If you have just been diagnosed....

Hello girls,

I just received my diagnosis this evening from my internist and I'm so terrified I can barely think.  About 2 weeks ago I had a mammogram after finding a large, spongy lump on my breast a couple of weeks earlier.  I had a cyst in the same breast about 10 years ago and hoped it was just another one.

When the radiologist viewed the mammo, he immediately suggest a sonogram which they did.  He called me into his office and said "You are very, very lucky.  It's just a cyst".  He suggested I have a sono guided aspiration which was done on March 2nd.  The results came back on March 5th saying I had "a few atypical cells" and a core biopsy was scheduled.  I should also mention that the cyst immediately refilled. 

I had the core biopsy yesterday, March 9th.  The cyst had refilled and the radiologist mentioned that it was full of blood.  After the core biopsy, the cyst is now completely down.  The results came back today and the pathology report reads as follows:

INVASIVE MAMMARY CARCINOMA, POORLY DIFFERENTIATED WITH MODERATE LYMPHOCYTIC REACTION.

IN SITU COMPONENT NOT IDENTIFIED

NO DIAGNOSTIC EVIDENCE OF LYMPHOVASCULAR INVASION IS SEEN

FIBROADENOMATOID CHANGE.

ACUTE HEMMORHAGIC AND NECROTIZING TO CHRONIC FIBROSING INFLAMMATION, CONSISTENT WITH PREVIOUS ASPIRATION SITE.

IMMUNOHISTOCHEMICAL STUDIES FOR ER/PR AND HER 2 NEU PENDING.  A SEPARATE REPORT WILL FOLLOW.

NOTE:  POSSIBILITY OF MEDULLARY CARCINOMA OF BREAST SHOULD BE CONSIDERED ON EXCISIONAL SPECIMEN. 

Can anyone please explain this to me.  I'm so confused at this point that I can't think straight.  They didn't stage the cancer and I'm not sure why.  My internist said it's "probably stage 1 or 2" but he has a tendency to be very, very optomistic.  On Monday, he told me there was virtually no chance it was cancer, so I'm not sure whether to trust him.

If anyone has any thoughts, I would be so greatful. 

Thanks.   

Hi Deanna,

Thank you so much for responding.  I'm about a step from freaking out and your post was really helpful.  Thanks for explaining that the staging won't come until after surgery.

My internist is looking for a BS who is part of my medical plan.  He said he'd get me the information as quickly as possible.  Believe me, I will be calling his office tomorrow. 

Regarding the size of the lesion.....I'm pretty confused about that.  The cyst was 3.4 cm.  In the pathology report, it's referred to as a 3.4 cm complex lesion.  Is that the size of the cancer?!?!  OR the size of the cyst that contained the cancer??  Does it even make a difference?  3.4 cm seems very large to me (this thing was HUGE - the size of an egg). 

If anyone has any additional insight, I would sincerely appreciate hearing it!  Thanks again Deanna. 

Kathy 

Kathy ~ Quiet night here on this thread, so I wanted to stop back with a couple of suggestions for you.  First, on the information side of this website, you can search all of the pathology terminology.  I just did that for medullary carcinoma, which I wasn't familiar with, but which seems to be suspected -- or, at least "should be considered" -- for you, and I found out that while it's a rarer from of bc (7%, I believe), the prognosis is excellent.  Also, the fact that you don't have vascular invasion or any evidence of in situ bc is also good.  In other words, it sounds to me like the pathologist who did this report thinks the bc is confined within that one area of concern. ER (estrogen), PR (progesterin) & Her2Neu factors can either be positive or negative.  When you get those readings, which haven't been determined yet -- possibly because the slides were sent to another lab for reading -- those three factors will help determine your treatment.  

The other thing I wanted to suggest -- because this thread is a long, ongoing one, and many women may not check it too often -- is that you try posting your question as a new thread, asking for help interpreting your biopsy pathology report.   I think it will be found faster when not on page 23 of a thread.

To answer your followup question -- no, I don't believe 3.4 cm is the size of your breast cancer.  I believe that's the size of a rather complex lesion that is cyst-like and/or fibroid-like and within that lesion was an area that the pathologist thinks might be a medullary carcinoma. 

Hope this helps a bit more.  I know all too well how shocking and surreal it is to get a bc dx, but hang in there -- things will get better as you get more information.  Not knowing much at this point makes it excruciatingly hard, but we'll be here to help you through this, and it will get better as soon as you know more.    Deanna

Deanna,

I feel like an idiot.  I don't know where to go to start a new thread.  HELP! 

I AM NEW TO THIS SO BARE WITH ME. I WAS DIAGNOSED WITH BREAST CANCER ON 2-13-2009 .I AM SCHEDULE FOR SURGERY ON 3-17-2009,  I'M STILL N SHOCK .BUT I KNOW I WILL GET THRU THIS WITH GODS MERCY. PRAY FOR ME AND I WILL PRAY FOR YOU.

My mother was just diagnosed with DCIS (I think).  My family's a bit lost, and we have no idea where to go from here.  We're kind of in shock.  Who should we go to - we don't even know what kind of doctor we need.  With G-d's help we'll get through this, we just have to find the right messenger ...

Hello everyone.  I was diagnosed in Jan 09 with dcis, had a bilateral masectomy on 2/23/09  where they did find a less than 1 cm invasive cancer. I was hoping to dodge the chemo bullet and will find out on Tuesday what the onc dr suggests.  My breast dr said the oncotype test came back good but I have to talk with onc to find out about chemo.  I am more worried about chemo then I was about having my masectomy.  I have 3 children, 13, 8, and 7 and I don't want them to have to see their mommy sick and bald.  I am sooo glad to have found this group.

I was just diagnosed today with Invasive Ductal Carcinoma and am already leaning (strongly) to bilateral mastectomy.  Was that a hard decision for you to make?  Are you contemplating reconstruction? 

hello deni63, I have some good inspiration for U honey, I am a 15 yr cancer survivor (Praise GOD), I too and I believe all of us here know what your feeling, get your cry out then fight for your life, I found that HOPE and POSITIVE thinking kept me alive.Believing in God is a main stay for me and ALL I go through in life.. My husband was also devastated as we were preparing to get married, But he kept me strong through out the treatments. I had Left radical total mastectomy, with chemo and radiation, and 5 yrs on Tamoxifen God Bless U sweetie, YOU can do it. msphil

junebug40: I know just how you feel.  I am 31 and I have three kids 9months, 4 and 6 and this is all so much to take in when it comes out of left field.  You will be surprised how much strength you have. I never thought I could get through it having surgery, a newborn, chemo, rads, etc. but I did and so far so good.  Wait for everything to come in and then research and try to figure out what the best decision for you is. Best of luck to you. Lauren

hi, im totally new to all this. Im 22 and have just been diagnosed as what im guessing is called stage 1, i dont really understand whats goin on and im very frightened. I dont want to worry my family yet as obviously its not as serious. I dont understand what will happen next, theres been no talk of surgery or chemo just tablets what do these do....can anyone help me understand please????? I wasnt really taking in what the doctor said and i just feel stupid asking people that are going through so much of a struggle and id really appreaciate any advise.

Hi Junebug40 , I just went through this process last year, with the same diagnoses. The first visist with the surgeon and the onocolgist went by with me in a fog, not quite believing this was really happening to me. But by the second visit and talking to others who had gone through this I knew what questions to ask although still scared I was dealing. I did what you are considereing and had them both removed in fear of having to go through the same thing again in another year or two. It has been hard but I am okay. I am also a mother of six ages 23,21,20, stepmother to three ages 19,18,16 I did not want to tell them until later but my daughter was called by a concern friend who heard it from her mother so I had to sit down and explain it. That was harder than anything to do but they became my biggest support group and my strength through this all. If you just keep God first through all of this test you will pass it with all A's.

I've been just diagnosed with mucinous ductal invasive cancer. Anybody know what I should expect? Scared to death & scheduled for an MRI on Monday, worried for my partner.

I did not know where to post this so feel free to copy it and post it elsewhere.  My wife has had chemo, bilateral mystectomy, reconstruction, radiation and now pills for years.  I will be gone for about 10 days so I will reply when I return.  My wife had a 6 cm tumor that did not show up in 15 years of mammograms.  My wife had dense, fibrous breast tissue and was always told that her mammograms were hard to read.  The tumor was hidden like a polar bear in a snowstorm.  About 15% or more of breast tumors do not show up on a mammogram.  The dense fibrous tissue was also difficult to 'read' by touch so that is why my wife and doctors missed the tumor until it was 6 cm.  My wife often heard the doctor state, "It is difficult to examine your breasts" because they were always lumpy.  I think it is malpractise to not have ordered a MRI for dense fibrous breast tissue.  I know there are false positives with MRIs and that many negative biopsies are done after a MRI.  I now know of women whose doctor did order MRIs and some even had them paid for by their insurance.  If my wife's gynocologist had told us that most tumors are found in women with no family history of cancer and that 15% of tumors do not show up on mammograms and that women with dense fibrous tissue are hard to read in all respects and that women with dense fibrous tissue are more likely to have tumors, THEN we would have paid for the MRI.  I think it is malpractise that my wife's gynocologist did not provide her with this information.  My wife does not want to sue because it is not in her personality.  I also think it is healthier to focus on healing than it is to focus on a lawsuit.  For the woman out there that can focus on healing and also sue their gynocologist then please do all women with dense fibrous tissue a favor and sue your gynocologist for not ordering a MRI before your tumor grew large.  The MRI clearly showed the tumor the size of a grapefruit with a net of blood vessels all around it.  It was as clear as a stop sign.  If my wife had a MRI years ago then we would have caught the tumor when it was small.  I know there are other women in my wife's situation and I appeal to them (if it is in your personality and will not hinder your healing) to sue your gynocologist's for not ordering a MRI.  MRIs should be standard practise for women with dense fibrous tissue.  Help make it standard practise by creating as many lawsuits as possible.  You will be saving the lives of women who come after you.  Please post this in any other thread you deem appropriate.  I used to be mad as all hell and now I am at peace that MRIs will become standard practise for women with dense fibrous breast tissue.  God Speed.

I was just diagnosed on Thursday. I'm not sure what stage I am in yet b/c I am still waiting for the completed pathology report.  I went to St. Vincents in NY but have a second opinion at Sloan Kettering this week and I will probably go with them.  The surgeon at St. Vincents told me that I have calcifications throughout so that I will likely need to remove my breast. I am going for a the MRI/bone scan, etc this week. What scares me the most is: (1) whether it has spread and (2) whether I will be able to have children after chemo.  I don't know if the cancer is estrogen positive or negative at this point. I'm 31 and I'm going to see a fertility doctor this week. If anyone has a good fertility doctor in NYC - I'd love to hear about it. The cancer is bad enough but the thought of not being able to have children is just too much for me to take at this point. My husband, family, and friends have been so supportive and I've gotten a lot of great information in the past few days. The waiting is just so hard.