IDC of breast

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Renia
Renia Member Posts: 15
edited June 2014 in IDC (Invasive Ductal Carcinoma)

My mom was just diagnosed with Invasive Ductal Carcinoma. I have researched it, and found it to be the most common type of breast cancer. We have an appointment with a surgeon tomorrow to know what surgical options are available ( mastectomy vs. lumpectomy?) I have the patho report and it says: Nottingham Combined Grade I/III. Grade is based on the following histo score:

tubule formation 2/3, nuclear pleomorphism 1/3, mitotic activity 1/3. Microcalcifications present.

They have sent for ER/PR and Her2neu, so we do not have all the results.

Question I have why they did not include a stage of the cancer on this report what does I/III mean?!

I know that 4/9 or even 5/9 means low grade but how does this translate into treatments? Is she going to need chemo or radiation or both?

I am nervous, and I know we have to wait until tomorrow, but can anyone ease my anxiety in the meantime?

Just want to mention , my mom does not speak English well, so I am the main point of contact and health rep for her. Just want some answers, please anyone I welcome your opinions.

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  • bre
    bre Member Posts: 89
    edited February 2009

    Hi Renia, 

    I know that grade 3 is an aggressive grade.  Not sure what the combination is.  Have you checked this site for the link on pathology report?  They can't put a stage to the cancer until you have the surgery, nodes checked, and other scans done.  Biopsy pathology sometimes differs slightly from the final pathology.  If she has a lumpectomy then she will also need to have radiation.  One thing to ask is how much of the breast would be removed and what the look of the remaining breast would be.  That may influence the decision on whether you want a mastectomy or lumpectomy.  For me, 3/4 of the breast would be gone after removing the tumor and microcalcifications, including the nipple and what would I do with that?  So a mastectomy was the only real option.  Chemo decisions depend on the size of the tumor, grade, node involvement, and er/pr and her2 status.  Hope this helps a little.  Brenda 

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  • Renia
    Renia Member Posts: 15
    edited February 2009

    Hi Brenda,

    Thank you for the information, in her case as the initial suggestion from the surgeon stated, she is not a candidate for breast preservation ( similar situation to yours, too much would be taken out for it to make any sense cosmetically). I have checked the site for pathology report, but it does not tell me anything about the I/III, I guess we will find out today. And thank you for clarifying the rest, from what I have researched, it looked like we will have to wait after the rest of the results are back and the surgery to know about the chemo.Thank you for your response, this whole thing, even though we expected the results to be what they are, is still overwhelming.Renia  

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  • unlimited
    unlimited Member Posts: 327
    edited February 2009

    Renia -- as you stated above ....

    I have the patho report and it says: Nottingham Combined Grade I/III. Grade is based on the following histo score: tubule formation 2/3, nuclear pleomorphism 1/3, mitotic activity 1/3. Microcalcifications present.

    The Nottingham scale can be of Grade 1 ( or Grade I ) -  Grade 2 ( or Grade II ) - Grade 3 ( or Grade III )...... so what the report is saying is that your Mom's tumor is a Grade I/III meaning its a GRADE 1 out of a possibility of Grade III ( Grade 3 )   its a SCALE  ...... just like the tubule formation is 2/3 .... ( that could have been 1/3 or 2/3 or 3/3, the same goes with the rest )

    Then the COMBINED total scores of Tubule, Nuclear, and Mitotic is based on a range added  to a total potential of score 9 ......... your Mom has a combined score of 4/9 .... and that translate into a tumor grade of I/III  ( Grade 1 out of the possibility of Grade 3 ) for this they use ROMAN numbers ... yet use the numbers for  Tubule, nuclear and mitotic  !!!!

    I'm probably too wordddddddddddddy   lol --- but a breast tumor can be 1 of the following ...Grade I/III  OR Grade  II/III    or Grade III/III   your mom has a Grade 1 tumor  .... a slow growing, less agressive cancer....................

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  • Renia
    Renia Member Posts: 15
    edited February 2009

    Thank you, that makes whole lot of sense! I was concerned about the Roman numbers, as I could not find any explanation anywhere of what it means. Today the visit with surgeon, I am expecting him to confirm what we already know, but I also understand that a lot is left out until they have the patho from surgical specimen. So basically until it is out, we do not know the lymph node involvement, etc. By the end of this week we should be getting ER/PR and Her2neu. Thank you, for all info.

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