Grade 3: how fast is fast?

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Artemis
Artemis Member Posts: 759

Hello, Everyone ~

Newbie here with a (possibly silly) question.

My pathology report said the cells are "poorly differentiated/Grade 3" which I realize means "fast growing."  The MRI report used the term "central necrosis" which I know means "growing so fast that the blood supply can't keep up."

So, I have a fast growing form of IDC.  I'm wondering just how fast is this thing growing?  The radiologists, etc say there's no lymph node involvement.  I'm meeting with the surgeon on Monday Jan 12, and I guess I'm thinking: "Is this cancer just oozing through my system while I sit here waiting?  What if it's going to be a while before I can have surgery and the lymph nodes get all involved in this thing in the meantime?"

I'm not sitting here going nuts or anything, and I realize everyone's case is different, but I'm curious to know if anyone has thoughts or knowledge on "how fast is fast?"

Thanks,
Artemis

Comments

  • LisaF
    LisaF Member Posts: 200
    edited January 2009

    There are no silly questions!!

    I, too, have IDC with necrosis.  My oncologist says it isn't that big of a deal, but for him, he wanted me to get chemo, even though my Oncotype score was quite low at 14.  It's just one small factor or many, the the necrosis was enough to not just look at Oncotype, but at the size or the tumor and these other factors.  I also don't have lymph involvement, so I just had a lumpectomy in August..  I'm done with chemo and will start radiation in a few weeks.  So far so good!!

    Hang in there and use this board.  You will learn lots and lots! 

  • mzmiller99
    mzmiller99 Member Posts: 894
    edited January 2009

    Artemis, Welcome!  You'll get so much great support and info here, although I may not have too much info, you have my full support!

      My surgeon said mine had probably been growing for 5-6 years before I was diagnosed, and it wasn't going anywhere fast.  I couldn't believe she would even leave it in another minute after we knew it was cancer!!  However, she did convince me that the few weeks I had to wait would make no difference in the outcome.

    Things usually seem to take a couple of weeks to get going, surgery, etc., and it can seem like the loooongest weeks of your life.  Use this time to take bubbley baths, eat expensive chocolates, buy a pretty nighty, etc.  Pamper yourself and prepare for the whirlwind ahead of you.

    Please write back and let us know how your appointment went.

    Susan

  • mom_of_2
    mom_of_2 Member Posts: 347
    edited January 2009

    Artemis

    Same here...onc told me I probably had the cancer for 3-5 years and be patient a couple of weeks. Looking back over the last 7 months of treatment...I can't believe how much I have been through. I knew I was going to have 20 weeks of neo-adjuvant chemo but I needed the sentinel node dissection first. Felt like the world came to a sudden stop as I waited for the call that the first  procedure was on and I had the date to start chemo. The weight of the world was on me as I sat helpless waiting for the "healthy people" to get me scheduled. I want to start chemo so I could feel like I was doing something instead of waiting. This is the hardest part! Try to stay positive and be proactive. You are your best advocate!

  • Estepp
    Estepp Member Posts: 6,416
    edited January 2009

    It really depends on your status. Are you Her2+ are your er/pr+

    I am a grade 3 poorly differentiated and 3cm tumor... mine cancer was not on the mamo or ultrasound a yr ago.. so mine grew fast and my docs moved fast. I was DX June 25th 2008 and had my whole body scanned.. port put in... brain Mri.. and started chemo in two weeks.

    Find out what you are from the path.. and you will know more about how fast is fast....

    Take care of you! You will beat this too!!!!!!

    Love

    Laura

  • MZKITTY3
    MZKITTY3 Member Posts: 5
    edited January 2009

    I TOO HAVE GRADE 3 IDC. I AM SCHEDULED FOR AN MRI ON TUES. IF IM CORRECT IN MY UNDERSTANDING, THAT WILL DETERMINE THE STAGE. I RECEIVED THE RESULTS OF MY CHEST XRAY, AND IT WAS CLEAR. AND I DONT HAVE ANY LYMP INVOLEMENT. MY SURGEON WANTS TO DO SURGERY IN 10- 14 DAYS, FOLLOWED BY CHEMO. BEFORE I MAKE ANY OF THOSE DECISIONS, I WILL BE GETTING A SECOND OPINION. I HAVE AN APPOINTMENT AT UOFM ON MONDAY. I TOO AM FEARFUL OF THE SPEED THIS THING HAS. I HAD A MAMOGRAM IN JULY AND IT SHOWED NOTHING. BELIEVE ME YOU WILL BE HEARING FROM ME DAILY, AND THANKS TO EVERYONE FOR THE SUPPORT. I WILL BE A SURVIVOR!!

  • jezza
    jezza Member Posts: 698
    edited January 2009

    I may be wrong but I think all Grade 3 tumours are classed as fast growing. My path said the same" Grade 3 poorly differentiated invasive ductal carcinoma....also some areas of DCIS.

    My surgeon said if I wanted to get other opinions that a few weeks wait wouldn't affect the outcome.

    I have just celebrated my 17th year since being diagnosed and have had no recurrence.

    As you said Artemis..each case is different but be guided by your surgeon. I'm sure he/she has had plenty of experience in dealing with Grade 3 tumours and wouldn't have you waiting around if it was going to be a concern..although I can understand why you have these queries.

    Hugs.....and just keep asking...as lisa said...there are NO silly questions!

    jezza

  • rsben70
    rsben70 Member Posts: 137
    edited January 2009

    My onc said it really depends on how the cancer acts in you everyone is different a cancer can double insize anywhere from 23 days to 100 days.  mine is growing fast was pea sized in oct in dec it was silver dollar sized

    hugs to all, don't forget to ask questions

  • revkat
    revkat Member Posts: 763
    edited January 2009

    The only way to really know if there is cancer in the nodes is to remove them and have a pathologist examine them. The docs can make a guess from scans and palpatation, but it is just a guess. The same is true of the size of the tumor and even the grade (from someone who woke up with a whole different path report than the biopsy!).

  • DonnaDio
    DonnaDio Member Posts: 905
    edited January 2009

    YES..when i was diagnosed, it was told to me that this was probably in me for about 7 years.I never skipped a mammo since i have this cancer strongly in my family.. maternal and paternal. sides. Also , said though there is  necrosis/comedo  and  have invasive ductal carcinoma,  grade 3, i have some time to make the right deciison etc. Not a year for it would be a greater stage and most likely invasive staged !!  am scheduled for surgery Jan. 20th and the waiting has been since before Thanksgiving!!!

    This all could be different for everyone, i am no pro in this by any means.. this is just what i have learned for me thus far.

    Jezza.. since you are long term survior, what treatment and surgery kind did you have. GOOD for you and still in here helping us new comers!!!

  • Sassa
    Sassa Member Posts: 1,588
    edited January 2009

    You will also be getting a KI-67 score on the pathology (show how rapidly the cells are dividing, anything above 40% is aggressive),

    In my case, my tumor was very aggressive.  It doubled in size in the one month between mammogram and my biopsy.  I am extremely happy I was several months early on my mammogram (had it done because I decided to have breast reduction)and that I opted for an excision biopsy.  Otherwise, I believe I would have been at a far later stage than stage 1 if I had  been on my regular mammogram schedule or only had a needle biopsy.

  • DonnaDio
    DonnaDio Member Posts: 905
    edited January 2009

     Good to know this Sassa. Is the path report with this score come AFTER the surgery ? Good you had it all in enough time and to know it doubled in size in one month says alot also. You having a desire for the breast reduction saved ALOT for you!!!

  • DonnaDio
    DonnaDio Member Posts: 905
    edited January 2009

    Revcat.. GOOD info.!!So after the surgery my oncologist will then read to me the path findings?! Even with  my biopsy report the preliminary report was not the same as the final report!!! What kind of surgery did you opt to do?

  • bre
    bre Member Posts: 89
    edited January 2009

    Hi Donna.  My path report was different from my biopsy report also.  My tumor was grade 3 and very fast growing and was not on any previous mamo.  I felt it just about pea size right before Thanksgiving and it was 2 cm by Jan.  Had a delay in finding out I had a problem but after that things moved very quickly and had the mast and sentinel node biopsy done 10 days later.  Couldn't stand the thought of it continuing to grow and where it might be spreading.  That was 5 years ago almost exactly and I am doing great.  Had no nodes involved and did 4 rounds of chemo.  Am her2+++ but it was before herceptin was approved, darn it.  Your surgeon will be able to interpret your pathology report for you and the ladies here can also help.  Your onc can also help interpret it.  I had no choice but a mastectomy because to remove the tumor and malignant microcalcifications would have only left 1/4 of the breast and what would I do with 1/4 of a breast?  I'm glad I didn't have to do rads.  Good luck to you.

  • jezza
    jezza Member Posts: 698
    edited January 2009

    Donna....I had a mastectomy. I too wasn't given an option because I had malignant calcifications as well as the tumour throughout the breast.

    I didn't have chemo...no further treatment actually. I had no node involvement. I did opt to have a prophylactic mast. 6 months later on the other breast mainly because I was paranoid because I had a family history.

    Probably nowdays they would have given me chemo but my surgeon said he felt it was 50/50 as my tumour, although aggressive was small and the nodes were clear.

    Hope it goes well for you..I agree..my final path report was different to my biopsy report.

    Hugs

    jezza

  • Artemis
    Artemis Member Posts: 759
    edited January 2009
    Hi, All ~

    LisaF, thanks for the reminder that there are no silly questions and for sharing your story.  I'm glad your chemo went well, and best wishes as you begin radiation!

    msmiller/Susan, you wrote: >>Things usually seem to take a couple of weeks to get going, surgery, etc., and it can seem like the loooongest weeks of your life.>>  Oh, I can relate!  I had a meltdown last night that began by my wailing, "I'm so ready for this to be over!!".  And of course, that's kinda sad since I've hardly begun...

    mom of 2, I, too wish someone would stick some chemo in me, cut a tumor out of me, radiate me...just do SOMETHING...grrr...waiting, waiting...

    Estepp/Laura, I don't know yet about HER and ER/PR.  Biopsy report says these tests are pending.

    MZKITTY3,  Good luck with your MRI on Tuesday!

    jezza, I am greatly encouraged by this: >>I have just celebrated my 17th year since being diagnosed and have had no recurrence.>>  Thanks so much for sharing!

    Sassa, I don't know what KI-67 is.  Is that something that will be on the post-op report?  (Oops, I see DonnaDio beat me to the question!)

    bre, Thanks for sharing your story.  I'm glad you're doing well!

    Thanks so much, Ladies.  I cannot tell you how much this board is helping me deal with this, but I'm sure most of you know how I feel.
    :-)

    Artemis
  • DonnaDio
    DonnaDio Member Posts: 905
    edited January 2009

    Thanks Sassa on the aweosme info, on the KI-67 REPORT!!!  That is really necessary to know!!Hope all is well with you now!

    Bre and Jezza.. interesting as we all are kind of sharing a similar cancer journey, not having much of a choice than doin what we have to do with this surgery!! Both of you have been encouraging and feel i am not alone!!!

    This is goin to be the longest week of my life!!!All the info here though is just filling in one more piece to the puzzle!!Thanks for everything. Continued healthy wishes to all here too!!!!!!!And for us who are waiitng.. lets just have a group scream!!!!!!

  • Artemis
    Artemis Member Posts: 759
    edited January 2009

    Hi, Ladies ~

    I met with the surgeon as scheduled on Jan 12, and he apparently thinks fast is pretty darn fast.  He said the size of my tumor, the necrosis and being grade 3 make him think I should have chemo before surgery.  

    He is calling the oncologist tomorrow to get an appt for me.  

    Until now, I haven't been scared, but I'm beginning to get that way.  I think the more doctors I see, the more I'm poked and prodded, the more test results I'm getting...it's making me flat out SCARED whereas I've been only highly anxious and nervous before.

    He also said that BC can spread to other body parts without going to lymph nodes first.  I'd been thinking that wasn't so due to conversations with my nurse during ultrasound, MRI and biopsy.  Any input from any of you will be most appreciated!

     One good thing I did learn today is the biopsy says I'm ER+.  

    Thanks so much and love to all,
    Artemis...ready to join DonnaDio in that group scream!!

  • DonnaDio
    DonnaDio Member Posts: 905
    edited January 2009

    Hi Artemis,

         Everything seems ok in our head until we talk to the DR. again!!!! The only way that works for me, is to stay connected,especially here and taking one step at a time. Your DR. gave you alot of info and it does not mean it pertains to you. You are in good hands and doin all that is necessary to get to the right options etc. The hard part is doin the test part and we of course just want it over with NOW!!!

    Personally, i always thought it went to lymph nodes first too. The way he explained it to you opened my eyes and are any of us really ok as it seems different in the way it is portrayed? Somehow, it all will be ok.  I am still waiitng for surgery and am  a newbie.. i just know how you are feeling and to tell you, your not alone

    NOW go and SCREAM!!!LOL...

  • carol1949
    carol1949 Member Posts: 562
    edited January 2009

    Artemis,  First of all there is no such thing as a silly question.  Well, maybe there is but not when bc is in the picture! I think there is information something to the effect of doubling every 90 days or something like that for tumors.  

    Mammo missed my tumor last year which was 6 cm by the time it was dx by clinical exam by my gyno.  My oncologist explained to me that on mammo it is like trying to find a cotton ball in a cloud!  Sometimes, we just think these doctors are super people and they are "just" people... just like us!   They have been trained to do a job!  Sometimes, they probably get tired and everything looks alike after a while!  I have looked at lots of mammo films.  Easy to see how they get passed by!

    They do say our cancers have been there for sometimes years before discovered.  Unfortunately, our medical tests are not as advanced as we would like to think.  The only tests we have -  pick up tumors, but not cancer cells.  Thermography will pick up hot spots which can indicate cells, but then we have no medical tests to confirm those indications.  On the other hand... the advantage to thermography is at least one can proceed with alternative therapies such as diet and supplements to help destroy the cancer cells.

    Everyone has cancer cells in their body... and with a  healthy immune system, they are sought out and destroyed , but in a compromised immune system they are allowed to grow into tumors.  May I suggest to do lots of research.  I especially like Patrick Quillin Beating Cancer With Nutrition.  He is a former VP of Cancer Treatment Centers of America which unless you are very wealthy, most of us can't afford to go to.  My friend went there and is 10 years cancer free and she did it with supplements and nutrition after surgery.  (No chemo or rads!).  They helped guide her in her initial choices and then she went on her own sources from there. (They did recommend chemo and rads, but she declined having lost a sister to bc and witnessing the tx she experienced.)

    I highly suggest to do lots of research and trust your heart.  I feel knowledge is power and we better have a back up.  Chemo does seem to be the first course of treatment in most progressive medical centers... again, because we have no tests that insurance will pay for that find cancer cells.

    Good Luck but be your own advocate!

    p.s.  you can Google Patrcik Quillin and read excerpt from his book.  I was able to get it from my public library.  (My onc approves of him!)

  • Dejaboo
    Dejaboo Member Posts: 2,916
    edited January 2009

    Welcome Artemis- I dont have anything to add to what others have said.

    I caught this thread because of your name.

    It was my Moms Name.

    It is not very common.

    Seeing it in 'writing'  Just made me smile.

    Good luck at your next appts. I hope you get some Answers.

    Pam

  • senorasue
    senorasue Member Posts: 2
    edited January 2009

    Hi

    I am new here. I was diagnosed 15/12/08 with IDC Grade 3 stage 1  0/11 nodes, clear margins. I had a lumpectomy on 22/12/08. Since then, everything has been OK but Monday I noticed a lumpy area under the scar, just 3 weeks after the op. This feels quite hard and about the size of a large marble.  There is some bruising on my skin over it but I don't know if this is caused by a haematoma or me  keep rubbing at this thing that has appeared. Has anyone experienced this. I rang my breast care nurse who said that she thought it was a haematoma  and to leave it alone until I see the surgeon for follow up on the 26th.. I try to tell myself that nothing can grow THAT fast and it must be what the nurse says..... but I don't know for sure...

  • Sassa
    Sassa Member Posts: 1,588
    edited January 2009

    Artemis,

    I noticed that no one has addressed your comment about BC spreading through the blood without going to the lymph nodes first.

    Your doctor is correct.  Eighty per cent of the time, BC will show in the lymph nodes first so being node negative is still a good thing.  However, it is the other 20% we have to worry about and that is why us early stage, node negative patients still have chemotherapy and take any other drugs (i.e., herceptin arimidex, etc)  that will hopefully rid us of any BC cells floating around the body.

  • rdrake0
    rdrake0 Member Posts: 180
    edited January 2009

    Has anyone been node neg but had bc mast elsewhere anyway?  Anyone had a pt scan and found something there even though they were node neg?

  • elizzim
    elizzim Member Posts: 146
    edited January 2009

    I have the same question:  how often do node-negative but aggressive/premenopausal cancers end up becoming metastatic?

  • lexislove
    lexislove Member Posts: 2,645
    edited January 2009

    Cancer cells can travel through the blood stream  as well ( thats why chemo is given ).

    There are woman who were diagnosed stage 1, no nodes with a good prognosis that developed mets. Then you have women with large tumors, bunch of nodes and are living their life fully.

    I asked the same question , now I say the hell with it. Smile

  • DonnaDio
    DonnaDio Member Posts: 905
    edited January 2009

    Not sure if any of these questions can be answered as it seems all so different for everyone I talk to!!  I have my surgery for a bilat/mx and recons this coming Tuesday and will have more info on the nodes etc to share?!

    Senorasue...after my core biopsy a hematoma as you described appeared on the incision site and is still there, like a marble too! Not being an expert, the timing of it for you sounds like mine. Seeing the DR soon will be good enough timing I would think.

     Healthy Wishes to all and keep the good info coming!!!!

  • senorasue
    senorasue Member Posts: 2
    edited January 2009

    Thankyou DonnaDio for replying. Its good to know that there are  others that  have the same symptoms etc  and we can all relate to each other.

  • IngridB
    IngridB Member Posts: 3
    edited January 2009

    Hang in there....

    I hd to have double mestectomy, in March 2008, had chem,rad and everything in between, and i have been given a clean result , don't be afraid, stay strong and be positive.

  • Rusty123
    Rusty123 Member Posts: 18
    edited January 2009

    Did the cancer show up in your lymph nodes?

  • Artemis
    Artemis Member Posts: 759
    edited January 2009

    Hi, Sassa ~
    Thanks for the info about BC's ability to spread without node involvement.  What you're saying does make sense just as it did when the surgeon was explaining it.  It did catch me by surprise, though, because the day of my ultrasound I asked the Breast Health Nurse about this.  She assured me that:

    1. BC goes to the lymph nodes first. (My question:  "Are the nodes the FIRST place it will spread?" She said, "Yes.")

    2. If it's not in the nodes, it hasn't gone anywhere else. (My question:  "So, if it's not in the nodes, it hasn't spread anywhere else at all?"  She most emphatically said, "No.")

    Ah well.  If it's spread, it's spread.  I'll deal with it as it comes.  After I go have a word of prayer with that nurse, that is.  Grrrr...

    carol1949 ~ Thanks for the info about Patrick Quillen; I'll read up on his ideas.  I've long been into nutrition and vitamins/supplements, so thank you again.

    Let's see, what else...Oh!  I'm meeting with the oncologist on Monday Jan 19.  I surely hope someone will start doing something besides have me fill out papers and be poked at...BRING ON SOME TREATMENT!!!

    Love to all,
    Artemis

    P.S. to Dejaboo ~ my name isn't really Artemis, but it has long been my favorite.  Had I been blessed with a daughter, that would have been her name.  How cool that it's your mom's name; I'm glad it gave you a smile here.  I thought it was a good name to use here because I am ready to hunt down and kill some cancer cells!!

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