Need some help with a few questions post surgery

jgbartlett · June 2011

I had a lumpectomy and SNB last week, and have got my preliminary pathology report back. 2.2 cm tumour, grade 3, IDC, they also found some DCIS and lymphovascular invasion, but my nodes came back negative.

I have a couple of questions I'm hoping you may be able to help me with:

1. are all grade 3 cancers HER2 positive, can I assume this (I'm still waiting for this result and my hormone receptors)

2. do they do chemo first or radiation, what order and why?

3. my lymph nodes came back negative on pathology, but I'm told there is a 15% chance this may be a false negative and they are sent away to be confirmed immunohistochemically. Has anyone had the result come back positive from this further testing?

Thanks, I really feel this forum helps, reading other people's posts is very comforting.

marial · June 2011

Hi and sorry you had to join us here, but welcome

No, not all grade 3 are hers positive..I have grade 3 and am hers negatice

The normal order is chemo then rads..I am not sure why except to get the chemo to systemically kill the cells quicker..where rads are local

My lymph nodes were neg during surgery and after so I can't answer that

grayeyes · June 2011

jgbartlett,

My tumor also was grade 3, and it was negative for HER2.

Two lymph nodes were involved in my breast, but not under my arm. However, both lymph nodes were seen clearly as two spots by MRI before surgery, and my original pathology report after surgery concluded they were two positive lymph nodes.

I finished A/C - very roughgoing for me - and I'm now on Taxol with six more weeks to go, followed by radiation for six weeks. Best wishes!

Elizabeth1889 · June 2011

Hi jgbartlett,

Yes, it is possible for the SNB to appear negative after surgery and then have it found to be positive later. I was one of the unlucky 15%, but I hope you will be in the lucky 85%. Thank goodness further surgery and pathology report found the other lymph nodes to be negative.

jgbartlett · June 2011

Thanks for your comments. I'm glad my cancer is out, now starts the treatments to make sure it never comes back. All the best to everyone.

Julie.

abcd · June 2011

I had IDC grade 3 HER2- with 6 lymph nodes enlarged.

The tumour was 2cm in size.

Out of the choices given I chose to have Chemo, lumpectomy and then radio.

Chemo reduced the size of the tumour from 20mm to 6mm ( FEC-T)

First lumpectomy on 19th May showed invasive ca removed but ca in situ left (no clear margin)

Second lumpectomy on 9th June showed ca in situ still left ( posterior margin 0 ).

The surgeon said ca in situ is lying close to the fascia that separates breast tissue from the pectoral muscle, so can not be removed surgically. He removed the breast tissues and according to his opinion this should not spread as there is no breast tissue left. There is always a "but" in cancer and they are now going to have meeting with oncologist, histologist and the surgeon the whole team.

The next is Radiotherapy as was planned before but I will know more from them soon re their plan.

Wish you the best.

abcd · June 2011

Sorry, forgot to mention that along with lumpectomy I had axillary node clearance. One showed metastasis. Although my chemo first, worked well and reduced the size of the tumour from 20mm to 6mm and lumpectomy was easier with minimal shape change, one axillary node still showed metastasis.

Opinion varies with individual. I chose the therapy in order after discussion with the surgeon.

Some would prefer mastectomy rather than lumpectomy to start with.

Need some help with a few questions post surgery

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