Pathology reports after surgery

suebak

I received my pathology reports today.  I have clean margins and negative lymphe nodes.  I was so excited when I got the news. Surgeon did say, the mass was a bit larger than he had expected.  It was almost 2cm. He also said the oncologist may want me to have kemo.  I was under the impression if my lymphe nodes were negative, I would not need kemo, radiation only.  Looking for some opinions on this matter

Fearless_One

Chemo is not standard protocol for stage 1.   I would be surprised if they said you should have it.  

lisa1313

I am under the same impression as you. No chemo

Melmes

I have been told many conflicting things concerning this. One, that chemo is not called for in stage 1 cases. Two, chemo is called on dependent upon the grade. Three, it depends on your age - younger folks should treat more agressively w/ chemo and rads to decrease risk of recurrence. Four, that your oncologist should do an oncotype and that determines it. But I think in the end, it is 5. Your personal decision on the matter, that should be the deciding factor, and fortunately my doctor agrees with me. I know that is not a straight answer, but I don't think anyone has one. It's individual, for each individual dealing with this.

CandDsMom

From my understanding (granted I am not an oncologist), chemo is considered when concerning pathology is present even for stage 1 (ER PR negative, ER+ PR - (pending oncotype), ER+ (pending oncotype) , or HER2 +, I am sure nuclear grade and the patients age and other health issues factor in too). The oncotype test is only done per my understanding for ER+ women to determine benfits of chemo.  The other issue that matters, even without nodes, is size of lesion.  For instance, someone with a microinvasion would likely be treated differently than someone with a 1cm lesion, even though with negative nodes both could be stage 1. This being said, it seems cancer medicine is progressively more individualized, so all definitive info needs to come from the breast surgeon and oncologist.  Best wishes to all dealing with these choices and decisions.

lisa1313

CandDsmom, if you don't mind me asking, what was your treatment?

Lisa1313

Sherryc

When my MO went all through my path report with me.  On every line (ie: size, grade etc) he said it indicated no chemo.  When he got to my KI67 which as less than 10% he also said no chemo.  He did say that had my KI67 been over 10% he would have recommended chemo for me.  My onccotype DX score was a 23 which is in the middle of intermediate. I am 48 yrs old.

dogsandjogs

In my case I had a 9mm tumor, medium growth rate and the KR was 13 percent. No nodes. All docs agreed no chemo. I am 75.

CandDsMom

Hi Lisa1313 - because I had DCIS ("in situ" pre-invasive breast cancer - basically it had not yet broken through the duct walls), my choices were lumpectomy + rads (which I didn't qualify for since I had multifocal/multicentric disease - it was basically in several different quadrants of the breast in several different points in those quadrants) or MX, which I had.  So I usually post in the DCIS forum but I had numerous talks with my onc about stage 1 treatments as I had both an MRI suspicious for invasive disease and just in general everyone thought I would be upped a stage post MX (which didn't end up happening) so that is why I thought it would be ok to post what she had said to me about stage 1 treatment here.  Hope I didn't overstep any boundaries. Again, my best wishes to stage 1 and 2 sisters on this thread (((hugs)))

prayrv

I'm wondering if the onc is thinking chemo due to the size of the tumor.

lisa1313

CandDsmom, thank you for replying. I am trying to gather as much info as I can.

My doc said no chemo or rads with mastectomy and I just want to see if other doc feel the same.

I welcome anyone's stories or in site please keep them coming

Thanks

Lisa1313

suebak

Thank you for all the responses.  I will have to wait to speak to the onco. I called yesterday and couldn't get an appointment until May 29

GabbyCal

Did others have to wait over a month to discuss their lumpectomy pathology with their MO? 

Suebak: I hope I'm not overstepping the boundaries of the board, but I'm a bit curious that your doctor doesn't want to see you sooner. May 29 is over a month away. Should they want to run more tests, that will take more time. I would think they would have some sense of urgency now that you've had your surgery and have your pathology.

Sherryc

I started out with my RO at first and he called me when my path came back.. It actually came in in two stages and he called me both times.  Then he decided he wanted an oncotype DX done and ordered that and called me when it came it.  At that time he then wanted me to go see a MO when they got me in the next week to see.  Can't imagine waiting a month to get information and possibly more test.  Even when I switched MO's I was able to get an appt in two weeks with the new one.

suebak

Gabby-I never feel as if anyone on here is over stepping their bounds, I have learned more on here than from any website or dr. I am going to call my surgeon today, my right breast, which is the cancer breast, is as hard as a rock.  Does anyone know if that is normal after a lumpectomy. I will also express my concern for having to wait so long to see an oncologist.  I think that is the one negative side of going to a major cancer center. I was under the impression, I got the best results possible. Negative nodes and clean margins?  I am going to ask for a pet-scan.  I have back issues.  Back pain every day.  I had been diagnosed with degenerative dics desease over a year ago, but now I am starting to wonder if there is more going on in there. Now, I fear, I may have cancer in my spine. Wouldn't I have to have positive nodes, for the cancer to have spread elsewhere?  So many questions, so much to digest. 

rianne2580

Would my stage be 1b according to NCI website? My M/O said I was stage 2. My node was micromets and my tumor 4mm or microinvasion (2nd opinion from Hopkins). Hopkins could not see 4mm and I spoke with them on the phone about all the tissue involved. They ordered all the parafin tissue as well as slides. Nothing had moved into vascular system. And the DCIS in another quadrant was well contained, no extension there.

I am puzzled by docs, especiallly since the needle biopsy got ALL of the invasive IDC out. None was in the MX.

GrammyslilButtercup

Hi girls,I had a lumpectomy on April 1, path came back 2.3 cm lesion, no nodes involved and grade 3. I went back April 15 to excise one small area, they got all the first time but just wanted the margin a little bigger in that one spot. That pathology came back completely clear. My family doctor and surgeon told me if the nodes were clear I would probably only need radiation but the oncologist would make the final decision. Now the surgeon also told me after looking through my pathology , which he said came back great, that they may sit me for chemo as well simply because I am only 44 and the grade was high. He said if I was older they wouldnt. I was also told that I would need 4 weeks recovery after surgery to start treatment because they want the body to have healed from the invasion of surgeries. In this 4 weeks I am having my catscan and my bone scan so that everything will be on the oncologists desk when I go. My right breast where I had the surgery is hard, very hard. I was told that it is scar tissue and will take some time to settle, possibly up to a year. The doctor told me to put vitamin E cream on and around the incisions, and then I add baby powder to my arm and underarm, it feels smoother, I find the rubbing of clothes around the site of the lympnode disection gets irritated, the powder really helps.I am not sure I am much help but this is what I am experaincing right now. Sending lots of love, energy and inspiration to all of you girls. Love Hope Faith.