My Mom's diagnosis and a few questions

tscharf

I know this isn't good.  My Mom's an ex-nurse and 75 years old.  She was diagnosed about 10 days ago and had a mastectomy.  I've gathered and read a fair amount of technical info from the web.  We got the pathology report today.  It seems to be, all bad, all the time.

Diagnosis:
(A)
Metastatic poorly differentiated carcinoma with signet ring component
Tumor extending to pericapsular fat and excision margins

(B)
Left Breast (Modified mastectomy with axillary nodes)
- Poorly differentiated carcinoma with signet ring component, Nottingham modified histologic grade 3 (Tubules 3, Nuclei 2, and Mitosis 3)
- Evidence of lymphatic invasion; Negative vascular invasion
- Tumor closest to excised margin <1 mm and 0.7 cm, superior lateral aspect and upper outer quadrant, respectively
- Nipple stroma positive for carcinoma
- Maximum tumor diameter is 8.5 cm
- Metastatic carcinoma to 22 axillary lymph nodes, largest positive node is 2.5 cm

- Pathologic tumor staging: T3, N2, MX

Questions:

1. I believe the 8.5 cm tumor size, 22 lymph nodes (I though this was N3?) involved, and poorly differentiated carcinoma are some pretty bad indicators, correct?

2. She is having the assortment of body scans this week looking for the spread of the cancer.  This (metastatis) is the most important factor for prognosis and survivability at this point, correct?

3. She is estrogen and progestrogen positive, is there anything else here that is encouraging?

4. I have no feel for how likely she is going to be stage IV,but I'm kind of anticiapting she is likely to go to stage IV, is this correct, or am I being overly pessimistic?  I don't want to get anyone's hopes up.  Just looking for the facts.

5. Are there any other important parameters I should be looking at?

FYI: She found a lump last March, but the mammogram was diagnosed negative, so she thought there wasn't a problem, almsot zero cancer in the family tree.  Wasn't looked at again until recently. 

KerryMac

Yeah, I am sitting here too because I got a false-negative scan. Unfortunately it is not uncommon.

So, basically she is currently stage 3C, and there are women on these boards doing well, many years out with a similar diagnosis. So, don't lose heart. Generally with cancer less is better, but there is still a lot that can be done for her.

A lot of treatment decisions will depend on the results of the other scans. If they come back positive for distant metastases, then she is no longer considered curable, but is definitely treatable. Being ER/PR + is definitely a good thing as it opens up more treatment options. I'm not sure what the Signet Ring component thing is, or how that would affect her prognosis.

If the scans are clear, then she would probably have Chemo, then Radiation, and then Hormonal treatment. If scans are not, they may start her first on hormonal treatment, to see how she responds.

I know you probably feel like a bomb has just gone off in your lives! It is great that she has your support, it will be a tough road ahead.