What Stage is my Mom?

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lieberman1
lieberman1 Member Posts: 42

My Mom was diagnosed in June with IDC BC.  She had a bi-lateral masectomy a little over a week ago.  I got a copy of the pathology report and it does not say what stage she is.  The report says she has IDC Nottingham Grade 3.  Ductal Crcinoma in Situ Grade 3 with Comedo Necrosis Comprising 20% of Tumor.  Her tumor size was 2.0 cm and proximity to margins was 2.2 cm to deep margin.  Extensive intraductal component status was absent.  Vascular invasion identified.  Calcification Identified.  Skin and nipple free of tumor.  Surgical Margins free of tumor.  Metastatic carcinoma in twenty of twenty three lymph nodes with extranodal extension size of largest tumor focus is 1.0 cm.  Non-Neoplastic breast with Fibrocystic change.  TNM Stage:  T1, pN3a,mx.    Can anyone tell me if you can tell what stage she is based on the pathology report?

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

    Hi there...

    First I'm sorry about your mother. This is a great place, and you will find a great deal of info. To answer your question....your mothers breast cancer is ADVANCED.

    A 2 cm tumor is small..BUT 20 out of 23 lymph nodes containg cancer with extranodal extension would put her at stage 3. To be more exact, stage 3C. 10 or more lymph nodes involved is stage 3C automatically.

    The "T" = tumor size, "N" = nodal status, "Mx'= Distant metastasis (cancer has spread to other organs in the body)

    Here is a link to help explaine...hope this helps.Ask lots of questions!

    http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

  • makingway
    makingway Member Posts: 799
    edited August 2009

    I don't remember the size indicator for the T value. I think pT0 is the smallest size of tumor and it goes up from there. My tumor was 4.0 cm and my T value was pT2. The N indicates how many lymphnodes were positive. Your Moms would say pN20a if she had 20 positive nodes. The pMX is what it says on my pathology report. It's an indicator for the cancer metastasizing to another location in the body. I don't know what it reads when it's positive for that. My report shows pMX and from what I was told there is no metastasis. The grading system is called AJCC Staging. Google that, I'm sure you will find it on the web.

  • lieberman1
    lieberman1 Member Posts: 42
    edited August 2009

    Thank you for your honesty.  We lost my sister-in-law 10 years ago to breast cancer and she was a 3b.  I hate this disease!  I am not ready to lose my Mom and I don't want to see her go through this.  I am afraid to find out where it has spread to.  My sister-in-law's spread to her brain and it was so hard.  We have an oncology appointment on Friday.  Do you know if they will tell us where it may have spread to or if they will order more testing?

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

    Your mom will need nore tests. Perhaps a CT Scan, PET scan and bone scan to determine so. Lets hope she is clear. They should be ordering more tests, follow up with them.

  • lieberman1
    lieberman1 Member Posts: 42
    edited August 2009

    I will ask about the tests at our appointment on Friday.  I wish we had known about this site when my sister-in-law was going through everything.  Thank you for all the information and for responding so quickly. 

  • jrgolomb
    jrgolomb Member Posts: 1,236
    edited August 2009

    I thought the Mx meant they hadn't tested for distant spots and won't know till they have a ct or pet scan.......

    Lieberman----hugs and yup, this disease SUCKS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  • KerryMac
    KerryMac Member Posts: 3,529
    edited August 2009

    You might also want to check out the Stage 3 forum for advice and read some uplifting success stories. All the best....

  • dlb823
    dlb823 Member Posts: 9,430
    edited August 2009

    lieberman ~  I'm sorry about your SIL, but please don't lose hope or assume your Mom's bc will follow the same course.  If you check the Stage 3 forum, you will see that many women with multiple positive nodes have become NED (basically disease free) and are doing very well many years after their dx.  One of the keys is proper aggressive treatment, which it sounds like she's started with the bi-lat mast.  Hormone status also plays a key role.  Some bcs are harder to treat because they don't respond as well to chemo or hormonal therapy.  Another thing to keep in mind is that not all oncologists will recommend the same chemo.  As others have said, your Mom's situation is serious, so depending on where she is being treated, I would consider getting a second opinion from a major university teaching hospital if she isn't already at one of those.  I say that because they see far more bc in every stage, so have the most experience figuring out what works for different situations.  They also have the latest trial drugs available, which may or may not appeal to your Mom, but can be an option.  Here's a list of the NCI-designated cancer centers.  If you're not near one, they can sometimes offer a second opinion -- even by mail/phone, if necessary -- that you can take back to her local docs to be sure she gets that level of treatment.  I personally switched my care from very fine local facilities to an NCI-designated place midstream in my treatment, which is why I am so high on the facilities listed here:

    http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html

    In addition to the treatment protocol itself, your Mom needs an expert team of bc specialists who are so ultimately capable and confident that and can instill that belief in her.   

    Please stay with us and let us know how else we can help ~  Deanna

  • lieberman1
    lieberman1 Member Posts: 42
    edited August 2009

    I really wanted to get a second opion from the Revlon Center at UCLA.  My Mom has Kaiser and I don't think I can do that.  I really would like advice if any of you know how the Kaiser system works.  I feel like I am stuck with her getting treatment there and really have no other options. 

  • dlb823
    dlb823 Member Posts: 9,430
    edited August 2009

    lieberman ~  There was a very recent thread here about your exact question.  I'll try to give you a link to it, but if it doesn't work, the thread is entitled "TROUBLE GETTING REFERRAL FROM KAISER IN CA," and had some excellent suggestions.  It's in the Breast Construction section, and I'll go and bump it for you now so that it should be near the top of that section.

    http://community.breastcancer.org/forum/44/topic/737472?page=1#post_1449648

    UCLA is where I went (I'm in the Palm Springs area), and I can't say enough wonderful things about the doctors there!       Deanna

  • Aliceann
    Aliceann Member Posts: 62
    edited August 2009

    lieberman1 - You really should ask the oncologist your questions.  They are the experts and this should be explained to your mother and yourself.  I am blessed having a great guy oncologist on my side, but he would never stand in my way if I needed a second opinion, and nor should yours.

  • lieberman1
    lieberman1 Member Posts: 42
    edited August 2009

    Hi Aliceann:  Thank you for responding.  We went to the oncologist but before going we realized Lexislove was correct and she is a 3C.  The oncologist confirmed it and he actually seemed to be hinting the worst is yet to come. I appreciate your advice and I am talking to my Mom about getting a second opinion.  We are getting alot of xrays and scans done and will be done with everything on Friday.  We go for the results next Wednesday and after that I am hoping she will agree to let me take her to UCLA for a second opinion.  We will have to pay for it out of pocket as her insurance is Kaiser.  Going outside of Kaiser is not covered.  I don't really see the benefit of getting a second opinion from Kaiser as I assume they will be pretty much the same.  

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