Multifocal Breast Cancer what stage am I

shoppygirl

Hello all you smart, knowledgable ladies! I have a question about my BC stage as my nurse and my oncologist have a difference of opinion. I had a 9 mm Tumor and a 2 cm Tumor. I also had less than 2 mm of cancer in my sentenial lymph node. My oncologist originally told me that I had a T1 Tumor as you don't add them together and I was stage 1b or 2a. I met my bc nurse that will be following me for the next 10 years (what a piece of work she was but that is another story). Anyway she said I could be stage 2b with a t2 Tumor as you add them together. Anyway I was just curious what you ladies thought since my medical experts cannot seem to agree!

Ridley

Hi Shoppygirl,

I also have multifocal breast cancer, and all of the information I have read seems to stage based on the size of the largest tumor. However, when I asked my medical oncologist, he encouraged me to not focus on staging, but on the biology of the cancer (e.g. Hormone status, grade, etc.)

When we talked about recurrence risk and he took me through adjuvant online, he used the size of my largest tumor, but then toggled on the risk to give me a range, as mutifocal cancer does seem to have a higher risk of recurrence.

Good luck,

Ridley

coraleliz

I was staged 2A based on my smaller 1.3cm tumor because on that side I had 2 positive nodes(3mm). The other side was 1.6cm & node negative. One MO I talked to thought I should be more a aggressive with treatment because of bilateral disease. All the others disagreed.

Beesie

Yes, trust the oncologist.

Staging is based on the "primary" tumor, i.e. the largest of the invasive tumors when there is multi-focal cancer. The size of multiple tumors is not added together.

How is breast cancer staged?

"Stage IB: T0 or T1, N1mi, M0: The tumor is 2 cm or less across (or is not found) (T0 or T1) with micrometastases in 1 to 3 axillary lymph nodes (the cancer in the lymph nodes is greater than 0.2mm across and/or more than 200 cells but is not larger than 2 mm)(N1mi)."

Your diagnosis is right on the edge, however. Being 2cm in size, your primary tumor is at the high end of a T1 tumor, and with less than 2mm of cancer in your node, you qualify as having micromets to the nodes.

shoppygirl

As always,thank you ladies. This nurse was quite aggressive, I was vey surprised by it. In addition to the confusion about the staging she tried to talk me out of having my ovaries removed even though I have a family history of ovarian cancer. Also, even though I have already lost 20 pounds and am a healthy weight, she told me I needed to lose 6 more pounds to have the perfect bmi. The funny thing was that she was about 70 pounds overweight herself! Now I know how hard it is to lose weight but she was so aggressive about me losing even more weight, it was strange!

Thanks again!

pupmom

Shoppygirl, I think that nurse is stepping over the line. She is NOT the doctor (even if she likes to pretend she is) and has no business giving you medical advise. Sheesh! You show much kindness and restraint towards her. I would probably already have complained to the MO and created a fine mess for myself!

shoppygirl

Yorkie

I felt that she was stepping over the line too! I told my husband that I would give her one more chance at my next appt in 6 months and if she was still the same then I would ask for a replacement!!

Sugar8

Maybe I got my stage wrong. Staging has never  been discussed with me. My diagnosis is 4mm gd3 IDC plus multifocal high grade DCIS 50mm+11mm+5mm plus multiple areas over 28mm. ER 7/8, HER2 positive.  Node 0/2. 

I had lumpectomy,  reexcision then MX.

Wish I had come on this forum earlier, it would have made more sense.  I now realise that the findings are not always straightforward as the literature.  This makes it very confusing.