multifocal cancer

Hi all!

I'm new to this site. Three days ago I had a mastectomy of my left breast and a lumpectomy on the right. The SNs were taken out and looked fine. Whew! Of course, I have to wait for the pathology results after the surgery, but the mammos/ultrsounds/biopsies/MRI showed 2 tumors of IDC (grade 2 or 3) of 2 cm. each in different quadrants of the left breast and a very small IDC (grade 1) tumor in the right breast. The surgeon said that there was no reason to do a mx on the right since it wasn't an agressive cancer type. What do all you other multicentric women think? I am also a little confused as to whether it always is hard to see DCIS on MRIs and mammos? It seems, from reading this forum, that DCIS often "pops up" when they do a mx instead of a lumpectomy. 

Otherwise, I'm doing fine- drain out yesterday (and not a moment too soon!), home from hospital today. I feel kind of banged up but don't need any pain medication any more. It looks like my future will be FEC chemo (because multicentric), rads (because of right breast lumpectomy) and hormone therapy. Fun, fun......

Hi jrgolomb-

Was your pathology report after the surgery about what you had expected from the mammog/ultrasound/MRI  that you took before the surgery? I won't be getting my post-op reports until 3 weeks from now so I'm just wondering how often there are suprises.... Especially with multifocal cancer, which I understand is somewhat unusual.

My breast cancer is also multifocal and my Dr. has me doing chemo x8 followed by surgery.

Hi,  I had 2 masses, 1 at 5 and the other at 6 o'clock.  and multifocal I think they wanted to shrink things.  I get a little confussed at times.  It's like learning a new language. 

krcll-

i have a 1.1cm mass in the 6o'clock and a1.0cm mass at the 5 o'clock.  it showed infiltering ductal carcinoma, the grade not stated.  there was some associated dcis. er/pr pos her2 neg.  sentinal biopsy neg.

Interesting reading all these posts... and how often the outcome has been mas, even bilat mas. I have multicentric IDC: 2.6 cm at 1:00, 1.5 cm at 11:00. Because of their proximity, BS is offering lumpectomy and rads or mas - my choice. I'm leaning to the first.

I'm meeting with her tomorrow and here are my questions: how would procedure be done (single incision, remove tissue between tumours as well as tumours and get clean margins)? if so, what would reasonably be left?  (I have medium sized breasts, the cancerous one is the slightly larger one). How much scarring is likely to result (obscuring future scans)? how often have your encountered this situation and what have been the outcomes? would it make sense to do chemo to shrink them first? on SNB, is sentinel node the same for both tumours? what on the MRI (scheduled for Oct. 5) would tilt this to mas?  

I'm sure I've forgotten some questions -- what else would you ask? or wish you had known? Deeply appreciate any suggestions you may have on my line of questioning... thanks in advance.

Thanks Jess.  I met with BS today and got all my questions answered.  Still leaning to lumpectomy (yes with rads and probably chemo too, given stage 2 at least), but it will really depend on the MRI results; if that shows more cancer, then I won't need to choose - the mas it is. Have to wait til Oct. 3 for an MRI and end of October for surgery - would dearly like to get that moved up. 

It's great that you had the benefit of the whole team before your surgery; the practice here seems to be to do surgery, then refer to oncologists. And apparently trying to coordinate a PS with a BS can take quite awhile - just don't feel I want to wait any longer.... 

I have multifocal too - 2.4 cm IDC at 7:00 with another area right there of "something," possible DCIS, making for a total of 4.5 cm, extending to the mediial breast area near the nipple. Also have LCIS.  MRI was not conclusive in pinpointing location - so having an MRI-guided core biopsy tomorrow.

Onc thinks shrinking it down first won't help, so it's either mastectomy or lumpectomy, depending on tomorrow's test.  I VERY MUCH wanted lumpectomy which is why this one more test -  but I know it's going to be mast.    I feel more thickening and lumps than before.

Good news was even with LCIS, my left breast is clear.  (It's my right one that's infected.)

I've been waiting forever and yes, like Luah, now I have to wait until the sugeon coordinates with PS.  I'm ready to get it done, whatever "it" is.

I also had multifocal cancer.  Two tumors 1.2cm  and 1.8 cm very close together.  I had DCIS in a different quadrant though and nothing in my right breast.  I had chemo first.  They were trying to shrink the tumors but the DCIS threw me into a mastectomy anyway.  I am now 2 years out and doing well. 

Jess, what did you decide to do about chemo.  I think your situation might be similar to mine.  I had a lumpectomy on 11/20 to remove my 1.1cm tumor and my nearby intramammary lymph node.  Surprisingly, my sentinel node came back negative during surgery (although final pathology is not back yet).  Assuming the sentinel node comes back negative on final pathology, my oncologist said we will do oncotype testing to determine whether chemo is advised.  However, I had a consultation with a radiation oncologist (different than the one I am using) and she thought I definitely should have chemo based on my age (41) and the intramammary node being positive. 

What did you decide to do about chemo?  And how did you decide?

I was dx in Feb with multifocal IDC aged 40, I discovered a lump myself (2cm)  on Mammo and ultrasound another 1.5cm tumor was discovered, not able to be felt. The tumors were close together, one 4cm from nipple one 1.5 cm from nipple in same quadrent so I had a lumpectomy and node clearance - 2 positive nodes. I am triple positive so I did Chemo ACx4, followed by 12 weekly taxol, Herceptin, 6 weeks of Rads and now on Arimidex as post menopausal from Chemo, may need ooph if hormone levels rise.