Node Question-So confusing

Hi Pure,

It's the number of positive nodes, not the number removed, or its a tumor greater than 5cm with any positive nodes.  Or it can be the location of the positive nodes ie. supraclavicular or infra-mammary.  Or it can be the condition of the positive nodes ie. clumped and matted together etc.  Any one of these factors can result in a Stage 3 dx.  So yes someone with less than 10 positive nodes can still be Stage 3.

Here is a good link on staging:

http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page2

Pure-What is it that worries or confuses you? You know how many of your nodes were removed and how many were positive as well?

Sherri-You answered my Q about "extra-capsular" today on another thread -is this what krcll-is referring too-when a node is increased in size (2mm). So with one of my nodes (bing 3cm) in size, I would have also likely had extra-capsular? right??? I have never been given a copy of my path report (yet). I have only read the Onc's consultation reports that was sent to my (work-benefit company). I copied and read these (limited reports) before mailing them out. I was told that I would have to pay $50.00 to get copies of a limited amount of paperwork (path report, reports of scans). Once the $50.00 was covered I would have to pay another $50.00 and have a credit -until it again runs out for copies of my reports. I just haven't been bothered to shell out that kind of $ (yet) but I will one of these days. But I am also one of those people that get caught up in detail-and reading my reports I will GET caught up on every terrifying term and have it tatooed in my mind forever!!!

medigal, I would ask your onc for copies of all pathology reports and start a file with them. it will help you research your specific cancer.

Grade: tells you how much the tumor cells look different from normal cells  They usually know the grade after the inital biopsy. http://www.breastcancer.org/symptoms/path_report/the_cancer/grade.jsp 

Stage: is based on the size of the tumor, whether the cancer is invasive or non-invasive, whether lymph nodes are involved, and whether the cancer has spread beyond the breast. They don't know the stage until after main surgery (lump or mast). http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

Sheila

all i know is my surgeon told me that even tho he only got 12...and i had 10 totally encased...he was pretty sure i had more positive nodes then what came up on the surgery and pathology report.

My BS told me every woman has a different amount of nodes in the Level 1 and 2 node chains. She said she's seen as few as 9 and as many as 29. Can really make things confusing.

Yeah, my surgeon said the same - no two sets of lymph nodes are the same.  If you go by %, my 5 out of 32 looks pretty good at 16%, but if you add in the extracapsular invasion (though not sure with how many) and the 2.6 cm tumor in one of my nodes, it's not so good.  Maybe just a little fully-contained cancer in twice as many nodes would be better?  It probably just depends on exactly how each individual lymph system was set up, you know?  The classification system seems crude when you really look at all the possibilities, but I guess they need to start somewhere.

Thanks ladies for your info. Geesh....thought I needed big gloves for this fight already for...large tumor, HER2+, node involvement, vascular invasion and now I am not even sure about this new term I just learned from you ladies (EC)??? At this point I 'm not sure I wanna know if I have this to add to my list! By the looks of the node %  8/8+ guess I am looking at 100%. Guess it is what it is...and It will be what it will be. CANCER SUCKS!!!

Thanks Sherri and LindaLou for your words of encouragment!!! I don't mean to be a "Debbie Downer"-but the past few days have been really hard. Just lost a friend (44) to a 4 year battle with Stage 4-Colon Cancer.  I also had a follow-up MRI -at my request to look at my spine (due to conflicting CT Scan and Bone Scans) that were done in April. Had the MRI Thursday afternoon-so I am expecting a call from my Onc's office any day now with results. Scared and frightend!

My BS did an axillary dissection at the time of mastectomy as we knew that there was node involvement from MRI and 2nd round of biopsies....don't know how many nodes were take at the biopsy as don't understand all the goobly gook in the path report...BS said she was only taking the 1st layer of lymph nodes (we have 3 layers) to help reduce the risk of LE... I had 8/12 positive nodes....she said that we all have different amounts of lymph nodes in each layer....we asked onc about this.....what if more nodes were positive but not taken out since only 1st layer taken....he said that it did not matter since I did chemo and rads and probably got them all with both of those....I am 4 years since finishing chemo and still NED.....it is all so confusing....I've tried doing some of the "calculators" and they just confuse me more.....before MX, I was stage 2B, after MX, stage 3A because of the number of positive nodes....just re-read my pathology report from both biopsies and Mx and cancer was ILC and IDC with ALH andf ADH.....none of the tumors were large in themselves, but the number of tumors in the breast is what added up...I was staged 3A....one more positive node would have been 3B....does that really matter????  My onc has given me all the Tx that were available....bilat, TAC chemo, rads, ooph, AI's (only stayed on for    3 1/2 years...taking a break right now for almost 4 months),,,while on AI's I also took Actonel...onc believes that the Actonel gives a lot of benefit and does not think that Zometa is necessary....since I have no desire to be in the infusion room....I have not pushed the issue....I'm bad as I stopped the Actonel when I stopped the AI's......but I take my Vit D.....Jenn...sorry that I got off topic.....the whole BC journey just stinks.....

Frankie - I'm so sorry about your friend.  I'll be praying for clean scan results for you!

Karen's BS described it the same as my BS.  After all my scans were done during my initial dx the recommendation was to remove levels 1 & 2 when it came time for surgery.  It's actually a "on the fly" decision when the surgeon has a chance to actually see the nodes and determine what needs to be removed and what is OK to leave behind.  Levels 1 & 2 are under the armpit and relatively easy to get to.  Level 3 is up and towards the chest and underneath a muscle.  My BS told me that she uses her fingers to feel the clump and determine if they need to be removed.  But because it would involve muscle damage she doesn't take them out unless she strongly feels it necessary.  But it's the rads that takes care of the issues with any cancer that's in the fat (from the EC) or left behind in a node.  That's why we get zapped in the entire breast area, under the arm and the clavicle area.

It was also a piece of trivia that I remember her saying that the highest number of nodes that they've seen at SCCA was 55. 

HI Frankie,  I'm thinking of ya tonight. I'm so sorry you are feeling this way.  At my one year mark, I lost a dear friend and it hit me so hard... I was crying for days and really losing hope that I'd be OK.  My kids were very small at the time.  I'm sorry for bringing up abourt percentage of nodes... I think that there is a lot they just don't know about this awful disease... they really need to study it more as often this disease doesn't "follow the rules" .  I try to remember that we went through the hard treatments and that we do what we can and then go from there... I still spend time worrying and then I regret that I do that.  It helped me a lot to go to a retreat for survivors--- they are held in Wisconsin-- Breast Cancer Recovery Foundation.  They even paid my way for me as I couldn't afford to go otherwise.  I met women there who had all stages of dx ( 1-4) and yet were living their lives -- they all gave me encouragement and strength.  They have flags waving made by women who have gone to previous retreats and just the site of that was awesome.  Wishing you peace and joy...

Wendy