Multi-centric question

comingtoterms, That is how they usually stage us. In my case I had the .6cm along with a .2cm of ILC. I also had a small bit of LCIS. My BS wasn't concered with the others only with the largest one, and that was the one that was tested.

I went to surgery with possible two cancers and final pathology showed three. One was IDC, measuring 1.3 cm; second one was mixed IDC and ILC measuring 1.1 cm; third one was ILC measuring 0.2 cm. First two were tested and both were ER/PR positive and Her2 negative. Decision for Tx was based on the biggest one (second one happened to be same). Third one was not tested at all. At first I was concerned if third one wad Her2 positive and I was not getting anything for it but my onc said it was too small. In Canada if cancer is less than 0.5 cm even if it is Her2 positive you are not getting Herceptin.

Since you've already received comments on the multi-centric nature from others, I'll just comment on the recurrence.  You say you had a "MS" which I think you are using to mean mastectomy (Mx) and I have heard that with the removal of breast tissue, there is only a 2% chance of recurrence.  I don't think it matters if it is IDC or ILC on that.  I think it does assume that you will be on some kind of adjuvant drug therapy.

Since they took out that many nodes and only found B/C in one, hopefully that means that every speck of whatever kind of cancer is now out of your body, so I would think you have pretty good odds to remain cancer-free.

The rare favorable breast cancers, like tubular and mine, mucinous look distinctly different from the traditional types of breast cancer. If you had dcis and Tubular, even if it was in a node, your prognosis is excellent. Good luck and sending you my prayers and good thoughts.

NEW YORK (Reuters Health) - New research confirms that tubular carcinoma
(TC) of the breast has an excellent prognosis and goes on to show that outcomes
are better than with grade I ductal carcinomas.

"Although TC is known to
have a favorable prognosis, it is still unknown whether this subtype represents
a distinct type of breast carcinoma or whether it behaves like other low-grade
luminal A-type breast carcinomas," Dr. Emad A. Rakha and colleagues, from
Nottingham University Hospitals in the UK, explain.

To investigate, the
researchers analyzed data from 2608 primary operable invasive breast carcinomas
entered in the Nottingham Primary Breast Carcinoma Series from 1989 to 2000. The
study focused on the 102 TCs and the 212 grade 1 ductal carcinomas included in
the dataset.

Relative to grade 1 ductal carcinoma, TC was more likely to
be identified on mammographic screening, had smaller median size, and was less
likely to have lymphovascular invasion, according to the report in the November
16th online issue of the Journal of Clinical Oncology.

During a median
follow-up of 127 months, both disease-free (p < 0.001) and breast
cancer-specific (p = 0.003) survival were significantly better with TC than with
grade 1 ductal carcinoma.

None of the patients with confirmed TC
developed distant metastases or died from their disease. Two patients who were
initially thought to have TC developed distant metastases and one died from the
disease, but on further analysis, their tumor histology was revised to grade 1
ductal carcinoma.

"TC is increasingly encountered in recent years as a
result of the widespread use of and the advances in mammographic screening and
can be managed by adequate local surgical treatment," the authors conclude.
"Adjuvant hormonal treatment may be appropriate in patients with evidence of
nodal metastases at presentation, but chemotherapy does not seem to be justified
in patients without distant metastases."

Reference:
J Clin Oncol
2009.

Hi, Tammy.  I had one tumor and a lot of DCIS.  but my tumor was made up of IDC, ILC, LCIS and DCIS.  I was 90% ER/PR+ and HER2+, but my HER2 (CEP17 ratio) was light.  

Since all of these methods of calculation simply involve the counting of cells with certain characteristics, it seemed to me that in a mixed tumor, you could have a lot of variation in response to chemo.  They had already told me that the "board" had agreed on AC/TH but that there was a case for other choices of treatment.

So I asked my doctor if that all meant that some part of my tumor could be TN and he said yes. At the time, we were reaching a decision about whether or not to undertake a second year of Herceptin or apply for the Neratinib trial at the end of my first year of Herceptin, so the usefulness of the year 2 of Herceptin was the issue.   

Warmly,

Cathy