Extranodal Extension of metastatic tumor in sentinel lymph node

Irene1524

Hi, everyone. I’m new here. I just had a lumpectomy a few days ago, which removed a 1.3 cm tumor plus a DCIS area of 1.7 cm, mixed in and adjacent to the tumor. Even though all my previous tests and examinations, including MRI and Ultrasound, showed no lymph node involvement, the sentinel node biopsy my surgeon performed came back showing a 5.5 mm macrometastasis, with “extranodal extension of up to 2millimeters.” Extranodal extension means this little tumor has broken out of the confines of the lymph node. Has anyone here had this extension? Does it change the recommended treatment? Am told my cancer is Grade 1, but is that even possible with an extranodal metastasis of this size when the primary tumor is so small

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bevin

hi there, I'd maybe get 2 opinions from oncologists for a treatment plan. While I cant answer your question fully my understaning is extra nodal extension does create more risk. Im sure others with more knowledge will be ny soon.

Newnorm

Hi Irene1524, I had nodal spread post neoadjuvant chemo in several of my affected nodes. It does increase the risk that cells have gone beyond that local area. However, my onc and I decided I had my tumour for at least twelve months prior to diagnosis and yet all my scans showed it hadn’t spread. Tumours are all different. We just have to try and move on the best we can and enjoy every day. Sometimes harder said than done. All the best. Xxx

Peregrinelady

Have you had an Oncotype test? Also, if your DCIS is mixed in with your IDC, I thought it would be counted as one tumor, so it would be 3 cm. At least that is what I was told by my oncologist. I agree that you should get two opinions.

Irene1524

Here is what I have learned: Any size DCIS is considered Stage 0, so for staging purposes only the IDC 1.3 primary tumor is relevant. A node tumor the size of mine is unusual given the non-aggressive, Grade 1 nature and small size of my primary tumor. So unusual, that we ordered a biopsy of the nodal tumor, to see if it was the same cancer. And it turned out to be the exact same. I had a Mammaprint done, which identified my cancer as low risk, Luminal A, so no chemo. My docs tell me that the sizable tumor in my node is unusual given all the rest of my situation, but not impossible. Just really bad luck, possibly because my primary tumor has been around for a very, very long time. And everyone keeps shrugging off the Extranodal extension, calling it “minimal”. The most conservative treatment recommended to me has been radiation for six weeks, plus 5-10 years of AI. The radiation will cover the breast, underarm, plus the entire chest area below my collarbone, to include all the relevant nodes. One doctor recommended that a smaller area be irradiated, but I am spooked enough that I chose the more conservative approach. Also, I have had imaging examinations of my chest and abdomen, and it all looks clear. I’ll be starting radiation in a week. I don’t like hearing that my cancer is “unusual” or behaving in surprising ways, that there was a tiny chance of sizable nodal involvement and yet there it was, but it is what it is. I hope tostay on the good side of the odds going forward.