Lumpectomy and stage one but grade three (ugh).

Lafayette230

Lumpectomy and stage one but grade three (ugh).

Lafayette230

Hello ladies, 

I had my lumpectomy on April 25th and came through it really well.  Some older friends who had been through breast cancer were very reassuring and I think I had I had mentally prepared for lumpectomy, radiation, tamoxifen and a "new" normal - but I was doing ok. 

I had my follow-up with the breast surgeon two days ago and I have a copy of my pathology report.  No oncotype test yet (I won't meet with my MO until late May) but while he got clean margins they were close (less than 1mm) and my tumor was a solid grade 3 (ugh) and extremely estrogen and progesterone positive (Allred 8/8 and 7/8 respectively).  The surgeon didn't do a sentinel node biopsy and said that there was a "less than 1% chance" it would be in that node thanks to the size (8mm) of the tumor.  

I think I had checked out a little over the last few weeks but my brain is now very much back "on" and I am in a tailspin.  The chances of recurrence with a grade three seem to me to be much higher and you will knock me down with a feather if chemo isn't in my future.  

This now feels like a "life sentence" rather than a death sentence and I would love to hear from anyone who has had a stage one, grade three tumor and is doing well some years out.  I can do chemo, I can do early menopause but I am having such a hard time with the idea that my tumor was ninja-like in its aggressiveness and while I know that recurrence rate is generally only 20% I feel like my pathology results just blew that out of the water. Looking for a little bit of hope today. 

Thanks for reading, 

Laf x 

bluepearl

I had exact same diagnosis.  8mm, no LVI, clean nodes (had sentinel), high ER/PR +,  neg Her2. My oncologist said no chemo.....it would be too much.....I asked about the oncotypeDX three times and he said no...he would still recommend no chemo. I have to say that bothered me. My grade 3 was with two other pathology reports, the third was a grade 2, so we went with the grade 3. I am 63 though. I had mastectomy (the first was two years previous, grade 1 stage 1, 1 cm). Perhaps a younger age would spell chemo but in older journals of oncology, women with tumor less than 1 cm did exceptionally well, no matter what their grade was, except for people who had triple negative or were Her2 positive. Well, if those stats were good then, they should be good now even if oncotypeDX wasn't around then. I am hoping anyways. Oddly, even grad 3 tumors can have low oncotype while grade 1's can be high. I never knew my Ki67. The first tumor was less than 10% (favorable) but don't know this one...assume it would be higher. Anyway, would I have taken chemo? I don't know.....perhaps if it had been recommended yes. UGH!!!! decisions!

momand2kids

Hi

certainly grade 3 is aggressive but remember, this is about all the data. What's the good news?  No nodes, stage 1, no LVI, very small.... all good news.  I found when I focused on the good news, I felt better.  And I think you have a lot of good news.  It has been my observation (and experience) that we tend to focus on the one not so good piece of news.... but you have lots of good news here.  I think I would push for the oncotype so you can be sure and I think your argument can be that it is grade 3 and you want to leave no stone unturned.  I would hope your MO would go for that....

All that said, and I hope you can skip chemo, if you have to do it, come back--lots of people who can walk you through it.  But don't put the cart before the horse yet--- you have lots of good news....

Lafayette230

Thank you ladies! I'm trying to stay positive and will see my MO today for the first time.  I don't know why I didn't get a notification that I'd had responses - I checked back and couldn't see any so apologies for the delay in responding! 

Laf.