Pathology results...

ClareSim19

Hi Everyone,

So my mum was diagnosed with TNBC last July. Tumour was 5cm and 2 suspected positive lymph nodes. She completed neoadjuvant chemo of 9 x weekly PC and 3 cycles of EC chemo. She had an MRI scan halfway through and the tumour (after 9 weekly PC) had only shrunk by 5 mm, which we were a bit upset about.

After chemo, she had a single mastectomy and full axillary node clearance.

Today we received the results from the pathology report, and the tumour was actually 6 cm, and 4/18 lymph nodes contained cancer. 80% of the tumour was dead, with 20% residual, and they got clear margins.

Not sure how to feel about these results. I'm thinking either they got the measurements of 5cm incorrect, or the tumour grew during EC chemo, and also spread to more lymph nodes?

I'm pleased about the clear margins, but also struggling to understand how the volume can decrease by 80%, but it can also grow at the same time?? all very confusing.

It has been suggested radiotherapy next for chest wall and collar bone, but no mention of Xeloda/Capecitabine, which I thought was given for residual cancer.

Everyone I have spoken to have replied with a sorry/pity look on their face and I'm worried this does not provide a good outlook for the future, especially as cancer in lymphatic system.

Any advice/positive stories of something similar?

Thanks 🙂 x

moth

imaging is frequently not as accurate as the actual surgical excision so size changes post op are normal. Also, imaging cannot see all cancer in lymph nodes - the technology just isn't there. If it's small or the structure of the lymph node obscures it, it will be missed. That's why they do at least sentinel node biopsy at surgery....

80% necrotic is a good sign - sounds like it was dying from within.

re the xeloda, I'm looking at the NCCN guidelines (version 5.2020) and it does say for triple neg with positive node or residual disease "consider capecitabine 6-8 cycles" but that it should be after radiation.

So perhaps the MO just hasn't got to that point yet? I would definitely ask about what the MO is planning.

Don't let it get you down. Plenty of triple negs do very well, even with lymph invasion. Just keep plugging through the treatment.

ClareSim19

Hi moth,

Thankyou for you reply.

My mum has an appointment with her oncologist next week, so will definitely mention the chemo for residual.

I do worry about the lymph nodes, but glad to hear that lots of people do well after lymph invasion x

ClareSim19

has anyone else had positive nodes after chemo?

Nardina

Has anyone considered not having chemo?

I am pt1b n0 m0 surgically excised with +2mm margins

6mm tumor found by mammogram

Beesie

Nardina, welcome!

Your diagnosis is very different than what Claire is talking about in this thread. Rather that take her thread in a different direction, you really should start your own thread. That way, all the discussion will be about your questions. Go to the Just Diagnosed forum here: https://community.breastcancer.org/forum/5 and then click the box near the top of the page where it says "Start a new Topic".