Question on Surgery Pathology Report

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Kay_G
Kay_G Member Posts: 3,345
edited June 2014 in Stage III Breast Cancer

I am so confused reading this report, which is only all of one page.  The BS called me and told me there were good margins and I had a 1.2 cm tumor and two .2 cm cancers in two lymph nodes.  She said this was excellent news.  It didn't sound so excellent to me.  I was pretty disappointed with this since the MRI previous to surgery didn't light up at all and the BS right after surgery said she didn't see any cancer.  But still compared to the initial MRI that showed a 4.5 cm primary tumor and two other smaller tumors and two positive lymph nodes, I guess it means the chemo did a good job.

Now I'm getting physical therapy because I can barely move my arm.  (The BS did a level II lymph node dissection.)  The therapist asked me to find out how many lymph nodes the BS removed.  So I have a copy of this one page report.  I see the 1.2 cm tumor the BS told me about.  I also see a "deep" .3 cm tumor with a margin of about .1 cm, which the report seems to classify as less than optimal.  I also see the two .2 cm lymph nodes that the BS told me about.  She said she couldn't tell me how many lymph nodes had been originally cancerous since I had the neoadjuvant therapy, but that two still had evidence of cancer on the pathology report.  I thought this meant she also had lymph nodes on the pathology that showed no cancer. 

The report says these were in the axillary tail, associated with lymphoid tissue and may have been in lymph nodes prior to neoadjuvant treatment.  On the lymph node dissection, it says the specimen was 4.7 x 1.7 x .05 cm and that is was fibrofattiy tissue and no lymph nodes or cancer were found.  It says no lymph nodes were examined.  Has any one ever had this?  Where the hell are my lymph nodes?  Do I still have cancerous lymph nodes in me?  How do I know that?  I go through all this lymph node dissection for nothing.  To make it even worse, my arm seems to be swelling and maybe that is lymphedema already?  Surgery was only three weeks ago.  And the report also shows evidence of DCIS identified (no other info on size or anything), which the BS also did not tell me about.  And lastly it says that lymph vascular invasion cannot be determined.  I have a call in to the BS about this, but can anyone here  tell me any more about this?  I am getting radiation in a couple of weeks.  I am thinking the BS is going to tell me even if there are still cancerous lymph nodes in me, the radiation will take care of them.  If she does, I think that is a BS giving me BS.  I don't want to think I went through this lymph node dissection (in addition to the MX) for nothing.  Has anyone else ever had no lymph nodes found when they had a modified radical mx?  Thanks for any info you can provide.  I really appreciate it.

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