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rn4babies
rn4babies Member Posts: 409
edited June 2014 in IDC (Invasive Ductal Carcinoma)

I just got the final path report from my lumpectomy which the Nottingham score changed from 6 to 8. (3/3+ 3/3 + 2/3 = 8/9 )III/III. Pathological state T1b, NO (1+) Is it unusual for the Grade to change from biopsy to surgery? I had 2 tumors. The largest was 1cm (IDC) ER+/PR+ HER2 neg, and the second was 0.4cm (ILC). I had been DX'd with DCIS (Grade 3) last summer and just finished rads in December. I'm still waiting for Oncotype score. My surgeon still isn't sure if Pathology sent it out. Does the change in Grade to 3 possibly change my course of treatment? My surgeon said before my lumpectomy that I'd probably only need radiation if Oncotype score was low. Does the score even matter now? Am I looking at chemo for sure? I am 48 years old, BRCA neg with a strong family history. I've been on Tamoxifen since Feb 1. Thanks.

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  • dlb823
    dlb823 Member Posts: 9,430
    edited April 2012

    It's not unusual for the grade to change.  As you probably know, the biopsy only gets bits & pieces of the lesions.  Evidently, there were more aggressive cells the biopsy samples missed.  

    Hopefully, the Tamox might be enough.  But surely the Oncotype DX will reveal more helpful information.  Hopefully, it's been ordered.

    I'm curious... Did you have an MRI at the time of your initial dx?  I'm just trying to figure out how this was missed last July.   Deanna

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  • rn4babies
    rn4babies Member Posts: 409
    edited April 2012

    I still don't know if the tissue was ever sent for oncotype scoring. I can't seem to get an answer on that. The radiologist reviewed the mammo from July and said nothing was in the right breast at the time. I did not have an MRI until the most recent DX and that's because I requested it. I felt that if there was something other than what the mammo was showing, I would possibly have BMX. Also, the frozen section at the time of surgery was node negative but the final pathology showed a few isolated tumor cells. My surgeon told me that is the same is node negative. It still bothers me considering it is a Grade 3. He did agree that it must be pretty aggressive to have shown up so quickly. I don't have an appt scheduled with my MO until 4/26.   I hate waiting that long but can't get it moved any earlier.

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