Signet ring cells in tumour

bearcub

I was wondering if anybody else had signet ring cells in their tumour? I have read that this is very rare, about 2 to 4 % of breast cancer patients have this. I had no spread to nodes or LVI but just knowing these cells were there make me very nervous. Anyone else out there?

nic0912

Hi bearcub,

I also had signet ring cells in more than 50% of my tumor and it has been weighing on my mind since. Yes, it is my understanding that it is very rare in breast cancer and only occurs in 2-4% of patients. My BS assured me that although it is an agressive type of cancer, it is generally treated as regular breast cancer if it is contained to the breast area. I was lucky that this was the case for me and I also had no lymph node involvement. I too feel the same way you do about these cells being there and in the end I have decided to have a BMX instead of doing rads after my chemo is complete. Although not 100% guarantee, I need to know that I have done everything I can to prevent it from coming back.

I'm curious as to what information your BS gave you about it.

bearcub

Hi nico912...



Sorry you have this but glad to see I am not so alone. My Onc said the same thing treatment the same as regular BC. I guess I am counting myself lucky I caught this early, sounds like you did too. I had a lumpectomy back in July where I had 12mm clear margins all around. I did AC chemo and did do rads. I am also her2+ and have herceptin every 3 weeks until Nov... I am feeling great, my onc said that my prognosis is excellent at our last meeting. (Those darn cells though do sit at the back of my mind)..I have to have faith that I have done everything I can. It sounds like you are just starting out on your journey. Once the plan for treatment is in place things will seem less confusing. It is a lot to take in.

nic0912

Oh it certainly is a lot to take in. So many tough, personal decisions to make, but I feel like things are falling in place better now. I had a 2.1 cm wih clear margins and no lymph node involvement (thank God) Wating for that pathology report was the worst week of my life! I am half way through my chemo of TC and in the process of getting a second opinion from another BS/PS team. After BMX it's 10 years of tamoxifen for me. It is so great to hear that you are doing well and your prognosis is excellent! The more women I speak to, the more reasurring it is to know how many survive without reocurrance and that is really what I hope for at the end of all this.

bearcub

Nic, at least you are half way through chemo, that is a good thing...did you loose your hair? I am 15 weeks out tomorrow from my last chemo and I do feel great, the hair is starting to come back. It is about a inch long now. My tumor was 1.1 cm, it was caught with my mammogram, I never did feel it. I was in great shape, exercising eating well, and BAM...BC..



So you have had a lumpectomy and are going back in for a BMX. We all have to do what makes us comfortable with our decisions. I am sure you are making the right one for you. For me radiation was something I wanted to do, as I have read about ladies having MX that never did radiation and they had reoccurrences. I originally was thinking MX and then changed my mind to lumpectomy and radiation. The BS said I was one of the lucky ones that gets the choice. This was the right decision for me. I also am on tamoxifen for 5 years and I guess we will readdress things then.



I hope you are managing well through the chemo, with minimal SE. Hang in there!

nic0912

Bear, sorry it's been a while to respond. This last session really slowed me down. One more to go and I am counting the days.

Yes, I did lose my hair, but only half. I shaved it when it started falling out (day 14 on the nose), but it already starting to grow back in. It's great to know that it will really start growing back that soon after treatment.

I am nervous about the BMX but in my heart feel it is the right thing for me. Right now I am just frustrated as to how much the chemo has slowed me down and changed my body. I have always been very physically fit and I simply do not have the energy right now. I just keep telling myself that it is only temporary.

How long and how did you do with the radiation? Any fatigue, skin changes? How are you doing on the Tamoxifen?

bearcub

nic,



I finished my chemo on Nov14. I am 4 months out of chemo, then I did 16 rounds of radiation. I am in Canada so this is pretty much protocol for early breast cancer. I also lost my hair right on schedule while having chemo(I lost all of it). It is long enough now that I can go to town without any covering. It is still real short, I am also taking herceptin as I am her2positive and I think it slows the hair growth down a bit. I will be on that until November, it is a half hr. infusion every three weeks. I am on tamoxifen, have been since December and was a bit scared but so far I am not experiencing any symptoms. I managed the chemo fairly well, I had the hardest time between day 5 to about day 10, I felt like a slug...I was also physically fit, but did gain 14 lbs during chemo. I have taken 7 of that off and am working on what's left.



Do you know when you will be having your surgery? Do you have radiation afterwards?



I hope your last chemo goes smoothly...I can imagine being nervous for your BMX, I am sure your doctors have performed many and you will do fine. You will come out the other side, cancer free. That makes it all worth it. Take Care

nic0912

Thanks for the well wishes bear,

So happy to hear you are doing so well and getting back on track. Finished my last round of chemo Tuesday...wooohooo. I'm still feeling pretty good, but usually it catches up to me around day 4 or 5 and lasts a coupe of days. Every time has been different though. I'm just so happy this part is over and I can see a light at the end of the tunnel.

That's great you only had 16 rounds of radition. They said I needed 6 1/2 weeks! I will not need radition if I go through with the BMX. It's a lot to process. 

Had my PS appointment today and will see my BS on Monday. No date of surgery set yet because I am going to see another BS for a second opinion at Sloan in NYC. I noticed you put off your radiation for 4 months and started Tamoxifen first. I didn't know you could do that and I am going to call my DR and ask if this would be something I could do.

Good luck and I wish you the best.

bearcub

Hi Nic,



So happy you are finished the chemo, it is such a relief to get over that. I also would have a tough time around day 5 to 10. I had 16 rounds of rads because it is the canadian prodigal for my cancer. Less rounds than Americans but a bit stronger dose daily. He said it was just as effective. I asked my RO why so many women on the forums have 28-36 rounds of rounds as I thought maybe I wasn't getting enough. He told me Americans do more rounds because they have to pay and everyone makes more money. I live in British Columbia, we don't pay. Sounds like you are on the east coast of the US.

I didn't put off my radiation, it just appears that way. I started my chemo in sept and finished Nov 14, 2012. I started my tamoxifen and herceptin shortly after the end of chemo on Dec, 5. The chemo drug Doxorubicin that I was on cant be given at the same time as herceptin as it can be hard on the heart. In Canada rads start about a month after chemo. I started rads on Jan 3rd, a bit delayed because of the Christmas and New Year holidays. I have had no symptoms while on tamoxifen.

Good idea to get a second opinion. You are getting closer to the end, which ever decision you make will be the right one for you. It can all seem so overwhelming.

I am 20 weeks out from chemo now, my hair is a short pixie cut length. I feel almost the same as I did a year ago. I do have to go for my first post breast cancer mammograms the end of May so I am imagining I will have a bit of anxiety. I do not a repeat of this last year! I will try and stay positive.



Take care, good luck with your second opinion consult. Let me know how it goes and when you are having surgery.

nic0912

Yes, I agree with you, here in the US it seems like it's more about the money than the treament of patients. This has been my biggest arguement with my doctors. If they feel they got all the cancer both locally and bodily, then why will I need so many radiation treatments. Their answer is always the same "standard of care".

Standard of care is also why my BS does not agree with my decision for the BMX. She feels the radiation is adequate and if the cancer comes back locally, then I will get a mastecomy. She says it so casually, like it's no big deal to go through this whole process again.

My second opinion is on April 30. In the mean time I am going back to my radiation oncologist to ask a few more questions and setting up a surgical day for mid May with my current surgeons. I don't want to delay treatment and want to start feeling better by summer. We just bought a beach house one month before I was diagnosd and I intend to start enjoying it! LOL

How was your experience with radiation? Did you have many side effects (i.e. tired, skin changes, etc.)? We have several options here in US to administer radiation and that is something I intend to discuss  with my radiation oncologist on Thursday. I think the treatment option for me has a lot to do with my age, I have dense breasts and it was an agressive tumor (but most are in younger women).

That is so great your hair is back so quickly! I can't wait until I can look in the mirror and see even a little more than the fuzz that is currently there. I'm sure your imaging in May is going to be great and I would like to hear the outcome. I'll keep in touch and let you know how things are progressing. Be well...

bearcub

Hi Nic,



Sounds like you are doing well and a go getter...we do have to advocate for ourselves that's for sure.



Let me know how the second opinion goes on the 30th. Since we had the same cells and are basically at the opposite ends of this continent, I actually feel a bit better that your oncologist has the same opinion as mine. I can understand you not wanting to deal with this again, but even with a mastectomy ...no guarantees...my MO had BC and had a mastectomy and then got a reocurrance. She is doing very well. Did you read on the Breast Cancer in the news page 3 on this site, home page that a lumpectomy with radiation may be even a better survival rate than mastectomy for early BC. I certainly understand you wanting to have a BMX, the whole thing is so scary. I think what brings us peace of mind is a important piece of the process.



I am 55, pretty active, I ride my stationary bike 5 days a week 16 km. a day go out camping with the 5 th wheel, kayaking, I have a great DH and kids, grand kids, I have no intention of letting BC take me out!



While I was expecting rads to be harsh on me as I am a natural redhead with fair skin, it turned out to be just fine. I pinked up quickly but it stayed stable, never got any worse. I moisturized at least 3 times a day. I used Glaxol base I bought at Costco. The nurse also gave me some cream which worked great it acted as a silicone glove. I also used everyday a saline compress that I made up and put on my breast are to cool everything down. I think that was the best thing, if you do rads let me know and I will write out the recipe the rad nurse gave me. I never got tired, I drove myself to and from everyday, even in a few nasty snowstorms. My BC is on the left so my heart and my lungs were important issues for me. My RO told me my heart would not be getting any radiation but my lungs would get hit at the very top. The equipment was brand new as our radiation dept only opened in November of 2012 and I had rads January, so I don't know if that was why. I did ask about having rads on laying on my stomach with the breast hanging....then zapped...not a option for me.



Anyway Nic, let me know how things go, ENJOY your beach house this summer you surely deserve it!!

bearcub

Nic,



I also wanted to add that I am trying to avoid products with BPA, such as canned goods and plastic containers. I am also cutting way back in my dairy products as my cancer is driven by estrogen and dairy has lots of estrogen.

nic0912

Well bearcub, it's been a while and here I am contemplating my second opinion at Sloan. She was very nice and helpful in answering my questions, but unfortunately it has only given me more to think about and second guess. I now have two top surgeons, two radiation oncologists and a highly accredited plastic surgeon telling me that I should do the radiation! Really makes me think I'm looking at this all wrong. I guess at some point I need to put my trust in the experts.

Thank you for sharing your radiation exprince. I inquired about the partial breast, but it is not an option for m because of my age. They did say prone position is possible. My biggest fear (besides 6 1/2 weeks of radiation) is what the long and short term effects will be. I was told no sun exposure for a year and possibly permenant skin damage or dark patches could occur. Not to mention fatigue could last for years after treatment. I am going to take tomorrow to sit with my list and weigh the pros and cons. I intend to make the final, not-look-back decision by Thursday.

I have been gradually eating more whole foods, fruits and veggies. Have cut out a lot of dairy too. Seeing a dietician next Friday to get on track and get a real game plan. I will let you know what the final decision is and if it is radiation I will take you up on that recipe.

Right now, I'm just counting the days until summer!

bearcub

Oh Nic, so good to hear from you and sorry this is all so frustrating. You never did mention what the doctors advised as far as a BMX. Are you still planning on having that done?



As far as radiation has gone it really wasn't bad. I wear tank tops outside, I was just told to make sure I wear a sunscreen. My skin is fair so I was imagining my skin falling off and gaping wounds but I never had anything like that. I became pink but after 2 weeks it went back to normal. I never wore a bra from the first day of radiation until 2 weeks after. I wore a small men's tight tank undershirt for support.



I would suggest you check out the radiation threads, they may help you with your decision. I do have a peace of mind having had the radiation. My aunt had breast cancer over 30 years ago, she had a mastectomy no chemo but she did have radiation. She lived for over 30 years after radiation and passed away at a nice age of 80....that was with old equipment.



Good luck with your decision. Enjoy the lake and your summer, you deserve it.

Take care and keep in touch.

bearcub

Hi Nic,

Just thought I would check in and see how you are doing, everything okay?