Anyone found cancer in the lymph nodes

suekb

Hi,

I am trying to decide if my surgery can wait until June. I found out I had DCIS intermediate grade solid on 2/2 after a mammo and sterotactic biopsy. Surgery was scheduled 3/24 with a GS/PS. The cancelled on me because the hospital is out of isotopes during that time for the SNB. I now want to wait an extra 2 months. Ofcourse the docs say no but an extra 3 weeks was okay for them. Has anyone found more cancer after their surgery?   

suekb

Thanks to both of you for responding. Jenna, I hope you don't mind me asking but what was your reason for waiting? What kind of DCIS did you have? Is solid type more aggressive?  

Jenna1961

Sue,

after the atypical hyperplasia was discovered in a three year old lump, I was offered two approaches - surgical biopsy or "watchful waiting". In denial, I chose to wait.
The lump changed in size and feel. Unfortunately, nothing showed up on mamo/u-sound/MRI and there was no hurry - I had the surgical biopsy 8 months after the initial core biopsy.
DCIS is generally very slow growing, but again, every DCIS is different.
 
Regarding the solid type of DCIS - my perception is that it is more serious than cribriform or papillary  because the cancer cells completely fill the ducts. I am not sure this has any importance to you.

Jenna

Jelson

Suekb-

Are you having a mastectomy? Because SNB are not usually done with lumpectomies. I ask because of the remark in another post that your surgeon said that he/she may have gotten it all out with the biopsy. Could you go with a lumpectomy sooner rather than later and hold off on the mastectomy/snb until the summer?

Julie E

tibet

Jenna

How big was your microinvasive part? Was it smaller than 1 mm to qualify as microinvasive?

I also had 1mm micromet in one sentinal node, as yours. Did you have full node desection?

With 1mm micromet in one sentinal node, does it mean, the cells could also traveled to blood stream?

Did you have any lymhvascular invasion on the path report?

redsox

I second Julie's question.  Is it possible to have a lumpectomy and be likely to get all of the tumor?  I had a lumpectomy on a Monday and was back at work on Thursday.  I could even have gone back Wednesday if I had to. 

That would allow you to wait to schedule the mastectomy at a convenient time for everyone while easing your mind about what might happen from waiting. 

dutchgirl6

Sue, 

My initial dx was DCIS.  I had a lumpectomy with SNB on Feb. 1.  One of the nodes had cancer, so I had axillary node dissection 2 weeks ago.  Thankfully they are clear, but it changed my dx to IDC.  For me, the node involvement was more worrisome than the breast lump, since the path showed clear margins.  We thought it was going to be a walk in the park, but things got complicated.  Now I am waiting to start chemo (probably April) and rads.

You have to make the decision that you are comfortable with, do your research and talk to your doctors.  They have valid reasons for wanting to do surgery sooner than you might want them to.

Good luck 

suekb

Thank you all for posting! I really appreciate it. The reason for the DM with SNB is I am BRCA1+ and I have a strong family history. The lumpectomy idea is good though and I am wondering if insurance would cover both. I finally called the GS today and talked to the scheduler. She said they are trying to work out something for next week so I am willing to go forward with the GS if this happens. Taking time off of work is a big issue for me so if I can recover over Spring Break it will be worth it. Thanks again!!!! Sue

Jenna1961

newalex,

Regarding the microinvasive part of DCIS, the report states "there are microscopic foci consistent with microinvasion". The oncologyst said "a few very small microinvasions".
Mastectomy surgery included a stage1 axillary dissection - first 1/3 of the nodes. Not all were anlaysed ( only 12 if I understand the report well).

The surgical biopsy showed "margins widely positive for DCIS" because the specimen was only a part of what was inside the breast. It also stated "lymphatic invasion not definitely identified". Now we know it was present because of the micromet in the SLN.
The mastectomy report shows all clear margins (no invasions).

I don't konow much about vascular invasion - I am terribly scared of it (especially with HER2+). Lyphatic does not seem as horrible, feels more "regional" and detectable. My node was palpable, 16 mm lump for 1.1 mm micromet.
Did you have any systemic therapy?

Jenna

ak_survivor

Mine showed 2cm at time of biopsy, 10/21/09  and aggressive. For many reasons I chose to have a double mastectomy on 11/07/09 it had grown to 5cm. My doctor said she had seen other cases of it growing that quick in such a small time period. So yes it can grow very quickly and they have no way of knowing until the pathology report comes back. So please think long and hard about putting it off.

tibet

Jenna

in my case, at time of biopsy, I had DCIS but after mast., they saw within the DCIS there was

1 cm tumor and 1mm micromet in one SLN. So I had chemo, 4 EC, 12 weekly carboplantin and taxol and afterwards rads. Did you have chemo and rads?

Jenna1961

newalex,

we are always late to respond here on the west coast ...

No, no rads for me (although, it was a borderline) - all other nodes were clean.
I had 8 rounds of chemo + herceptin (see the signature line). Can't avoid chemo with any kind of invasion in the nodes.