The pieces of this puzzle don't fit!

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pitanga
pitanga Member Posts: 596
edited June 2014 in Second or Third Breast Cancer

Ladies,

I´ve just gotten the path report from the mastectomy performed to rid me of the recurrence I was dx´d with in early February, after 9 years NED.

The report says that the tumor was adjacent to the scar tissue of my old lumpectomy, thus confirming my suspicion, shared by all 3 of the drs who saw my MRI and biopsy report, that the tumor is a residual one that somehow escaped all previous interventions (lumpectomy w clean margins, chemo and rads). In fact, before I had rads way back when, the radiation onc saw some calcifications on my mammo that she thought were suspicious...i went throughumpteen attempts to biopsy the buggers but they were so small that they never managed to poke them and eventually gave up.

My new path report also states that there is both DCIS (already seen in the biopsy) and also invasive cancer that they described as tubular. Tubular breast cancers are rare and, supposedly, among the most docile and slow-growing, with the smallest chance of metastasis...

Meanwhile, before my mastectomy they found a problem on my C6 vertebra, affecting both disc and bone and also the disc of the vertebra below, "assymetric and highly suggestive of metastasis." A second MRI confirmed the results of the first one, including the ambiguity in the image. They started me on zometa while i ran aqround getting other opinions. So far 3 oncologists have looked at it, all agree that it is not conclusive but should be treated as a metastasis anyway. There was some discussion of biopsy which they eventually discarded. Radiation is now the unanimous choice.

So then my path report comes back suggesting the present breast tumor is such a mild-mannered beast that it would never ever leap out of its cage...

I´m now completely confused. I had chemo 9 years ago, during my 1st round of treatment, what my onc described as "the hard stuff"-- 4 rounds of A/C followed by 4 of Taxol. Yet this so-called "civilized" beast not only survived it, it also went on to set up a franchise in my spine...

Anyone out there have any insights or similar experiences?

Lisa

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  • Crystalady
    Crystalady Member Posts: 133
    edited April 2009

    Hi Lisa,

    I had a similar experience. It came back in the L4 Vertabrae 10 yrs after initial BC. I had a biopsy done which showed it was low grade ER+ . This happened Dec 2008. I had radiation and am now on Femara & Zometa.

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  • Reneepals
    Reneepals Member Posts: 2,196
    edited April 2009

    Lisa,

    I had a very rare type of breast cancer. Usually, older women get it. It is called mucinous colloid, mine was slow growing and is not supposed to metastasize. I had the hard stuff followed by rads. I now have mets to a rib and liver. I am doing really well on Lupron & Femara

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  • pitanga
    pitanga Member Posts: 596
    edited April 2009

    Hi everyone

    My internet was on the blink for a few weeks so I´m just now getting back into action. In the meantime my immunohistochemical analysis came back. Like the first time around it was Grade 2, mixed IDC/DCIS, er+ and pr-. The first time around it was growing fast (>50%) but HER2 -; this time the growth rate was <10% but it was HER2 +. So, I´m more confused than ever---growing slowly but aggressively??? I dont get it.

    Hopefor30, they believe this "new" tumor is a recurrence because it was immediately adjacent to the scar tissue of the old lumpectomy. But the first time around there was no mention of tubular structures. I asked for another analysis of the slides with a more quantitative statement of how much tubular, how much DCIS/IDC, etc but am still waiting for that info...

    Reneepals, I hear what you are saying. I guess the bottom line is that cancer's behavior still defies the logical arguments we have constructed in our attempts to explain it...this is where a lot of us fall through the cracks. Sigh.

    Lisa

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  • sian
    sian Member Posts: 23
    edited April 2009

    Hi Lisa

    During this last set of tests I had my breast care nurse was telling me about a client of hers who had a long delay between original diagnosis and bone mets in the spine, she was diagnosed with mets 4 years ago and is doing great, still working as a nurse in the local hospital.  I also know another woman who has had bone mets for 5 years and is still going strong.

    I'm not sure I understand the tubular thing properly, as I havent paid too much attention to it since my first diagnosis, but I think its a grading criteria, they are all tubular to a greater or lesser extent, and how tubular they are is one of the three components of grade, the more tubular the lower the grade potentially but there are also two other factors, I think they are how quickly they multiply and how similar they are to your own breast tissue, so it depends on all three. If anybody out there is more familiar with this subject, please correct me.

    My reoccurrence is also different to my primary tumor, my first tumor was ER/PR ++ Her2-.  My current tumor is ER+ PR- Her2 not out yet, but while I kept quoting my first tumor histology, he insisted on making a distinction and emphasised that they will not necessarily be the same. What was her2 neg might now be her2 pos.  I read a study on line about two weeks ago which looked into local reccurrence and histology, and I think that there was a high percentage, around 50% (dont know exactly) that were different to the primary tumor, the her2- to her2+ being one of the things which switched, as well as ER/PR status. I'm not sure if the Her2 gene implies a more rapid cancer, or just a more persistent one, that was before herceptin of course.

    As my doc insists its in breast tissue and implies a local reccurrence not a second primary I can only assume that tumors (like a virus) adapt to their surroundings and treatments thrown at them, and change their habits in an attempt to survive.  Luckily we can adapt our treatments too in order to thwart them.

    Please forgive me if this info is not accurate and I would like to hear from anyonewho has a clearer  understanding of these issues.

    All the best with your forthcoming rads I hoe all goes well.

    Hugs

    Jane 

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