pathology question

2timer

I saw my BS for my pathology report yesterday.  Two weeks ago I had a bmx with immediate reconstruction.  I was originally dx’d seven and half years ago with a small low grade DCIS.  I had a lumpectomy, radiation and did 5 years of tamoxifen.   Last October the radiologists doing my annual mammogram saw some things that were suspicious and they biopsied some calcifications which turned out to be benign.  They also saw some “shadowing” which they didn’t biopsy.  I was supposed to return for a 6 month followup.  I didn’t go back until June when I saw my BS and they said the radiology people felt I should get the MRI that I had suggested getting but that BS’s PA said I should just skip.  I got the MRI, and a quick call back and a biopsy and was DX’s with 3.6 cm of IDC.  After 6 years of being watched “closely”.  That path report said it was low grade and ER, PR positive.

During the surgery they took 8 nodes all of which were negative.  But on examining my breast after surgery they found a node with 2.5 mm of cancer – just a bit too high to be considered a micro met and Lympho-vascular invasion was present (catching absolutely no breaks here).  The cancer was also found to be grade 3 (8 out of 9).  On top of all of this I have something called neuroendocrine carcinoma with a small cell carcinoma component.  I used Dr. Google on this term and it’s rare and doesn’t sound positive.  The “good” news was that the actual tumor was measured at 1.5 X 1.2 X 1.2 which I think means it’s much small than on the 1^st path report, it’s ER+ and (weakly) PR+ and I’m still considered stage IIa so I didn’t get upstaged.  Also my reconstruction is going well I’m told and my margins were good.

Maybe someone here can help me.  My meeting with the BS was very short and he is taking my case to a meeting of doctors to discuss whether or not I should have more nodes removed.  I will see him again in two weeks along with an oncologist.  In the mean time I am a bit depressed and confused about the path report.  I know it is what is is but I NEED to know more about this type of tumor.  I’d also like to know how it affects my prognosis.  It bugs to no end that that one node kept me from being downstaged to a stage I.  Thanks for any help.