Tumor size significance?

Tiny tumors, if very aggressive, can be far more lethal than larger tumors.  I noticed you, as myself, are triple negative.  My tumor was 1.2 cm when removed, and I have no node involvement, but just due to the fact that I am triple neg, and our cancers can be a lot more aggressive than other types, I am going aggressive in my treatment as well (providing I live through the damn stuff!).  All the best to you -

Linda

thenewme, I've been trying to figure out how to answer your question. Let's see how this goes...

First, the size of the tumor is important. A tumor might be large because it has been growing for a long time, or it might be large because the tumor cells have been dividing very quickly. Also, when a tumor has been able to grow to a large size, that usually means the tumor cells are "happy" and are not having any difficulties.

Conversely, a small tumor could be one that has not been growing for very long, or that contains cells that are dividing very slowly.  It is also possible that the cells in a small tumor are not doing very well (maybe they are under attack by the immune system?).

But, size is not everything.  The "grade" of the tumor helps to explain how the cells are behaving--how quickly are they dividing, and how "normal" is their growth pattern?  A tumor might be very large but contain cells that are barely dividing and that look pretty much like "normal" breast epithelium (i.e., a "Grade 1").  A tumor could be small but contain cells that are dividing quickly and behaving as if they would invade surrounding tissue in an instant (i.e., a "Grade 3").  So, a small, Grade 3 tumor could pose a greater risk than a large, slow-growing, Grade 1 tumor.

Tumor size can sometimes be used as a predictor of the risk of spread of the tumor.  Again, in general, the larger the tumor, the greater the risk that some of its cells have been able to escape to the lymph nodes and even into other organs.  That's why chemo is often given to women who have large tumors, even if their nodes are negative.  That's also why, statistically, it's more likely there will be positive nodes in someone with a large tumor, than a small tumor (all else equal, which of course it never is).

In your situation, there was a lot of evidence that pointed to a high risk of spread.  Your tumor was not only large, but it reached that size very quickly.  That behavior was consistent with the fact that it was a Grade 3 and ended up being triple-negative. So, in your case, chemo was hugely important, to protect you against the possibility that cells had already escaped from the main tumor ... even if they weren't found in your lymph nodes.

Is that the sort of thing you were wondering?

otter 

My tumor was also large.  4 cm.  I noticed the "lump" (which of course I thought was just scar tissue from a lumpectomy I had in that area 13 years prior) about 4 months before my dx.  It too grew quickly.  In inches it was approx. 1 1/2 inches.  It was a grade 3 - er/pr negative but her2 positive - hence the quick growth.  I, too, had clear margins - no vascular invasion -  we were told at surgery the nodes were clear - but when pathology report came back they did find 1 microscopic cell (.085 cm) in the first node - second node clean. 

I am approaching my 4 year cancerversary the end of this month and to date I am NED and doing well.  It is so confusing how cancer operates.  Why some of us do well for so long when it looks like the odds are against us and why those who seem to have better odds do poorly.

Just thought I'd chime in to this thread.

Mary Jo

.085cm ?!  Stupid cell.

Otter, thanks again for your input ...your a lot better with your words than me. Perfect explanation!

Hi I am just recently diagnosed with BC 29.04.09, but when I felt my lump end of feb  I went to Gp and had a ultrasound the first week of March the lump measured 2.5 cm  and was also detected in my nodes under my arm.  I was referred to the Breast clinic at our hospital and saw them 15.04.09 it measure 5 cm on a the ultrasound.  When they measured me again 2 weeks later it 5.5 cm.

I was told my cancer was too aggressive and needed to stop it growing, and try and shrink it before I have my masectomy.  So I started Chemo, just had my second session today.  Saw Onc today and informed it has stopped growing and has shrunk already, responding very well to the chemo and she is hoping in 3 week (for my next session) it will have shrunk 50%.  I also got Ct and bone scan results.  My cancer has not spread anywhere else though.  That was my biggest fear.

It will be different for each of us. Really interesting read Otter thank you for sharing.