multifocal cancer

Thanks for asking, Jess.  I haven't made my chemo decision yet.  I should get my pathology results Monday or Tuesday and then I'll discuss it more with my oncologist.  Assuming the sentinel node remains negative, we'll do the oncotype testing and then I'll make my decision.  Given my intramammary node involvement and age (41), it seems like it would be prudent to do chemo, but I do want to hear what the oncologist has to say.  I'll keep you posted.

I'm also ER+, so I'll be taking tamoxifen as well.  You mentioned that you'll take tamoxifen for 2 years and then switch to something else.  I thought that it was a 5 year protocol.  What will you be taking after the tamoxifen?

- Lisa

I am glad for this thread.  I have multifocal tubular cancer and had a mastectomy in September (recommended over a lumpectomy due to difficulty reading my imaging).  I am more than a little confused by the pathology report - I am not sure where the second focus of the cancer is.  Emotionally I guess I would like to understand that.  I know my oncotype test result (score of 15) and I'm waiting for my genetic tests.  I see the oncologist on Friday. 

I have been wondering how being multifocal affects my case and it doesn't seem very clear.  It is nice to read about others in the same situation.  

Everything I read says multifocal doesn't affect treatment decisions or staging, mostly just surgical care.  Standard of care for multifocal is mastectomy.  It doesn't seem to have anything to do with chances of getting it in opposite breast, for those who are unis like me.  

*shrug*  I ended up with 3 areas of IDC (one 3.4 cm) along with intraductal carcinoma and invasion into the lobules.  The section of my path report that described my cancer(s) was a full page long!   However, I had no node or vascular invasion, which definitely surprised my doctors.   I'm doing chemo because I'm HER2+ with a larger tumor.  

Don't know about rads yet- looks possible due to a close margin.   Good luck to all my multi-cancer sisters.

True, Luah, my doctor told me the same.  Unfortunately, mine was too extensive.  

Interestingly, my smaller invasive cancers didn't show up on any imaging studies, so without the decision for mastectomy, they might still be in there.  Or, most likely, I would have ended up having two surguries.   It all turned out for the best, for me anyway.

I need advice. I too have multifucal cancer. 2 IDC. After MX path report showed ductal carcinoma in situ, atypical ductal hyperplasia, and other stuff. er and pr +, her2 -  The pathologist ran the fish test, Which came back nonamplified. When i got onco scores back, her2 was neg on one tumor and neutrual on the other.The oncologist is having them run the tests again. When I look at the report, it actually looks like they only ran the testing on one of the tumors. It's late and I may not be making any sense.  It is important to have some understanding of those path reports.

This is my question: when I was first diagnosed, the breast center scheduled me for a breast MRI. When I went to see the surgeon, he cancelled it, saying the MRI are give too many false positives. He scheduled me for a PET scan, which I had. The Pet scan did not even pick up the breast cancers that I had.  So now I am wondering if I should go ahead and have the MRI.  Guess I wonder if something is in my remaining breast.  Although, I have been told statistically it is unlikely. My oncologist said I should have MRI for my peace of mind (he is so nice) I hate being a baby!!! Should I????

My philosophy is that you should push for any of the tests that will give you peace of mind.  My surgeon didn't think I needed a PET scan, but my oncologist thought it would be a good idea, so I had that done.  I was having headaches and pushed them to give me an order for a brain MRI (everything is fine there, by the way).  So you should definitely go for the breast MRI, if your oncologist will write the order.

My surgeon recommended a breast MRI for me because my breast tissue is fairly dense and hard to test with mammogram.  When I had my breast MRI they discovered 2 additional areas of concern.  One was additional cancer in a lymph node (confirmed in a biopsy).  The other was a false positive confirmed by another biopsy.  I was still able to have a lumpectomy with 2 cancer locations in the breast since they were fairly close together.  But I'm glad I knew that the second area was a problem so they could deal with it right away.

Hei Jess! I'm fine. I was on the ALTTO trial, which is testing Tykerb (also called Lapatinib) against Herceptin. It turns out that my arm, Tykerb only, was stopped early because they were having too many "events" (recurrances I assume) on it. So all of us on the arm have to start a whole year of Herceptin even if we were long done with chemo (I was done 18 months ago). I was first very upset about the Tykerb doing badly because I was always worried about being on that arm. But then I realized I really come out ahead, being able to take both drugs in the end. I've had 2 Herceptin infusions so far and have hardly any SE's.

I know what you mean, Jess, about worrying over check-ups. But as my onc said to me, "we really aren't worrying about recurrance in the other breast. It's elsewhere we worry about." I try to remember that when I'm nervous for the mammo or think I feel a lump. Do you know if we have a higher chance of a new primary in the other breast? I mean, with multi-focal BC we have proved that our breasts are good at making cancer...

Also, I've been wondering, would the blood work at our check-ups show if we had gotten mets or is it just to keep track that we have recovered from our treatment? I mean, if it doesn't show anything, then there is no need to get nervous about the appointment. But then the only way we would know that we had mets is by symptoms and I'm already convinced nearly daily that my cough or my sore back or the bug bites on my neck etc etc are mets....... I'm getting better though with the 2 week rule and not letting myself worry until something gets worse. 

Jess, good luck with round 2 of your check-up and report back. I'm also wondering how our other mutil-focal friends are doing.

Jess- There is a discussion on the stage III forum about multifocal and survival. Why don't you come and join? http://community.breastcancer.org/forum/67/topic/776945?page=1#idx_14 We are all trying to figure out how much difference it makes....

Hello All -

New to the group.  Multi-focal was mentioned with an MRI, as 2 lesions were found.  Biopsy showed DCIS as well as IDC.  I'm not sure what qualifies as multi-focal, I guess BMX this week will give the final story.   

So ready to give these puppies away - they served me well nursing 2 kids, but the message is loud and clear that it's time for them to go.  Anxious to get on with surgery.

jrgolomb -

So it seems that I do have multi-focal, since tumors are in 2 different quadrants of one breast. From my diagnosis to surgery date, it will be almost 5 weeks - a really long time to wait!  I am doing okay - just ready to get this over with.  Thank goodness my hubby arrives today and will be with me for surgery and a few days afterwards.  

I didn't realize that mulfi-focal BC was rare?   When was your surgery?  Did multi-focal decide the course of treatment or the MX procedure?  

Wishing you continued health.  I'll check back after surgery.