Just received pathology report and confused

DallasCowboysFan

i just requested a pathology report and it says i was stage 3 (pT4b) no lymph nodes or vascular invasion, but based on size 9cm from medial to lateral x 10 cm from superior to inferior x 6.4 cm from anterior to posterior that it put me at a stage 3. So from my understanding it only travels via lymph nodes or vascular. If both of those were negative, why chemo or rads? I had a full mastectomy. Also says no intraparenchymal or laterally located lymph nodes are grossly identified. Triple negative, Ki67 95% Thanks in advance.

Moderators

Hi DallasCowboyFan-

We’d like to welcome you to BCO! We have some information on our main site on treatment for IDC that you might find helpful. While you don’t have any lymph or vascular involvement, chemo and/or radiation is typically advised or strongly suggested if the IDC is larger than 1cm in diameter. Your doctors might want chemo based on the size alone: http://www.breastcancer.org/symptoms/types/idc/treatment/systemic

We hope this is helpful!

The Mods

VL22

Hi Dallas, sorry you're here. Even without node involvement, being triple negative with a tumor over 1 cm usually means chemo and rads- it is an aggressive cancer and these are the two weapons to fight it

windingshores

Also your ki67% is high. This is not always considered a reliable test but still, it is worth noting because it measures proliferation rate. If you were hormone receptor-positive you could possibly skip chemo and take anti-hormonals, but since you are triple negative chemo and radiation are the best ways to go.  On the face of it, I can definitely follow your thinking and if you want to explore other ways to treat your bc you could always get a second opinion to make you feel more certain. Your oncologist can explain the reasoning.