-hope you are doing ok .With those micromets -I had /have in the surrounding axillary tissues and at the time I got the report it was a 'small thing 'in the overall picture ( I had 4 positive nodes)and it wasnt till later that I started to worry about it.When it eventually sunk in and I asked the onc told me that they would be dealt with by the chemo and radiotherapy.Now whether or not I should still be worried O.G.K.'S. Let me know if you get to Athens in the winter we will meet up.

Sukiann-I am with you there on the aches etc from Arimidex-when exactly does a pain become something serious?

I am still getting a lot of pains in the operated breast-I am 6mts out of surgery -how long does that last.....what are the lupron shots for?I thought that the Arimidex was taking care of the estrogen..I agree -the anxiety is awful wondering what the next pain is from -I hope that we will get used to it overtime-there is no more room in ny brain for more worries.

Good health to you all

Anna

Sukiann · October 2009

Anna,

The lupron shots are because I was not in menapause yet. I'm 45 (44 at dx) but I cannot take tamoxifen because my family history of blood clots (tamox has more of a chance of causing clots) and my onc didn't want to take the chance. So I go for lupron shots every 3 months to shut down my ovaries then I can take the aromatase inhibitor Arimidex. Aromatase inhibitors as I understand take the rest of the estrogen (that's made from other parts of your body) and stop it. Actually, I think what it does is take something that our bodies make called aromatase and stop it from becoming estrogen, hence the name aromatase inhibitor. I have no idea when the pain becomes more serious. That's my confusion. When would you know that the pain is from mets and not from the arimidex. I guess it would become more intense and concentrated in one area for awhile. I'm actually feeling a little better today. I am so happy, I'm running around trying to get all this stuff done because I'm not aching and can do it. I feel like I have to get it done now because I know the dreaded pain is coming back! This is what I took yesterday to try to help the ache: 600 mg of ibuprophen, calcium citrate 800 mg, vitamin D 1,800 iu, 2 brazil nuts for selenium. I've been reading a lot about selenium. Most it's supposed to help keep breast cancer away but you have to be careful not to take too much. Read up on it first if you want to take it so that you don't get too much. A couple of brazil nuts is ok but you can actually overdose if you eat more than that day after day. So, what helped yesterday and continuing into today. I have no idea. I felt horrible yesterday and I had to go from church to my daughter's regatta (crew or rowing competition) and I didn't know how I was going to make it. I popped an ibuprophen and it really helped. I'd say it was that but it wears off after 6 to 8 hours and this morning I'm still feeling pretty good. So, was it the extra vitamin D (I slack off on taking it usually), or the selenium? Don't know but I'm so happy. Gotta run and take Mom to the eye doc and hopefully this good feeling will continue so I can get more stuff done here!

Another thing Ann, I heard that your breast may hurt for some time because it's regenerating nerves. That's what the radiation technician told me. Whether it's correct I don't know but it makes sense.

Virginia, I wish I was there with you in England. I've been aching (literally, he,he) to get there someday and see the beautiful sites. In fact, my SIL gave me a book about places to see in England when I was recooperating because she knows how much I want to get there. Maybe someday....