Just got pathology back

chicagogirl52

Hello All - Had my lumpectomy on Jan 3rd. Going in I was diagnosed with Stage 1 IDC, ER+/PR+ HER2- (FISH) with a tumor around 1.8cm. Got my pathology report and they did find that it had spread to the lymph nodes stage IIA: STAGE: T 1c, N 1a, M 0, The report states Total number of lymph nodes examined 5, Number of Sentinel Nodes examined 2. 1 lymph node with macrometastases 1 (>2 mm). Because of the lumpectomy will definitely need radiation. The surgeon still wasn't sure if I will need chemo and said the oncologist will probably order the OncoType test. My oncologist appt isn't until Feb 3rd and my mind is running wild. I was pretty postive going into the lumpectomy so the lymph node spread has me thinking the worst. I'm worried that if I don't do chemo I will regret it and it will continue to spread throughout my body. Just wondering others experience and thoughts?

Thanks in advance!!

NNS121317

Hi Chicagogirl,

My results were similar to yours, positive node with macrometastatses found during surgery. My tumor was 2.1cm, so just a little larger than yours. I had opted for a BMX based upon the location of my tumor (couldn't spare the nipple, lumpectomy would've been quite disfiguring) and family history (but genetics were negative).

The Oncotype score will tell you a lot about the need for chemo...it would be nice if the surgeon ordered it so that the oncologist would have that info sooner, it takes weeks to get the results and as I'm sure you know, the waiting is the hardest part! My Oncotype score was 25, but combined with my young age (42), questionable family history, and very weak PR+ (5%), my oncologist advocated for chemo (tumor board concurred) because he didn't think radiation and hormone therapy would be enough to keep me alive for the long term. As much as I don't love chemo, I'm glad to be throwing everything at this cancer.

Good luck!

LaughingGull

I understand being upset after receiving those results. My surgery also found a lot of cancer in my nodes, and that was after months of heavy chemo. I was very upset, too. So I understand. But the reality is: your cancer is still early stage; you still have a good prognosis; the numbers are in your favor. Your MO has ways to assess whether chemo will be of benefit, given the features of your cancer. Your cancer is hormone positive and you will likely get hormone treatment, which is also a very powerful systemic treatment, sometimes more than chemo. The fact that the cancer is in one lymph node doesnt mean it is all over your body. Even if you had clear nodes, there would be no guarantees of the cancer not coming back later. Some degree of uncertainty was bound to be your new normal in any case. The truth is that you are at risk (some risk, a low risk) of a breast cancer recurrence, for the rest of your life. There is no way around that, and you will be able to live and thrive within that new reality.

Breath. Take it one thing at a time. If your mind is running wild (which I can totally relate to, btw) that is a separate and different problem from your cancer prognosis and treatment. Take it seriously and tackle that separately. Make sure you get help and support, including support groups, anxiety strategies, therapy, medication if needed. Find out what supportive services there are where you are getting your treatment. I promise you that you can and will feel better about all of this.

chicagogirl52

Thank you NNS121317 and LaughingGull for your replies! I have a message into my oncologist to see if they would be willing to order the OncoType test now so that we have the results for my upcoming appt. Its so true we never have any guarantees and I need to keep that in mind. Thank you so much!!