question about final tumor size?

andrearose

Hi all!

I just got the pathology report back after surgery for ILC and I'm confused. It says that the invasive tumor size is 2.5 but it also says there was LCIS and atypical hyperplasia in the tissue specimen. When I emailed my breast surgeon about it she said that "the invasive tumor size is 2.5 and includes the LCIS." I really don't know how to interpret that.

I'm confused because I know that LCIS is not invasive…so why was it included in my invasive tumor size? It puts me at stage 2 whereas the palpable mass was 1.8. Or maybe the LCIS was in the tissue and the invasive part is still 2.5 at its widest dimension?

I am driving myself crazy over this and don't know if I should push for a different pathologist to look at it? Or just wait until I get my oncotype results and go from there. Honestly I feel silly (and annoyed) because I've asked her so many questions and she's pretty tight-lipped. I think she is waiting for the medical oncologist to answer my many questions. My appt. is not until next Weds.

Has anything like this ever happened to anyone else out there? Did they measure your LCIS??? This is all so scary. And exasperating.

mary625

I never thought about it in the way that you did. I made the assumption that my ILC was born of the LCIS and some got left behind. I guess what you're thinking about is if not all of the tumor was invasive, does it count toward tumor size for chemo. I'd already had chemo so that thought did not cross my mind. I really don't have a medical explanation other than one oncologist told me that it's always that way that they find LCIS and DCIS too mixed in with the ILC.

Moderators

Hi Andrearose-

First off, we want to welcome you to the Breastcancer.org community. We're sorry for the circumstances that bring you here, but we're so glad you've found our community.

It sounds like perhaps the LCIS was in the tissue, and the tumor was 2.5 cm at it's widest (not including the LCIS), but you're right, the wording and subsequent explanation you got isn't exactly clear. There's no harm in asking for a second pathologist to go over it with you if you're uncomfortable waiting to meet with the medical oncologist. Arming yourself with as much knowledge as you can on this journey is important, and if that means seeking answers or clarification from other professionals, than that's what you should do. In the meantime, you can also try cross-posting your question in our LCIS forums. Someone there might have some insight into why it was included in your tumor size.

Keep us posted on what you find out, we'll be thinking of you!

The Mods

Ridley

hi Andrea - my advice would be to have the oncologist walk you through the pathology report - she or he is probably best able to do that with the report in front of both of you. However, unless you have issues with margins not being clean, I think only the invasive cancer will matter and as you noted, the oncotype will be really important in determining your treatment plan.

Ridley

Rosiesride

hi...I don't post on here much but I have been looking back at my path report as I am 3 months out from treatment, had a lumpectomy and finally feel ready to face possibility of bmx in the future. So I need to really understand the condition of my breasts! I will be getting diagnostic mammo in December but to be honest, can we really trust that?

My question is about Ki-67...my report says 42% and I don't really know what that means.

Also, I had nodes...1st sentinel node was positive for metastatic tumor, 1.2cm....2nd positive for LCIS and invasive carcinoma....right axilla node dissection positive for metastatic tumor in 1/9 lymph nodes...greatest dimension 6mm. I realize I had 3 positive nodes but I have always thought when it was in axilla, it's "worse" than catching it in sentinel...I guess I need peace of mind knowing it was only one metastatic in axilla rather than all 3 in axilla...or does that even matter? Thanks for any insight...I obviously have too much time on my hands right now! lol! Rosie...

Annette_U

My KI-67 was 63 so that is kinda high but the oncologist told me "no big deal" she has seen higher. I had no nodes, grade 1 but a big over 6cm mass. So - I would not worry so much about the score just make sure you are satisfied with the surgery to remove it and other treatment you are getting. KI is how fast the cells are proliferating.

ganzgirl2010

Andrearose..my path report was pretty much the same as yours. I have ilc, lcis, and alh. the only one that's really of any importance Is the ILC. The other two are not cancer..they are pre cancer. They will base your treatment on the ILC.