Staging

Options
Hindsfeet
Hindsfeet Member Posts: 2,456
edited June 2014 in IDC (Invasive Ductal Carcinoma)

What is staged, your biopsy or your surgical biopsy?

What if your biopsy is 2 Cem and your surgical biopsy (after surgery pathology report) is only 5 mm? Both show idc cancer. Which one is used for staging? What if the first biopsy was larger and a more severe cancer and the final pathology report was less aggressive or just dcis? Which one will they want to treat? Which one goes on your stats? What if the final pathology report shows less than 5mm of idc. Does that put me in the catergory of not needing herceptin?

 I'm not sure right now, but a question I've considered because in the past I was staged by the final pathology report.

I2007, 2008 dx dcis highgrade, Jan 2011, mucinious stage 1, Sept 2011, IDC high grade her2+ (3+)er + pr+
Diagnosis: 10/4/2011, IDC, Grade 3, ER+/PR+, HER2+

· Share on FacebookShare on Twitter

Comments

  • apple
    apple Member Posts: 7,799
    edited December 2011

     http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

    you might have to paste that into your browser.. i think the 'symptoms and diagnosis' part of the upper taskbar a great source of info.  For some reason, that task bar never stood out for me..   the moderators would link to it, but i could never find it.

    · Share on FacebookShare on Twitter
  • peggy_j
    peggy_j Member Posts: 1,700
    edited December 2011

    Yes, they determine the stage based on the final pathology report. It's not that unusual for the size or grade to differ from the estimates in the biopsy, since that's just a small sample. I've also seen women post here that their biopsy said it was DCIS but the final pathology report also showed the invasive kind. The final path report is most complete because they can study the entire tumor in detail; that's what they use to stage and make Tx recommendations.

    Yes, small size is a consideration when MOs decide whether to recommend chemo and 5mm (0.5 cm) is considered small. They also look at the grade. Grade 3 is considered the faster growing kind and patients usually "benefit" more from chemo than if they had a slower-growing tumor. I don't know much about HER+, maybe you can post in that forum?

    · Share on FacebookShare on Twitter
  • redsox
    redsox Member Posts: 523
    edited December 2011

    The American Joint Committee on Cancer (AJCC) and its international collaborator (UICC) are the authorities that define cancer staging:

    http://www.cancerstaging.org/mission/whatis.html

    From that website comes the following quote:

    "What are the Different Types of Staging?

    There are three different types of staging:

    • Clinical Staging determines how much cancer there is based on the physical examination, imaging tests, and biopsies of affected areas.

    • Pathologic Staging can only be done on patients who have had surgery to remove or explore the extent of the cancer. This type of staging combines the results of both the clinical staging (physical exam, imaging test) with the results from the surgery.

    • Restaging is used to determine the extent of the disease if a cancer comes back after treatment. This is done to determine what the best treatment option would be at the time. This type of staging is not common."

    The short answer to your question is that final staging takes all of the information into account.  That would include the results of the biopsy and of the surgical biopsy.  The initial biopsy may have removed a large part of the most aggressive cancer but that is still important information included in the final staging. 

    Edited to add: The above applies to your current restaging.  Technically, the stage from your initial diagnosis is your official stage and the restaging at recurrence is just to provide the best guide to treating the recurrence.

    · Share on FacebookShare on Twitter
  • Hindsfeet
    Hindsfeet Member Posts: 2,456
    edited December 2011

    redsock...thanks... The original staging would have been Dec 2007 highgrade dcis, grade 3, como-neurosis type. What I have now is a recurrence as it's right under the scar tissue of the original dcis dx. The biopsy vacuum out 2 Cem of cancer. I saw it before the surgery. It was highly dense calification cells in a tight grouping with a few stray ones above the circle of cells. After the biopsy I again looked at the mammo and the whole circle of califications were gone. The biopsy removed 2 Cem of calification maligant cells. What is left is a few stray cells above the biopsy site.

    So, basically it's restaging what I had in December 2007.

    I did ask my oncologist if the cancer being removed was smaller than 5mm if I still had to do herceptin. She said yes because 2 Cem was already removed....so I wondered which pathology report counted for final staging and treatment plan.

    · Share on FacebookShare on Twitter

Categories