Microscopic Metastatic Cells in Lymph Node

AlienWish

After my lumpectomy and lymph node dissection, I left the hospital thinking I had no cancer in the lymph nodes, but I found out at my follow up appointment that there are a few microscopic cells of metastatic carcinoma in the first node.

Do they still typically do chemo for this or is it usually just radiation?  I will see my oncologist in a few weeks.  (We are going camping for a week).  The lymph node was removed.

I'm really afraid of chemo.

Tomboy

many many women have had micrometastasies  in a lymphnode or two, without having to do chemo. it means the nodes were doing the job they were supposed to do, which is catching the bad stuff! did your doc look worried? they will probably give you a test like the oncotype dx to find out if chemo would be helpful. they may just think lumpy, radiation and a hormonal are enough for you. because you arent her2 positive, that may mean they would want to skip chemo. do you know your grade yet? i hope you don't have to do chemo too. if the said you should, it is still your body, and you could just insist on anti- hormonals for now. it even helps many stage four women in whom that was their only treatment what so ever, with a pretty good quality of life. please don't go to the dark place in your mind yet!

barbe1958

Alien, I had micromets in my nodes too and didn`t do chemo OR rads. IF I recur, my first line of defence will be a hormonal like Tamoxifen. It`s a powerful drug and will be a much easier first line of defence for me. I will be 6 years in December and have not had a recurrence yet. My surgeon mentioned it in passing, and my onc didn`t even comment on it! I had to bring it up, but like kathe said, it meant the nodes were just doing their job. 

Tomboy

barbe is in 'my friends' list!!!  iam happy you dodged all that, barbe, and hope alien does too!

BrooksideVT

I had ten isolated cells in one of two lymph nodes.  Technically, I'm node negative, as, I imagine, are you.  As for the errant cells, the docs are just not that concerned.  My oncotype showed staying on an anti hormonal drug for five years will reduce my chance of recurrence by about 50%; adding chemo gives only a 2-3% bonus.  As chemo has side effects, some of them permanent, my onc advised against it, and I was happy to agree. 

AlienWish

This makes me feel better, ladies.  I'll just try to relax and wait for the Oncologist appointment.  We're going camping tomorrow, for a week.  I'm hoping that will help me keep my mind off it.  

barbe1958

Thanks kathe!! I ALSO have ITC`s which are Isolated Tumour Cells floating around my blood stream. They aren`t too concerned with those either until they land somewhere and start reproducing.

AlienWish

I'm not 100% sure but I think I'm grade 2 because of the size..?

barbe1958

They changed the rules since I was graded and I think I am a 2 as well, as I was 1 cm too. They are finding them smaller and still had to grade them so it bumped us up a grade. No big deal. There are ladies here with 5cm lesions!!! Can you imagine??? My stats are the same as yours, but I think I had micromets in 2 nodes and 2 were mashed together which wasn`t a good sign but I don`t know why not as I`m still here....

AlienWish

  Mine was 1.6cm so it's rounded up.   The numbers don't mean much to me yet.  My Onco appointment is in 2 weeks because we're headed up to the mountains tomorrow for a week.

barbe1958

The numbers are used to set the treatment plan. It`s the stage that means the most, really. That`s what they base the chemo and rads on. I got it wrong in my post above, but I will leave it there for a learning experience. It`s the STAGE that has changed over the years, not the grade. The grade is just how fast the cells replicate in YOUR sample. That let`s them know whether chemo will work or not. Chemo doesn`t work on slow-growing cells, so no point. The stage, on the other hand is how far developed your cancer is. There is now a stage 0 for DCIS so that bumped a bunch of us up to stage one and two where we might have been back a stage years ago. 

Again, the numbers are just to help define your treatment path. They don`t mean anything in death rate at all, so don`t get hung up on them. 

SpecialK

Alienwish - grade has to do with what your cells look like under the microscope and that number is calculated with a system comprised of three components.  Here is some info linked below that breaks down how grade is determined.  It has nothing to do with size of the mass - that is what constitutes staging - completely different than grade.  Whether or not micrometastasis is considered important also depends on what your hormonal receptors are - if you are triple positive (ER+/PR+/Her2+) or triple negative (ER-/PR-/Her2-) that can be more concerning, but many oncologists consider isolated cells in the sentinel to be clinically node negative. It is important to realize that you are an individual and your MO will make treatment recommendations specific to your situation.  Also, just want to clarify barbe's post - grade numbers indicate aggressiveness of the cells, staging numbers (comprised of mass size, lymph node status, and location of tumor) are tied to disease-free survivability and overall survival.  However, your mass and lymph node status would indicate you have an early stage situation, which is favorable.

http://pathology.jhu.edu/breast/grade.php

 

 

barbe1958

SpecialK, you explained better than I, thanks! The only thing I have a concern about is the fact that you say stage is tied to survivability. I have seen stage 0 gals on here go on to die as stage iv, so I don`t see the correlation.....as I have also seen stage iv women that have been 20+ years on the go. Stage, as explained to me by my onc, is strictly for treatment purposes. It signals the advancement of your cancer but certainly cannot predict mortality.

SpecialK

barbe - if you look at the SEER data about 5 year survival based on stage it does clearly correlate stage and survival.  Certainly there are outliers at every stage as you indicated with stage O at initial diagnosis recurring, and stage IV having a longer than average survival, but the ACS stats show at 5 years -  100% survival at stage 0, 100% at stage 1, 93% at stage 2, 72% at stage 3, and 22% at stage 4.

Here are some links:

http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-survival-by-stage

http://seer.cancer.gov/statfacts/html/breast.html

 

barbe1958

Okay, there is the first problem. I don`t consider 5-years a survival!! I am almost 6 years out and see my onc more often NOW than I did at the beginning. My cancer is slow growing ER+ and it is NOW that I have to worry. Heck we can live with almost any deadly disease for 5 years...with life insurance you only have to survive 90 days after diagnosis to get paid out.

HomeMom

I'm going to live into my 80's just like the rest of the women in my family. I don't give a rat's butt about stages and size of the tumor , grade - micromets macrotmets whatever! 

barbe1958

Me too!!! That`s why I don`t even post them on my tag line. Everyone has an opinion on them but no ones opinion matters a bit!