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Roberta2
Roberta2 Member Posts: 106
edited June 2014 in IDC (Invasive Ductal Carcinoma)

More questions:   Path report show lymphatic invasion present but no vascular invasion.  If I understand this correctly, there is invasion so far in the fluid that could lead to the lymph nodes (no lymph nodes taken yet but having another surgery next friday),

First--Path report does not really show the staging yet, not sure if it will when the hormone test, dna analysis, ki-67, etc. is done.  I know if there is an invasion outside of the orginal area, I believe it would be considering stage one now unless later shows lymph node involvement.  Is this correct?

Second--how important is the lymphatic invasion?

Third--What does the DNA analysis show?

The findings show infilitrating ductal carcinoma, intermediate combined score, 1.2 CM size (I believe this means the infilitrating portion is this size), with associated component of intermediate nuclear grade DCIS (this is why they believe recurrence from orginal DCIS) without necrosis. FYI--doc said the infilitrating portion was center of the tumor but located at the bottom of it near the chest wall.

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  • LtotheK
    LtotheK Member Posts: 2,095
    edited May 2010

    Hello, as I'm finding out, I have an extraordinary oncologist.  I was worried about my core biopsy lymphovascular invasion, flipped out, to be precise (I showed positive).  She called on a Saturday night to calm me down.

     Here's the story:  the studies are back and forth, but the latest show that there seems to be little correlation between lymphovascular invasion and reoccurence.  It happens in approximately 50% of tumors.  The nodes are where it's at.  Based on what you are telling me about your tumor, if your nodes come back clean, you will still probably be considered stage 1. 

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  • Tabatha00
    Tabatha00 Member Posts: 133
    edited May 2010

    I'm glad to hear this as well.   I'll spare all the gory details (ha) but after today I'll have 5 more radiation treatments and then I'll be done with cancer.  I'm turning my back on cancer!!!!   I still have to do reconstruction but I told my Dr's there was NO WAY I was going to do it this year.  I'm sick of dr appointments, I'm sick of tests, I'm sick of chemo, I'm sick and tired of being sick and tired!!!!  ha

    My path report said "extensive lymphatic invasion" and was told that is bad.  I'm glad to read that it's not.  Thank you! 

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  • Tabatha00
    Tabatha00 Member Posts: 133
    edited May 2010

    MHP, thank you for the information.  What else ya got?   ha

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  • LtotheK
    LtotheK Member Posts: 2,095
    edited May 2010

    Tabatha, that's the right attitude!

    If I understand correctly, results on lymphatic invasion can be different in core-biopsy and final surgical pathology.  What I'm still very upset about is the waiting.  If you've got lymphovascular invasion, it's a strong indicator for SNB positive results.

    The doc said that tumor size is more important now.  I guess I still have about 40% chance I don't have it in the nodes. In my case, this is all compounded by my relative young age:  39.

    My, I'm so enjoying this disease.

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  • Roberta2
    Roberta2 Member Posts: 106
    edited May 2010

    Received some answers on the tumor testing.  Can someone please help explain all this?  Doc acted like the ER/PR+ is a good thing and will respond well to any type of treatment.  I am worried about the borderline with the HER2.  What does the ki-67 shows, is 59% good or bad?

    Having second surgery tomorrow for reincision for better margins and lymph nodes under arm taken out with open incision this time.

    First cancer=6years ago Stage 0 DCIS double mastectomy (they were unable to get clear margins after three surgeries)

    This cancer= DCIS with invasion outside of the tumor area, lymphatic invasion, CT scan showed no enlarged lymph nodes under the chest wall, bone scan have not received results yet. For now, doc considers me stage 1 but have to wait and see on the lymph nodes.

    ER positive 97% of tumor

    PR positive 74% of tumor

    HER2   2+ bordeline  FISH test has been ordered 

    KI-67   59% high

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  • LtotheK
    LtotheK Member Posts: 2,095
    edited May 2010

    Roberta, why is your doctor not walking you through this?  That is so important...maybe you'll get a call in a couple of days.

    Not an expert here, but the reason ER/PR is "good" when it's positive is they have the drugs to treat it - tamoxifen.  The "triple negatives" don't have additional "insurance" for a better long-term prognosis.

    The simple fact is, no one is 100% sure about how and why things come back, and so doctors are thrilled when they can throw a few things at it to better the chances.  Chemo sounds like a horror show to me, but in my case, it will provide much better chances of non-reoccurance.  Same with radiation.

    Not familiar with KI67 yet...

    I also don't understand how a DCIS can have invasion.  My understanding was DCIS was precisely non invasive.  Congrats on no node involvement!

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  • Roberta2
    Roberta2 Member Posts: 106
    edited May 2010

    MHP70--First we do not know about the cancer regarding lymph node involvement, having surgery tomorrow.

    Regarding the DCIS==sorry further explaination Tumor was DCIS with IDC outside of the tumor area but still in the breast

    Doctor did explain but I was trying to get a clearer understanding on the boards here.

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  • LtotheK
    LtotheK Member Posts: 2,095
    edited May 2010

    You deserve to know everything any way you can find out, we all do.  I get upset when I read people and their confusion over diagnosis--clearly, doctors are doing a spotty job giving full info.  Patients should have a 24/hr hotline!

    Sorry to hear about the nodes, I didn't understand they didn't take any during first surgery.  Wishing you lots of luck.  I am in the waiting game, too, so I understand the fear and anxiety so well.

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