How many of us are multi focal?

The tumour in my right breast measured 8.7 cm and was removed with unclear margins by diagnostic lumpectomy necessitating a mastecomy. I had a BMX and pathology found an additional 1.6cm tumour in the right breast and multifocal LCIS in the 'healthy' left breast. From my later reading I found that ILC is more likely (14-32%) to be present as multifocal disease compared to IDC. It is a sneaky beast!!

My tumor was several that had merged. Because I had neo-adjuvant that shrank the cncer a lot, I don't think they ever got a good handle on the size of the thing and how many tumors there were.

I'm another ILC multi-focal girl. One tumour 1.7cm pleomorphic grade 3 and a second 0.9cm classic grade 2. My onc was pretty non-committal about how to deal with this when deciding whether I should have radiotherapy. She tried using the higher grade larger one only and applying her criteria and then she tried adding them together to give a size of 2.7cm. Needless to say this gave different recommendations but in the end I was advised to have the radio. She did discuss it with colleagues but nobody seemed very definite on how to view these multi-focal tumours. I still don't know if I'm considered Stage 1 for the largest tumour only or Stage 2 for the total size of my tumours.



The two other women I met during my treatment who were ILC girls were also both multi-focal with two tumours. They didn't know whether to add them up or not for staging and treatment decisions either. Confusion reigns here.

Diana, how are you holding up with the chemo?

My pathology report reads:

Right Breast - Multicentric ILC involving all quadrants of mastectomy speciman except lower inner quadrant. Invasive carcinoma present in background of LCIS also identified in all breast quadrants.

Left Breast - Simple mastectomy specimen with foci of LCIS. No invasive component identified. Associated proliferative fibrocystic changes.

Level I and II sentinel nodes on right side had isolated breast carcinoma tumor cells and malignant lymphoma, axillay lymph node had only the lymphoma.

What is the difference between multicentric and multifocal?

Kestrelgurl... here's a good explanation of multifocal vs. multicentric..

http://www.ehow.com/about_5530776_multifocal-vs-multicentric-breast-cancer.html

Multifocal Breast Cancer

Multifocal breast cancer occurs when there are multiple tumors in your breast that all come from one original tumor. Parts of the original tumor break off and start to grow separately from the original. These tumors tend to be located in the same section of the breast. Multifocal breast cancer tends to be a less invasive cancer because the tumors have not moved into other parts of the body.

Multicentric Breast Cancer

Multicentric breast cancer involves multiple tumors in the breast that do not all come from one original tumor. These tumors have all grown separately from each other. Multicentric breast cancer tumors are found in different sections of the breast. This is a more invasive type of cancer because each tumor represents a new area of cancer growth. In this type of cancer there are multiple sites to be treated in each breast that is affected. Multicentric breast cancer occurs less frequently than multifocal breast cancer.

Read more: Multifocal Vs. Multicentric Breast Cancer | eHow.com http://www.ehow.com/about_5530776_multifocal-vs-multicentric-breast-cancer.html#ixzz21DS6Luni

Im a multifocal girl as well. Just found out that the 3 nodes they took out during surgery came back as positive with extranodal invasion. They show up as negative during the surgery so now i get to go back for axillary dissection. Anyway i had 3 foci biggest was 2.4 with macrometasases. whatever that means. lol

As I was prepped for the wire localized lumpectomy last August, the radiologist (dr.) was trying to get my BS on the phone. He had found more than one tumor site in my left breast and was wondering which one he should be identifying for the surgery. Of course, alarm bells went off in my head. More than one tumor (to me) meant mastectomy, not lumpectomy. I was so scared about the whole procedure and just wanted it over, that I didn't call a halt to it right then and there. So I went forward with the lumpectomy and the results were unsurprisingly not clear margins. The BS wanted to do further surgery to get clear margins. Due to numerous communication problems (between her and the radiologist as well as between her and me), I switched surgeons. I think she wanted to do numerous lumpectomies until I finally "gave up" and went for the mastectomies...

Long story, shortened, my current BS did the bmx in January and the pathology report came back with multi-focal throughout the left breast and a second site in my right breast. Had the first surgeon read the mammogram films correctly (or listened to the radiologist), I would have skipped that lumpectomy in August altogether. I hope others can learn from this.

ILC is a sneaky beast!

Rocket, your story sounds a lot like mine.  I had a lump both my DH & I could feel, but my PCP couldn't, and nothing showed up on my mammo, so I chalked it off to too much caffeine.  When dx'd more than a year later, I also had IDC & ILC (side by side), plus a couple of smaller ILCs lesions (missed by my first MRI & surgeon) and a small tubular lesion.     Deanna

I think it's much more rare than folks realize. Yes those of us that have it don't feel that way, but because most women are dxd at an early stage possibly it's caught before they develop other tumors. For me it was an absolute miracle that it hadn't spread to my lymph nodes.