Poll: Tumor in Lower Quadrant?

neugirl · January 2013

Hey, so this is sorta a poll question... trying to hear if any of you ladies had breast tumors in the Lower Quadrant and how it affected your care? I am wondering if your breast team treated you differently, performed any extra scans or what you heard about a tumor in this area.

Mine is in the Lower Outer Quadrant. I have heard that tumors in the Lower Quadrant can sometimes drain directly to the inner mammary lymph nodes which cannot get a biopsy because they are below the breast bone. This makes relapse more common. It is unclear to me if this is true for BOTH Lower Inner Quadrant AND Lower Outer Quadrant or just Lower Inner Quadrant.

My tumor was at the 7:00. I am wondering why my tumor was in a more unusual area of my breast and what this can mean for me? I had a chest xray, bilateral MRIs, ultrasound and mammos and am wondering if the inner mammary lymph nodes would have shown on this OR if the sentinel node biopsy would have shown if it drained to the inner mammary lymph nodes. I'm also wondering if the location of my tumor had anything to do with the INTRA mammary lymph nodes found in the breast tissue. There were 3 and none had cancer.

I have tried seeking an answer on this and have found the response is alway convoluted. Was told by the doc that most tumors occur in the UOQ because there is more breast tissue there. He said location does not matter. He then said that tumors do sometimes occur elsewhere but that is rare. (I think he thinks my tumor is in the UOQ!) Hearing how rare it is to have a tumor elsewhere doesn't make me feel much better!

Any insight into this matter would be much appreciated. Thanks as always.

MelissaDallas · January 2013

Neugirl, here is one study that show that outer lower has better survival rates. My mass was outer lower also.

http://jco.ascopubs.org/content/21/3/467.full

Beesie · January 2013

Neugirl, as MelissaDallas said, the concern that you raise is specific to the Inner Quadrant, NOT the Outer Lower Quadrant.

Tumor location of the lower-inner quadrant is associated with an impaired survival for women with early-stage breast cancer.

Medial tumor localization in breast cancer--an unappreciated risk factor? ("Medial" is inner)

Relationship Between Tumor Location and Relapse in 6,781
Women With Early Invasive Breast Cancer

"I'm also wondering if the location of my tumor had anything to do with the INTRA mammary lymph nodes found in the breast tissue. There were 3 and none had cancer." You asked about this in another post several weeks ago. I provided information at that time. We all have intramammary lymph nodes. Some of yours happened to be removed during your surgery. Given your concern about the location of your tumor and the possibility of the tumor draining into the intramammary nodes, the fact that some of your intramammary nodes were removed and found to be benign should be a relief to you. It means that you know that your intramammary nodes were not affected by cancer.

From breastcancer.org:

Image - Axillary Lymph Nodes

Lymph node areas adjacent to breast area.

A pectoralis major muscle

B axillary lymph nodes: levels I

C axillary lymph nodes: levels II

D axillary lymph nodes: levels III

E supraclavicular lymph nodes

F internal mammary lymph nodes

This graphic hopefully helps explain why it is cancers in the inner quadrant that are of concern when it comes to the intramammary nodes, not cancers in the outer quadrant.

neugirl · January 2013

@melissa- thanks for the study! wow that is interesting... its so hard to try to find answers cuz there are SO many studies! but that is def. good news!

@ beesie... thank you so much for the graphic. yes that is very helpful... u also helped me before, but i do think i am confused again because i think there are both internal mammary glands (behind the breast bone) and intra mammary nodes (in the breast tissue).

Beesie · January 2013

Yes, we have internal mammary glands and intramammary lymph nodes. And internal mammary veins. And internal mammary arteries. And our breasts have lobules and ducts, etc.. It's all part of the biology of the breast.

Let me repeat here something the VoraciousReader said to you in another one of your threads:

"...sometimes it is bad to research diseases if you don't have the EXPERIENCE of understanding what the information means AND how it relates to YOU."

It's really good advice.

NBalla1956 · August 2013

I also had a tumor at the 7 o'clock position. It was while researching the diep reconstruction procedure that I stumbled on the significance of tumor location. Nobody discussed this with me while going through treatment that included lumpectomy followed by mastectomy after pathology determined there were no clear margins then 4 horrible months of chemo. I relocated to another state after treatment and brought the subject up with my new oncologist. Her answer was "we typically don't discuss tumor location". When I asked why she stated there was no definitive test to check the internal mammary chain because of the location under the sternum. She advised me to contact her if I became symptomatic. Not what you want to hear but I had to believe her since my surgeon and former oncologist never discussed it with me. I was diagnosed with "early stage II" cancer with tumor grade of 9 along with dcis. I think I would of freaked out learning all I have about location of tumor but hey, you have to embrace life and not live in constant fear.

I also want everyone to know about DIEP reconstruction surgery. I had it done at MUSC in Charleston SC by Dr. Milton Armstrong who is not only a superb surgeon and "body artist" but also as kind and compassionate a MD I have ever run into. I encourage all to look into this type of reconstruction because I now have a natural feeling and looking breast. I could not have asked for a better outcome and feel like a natural woman again!

Poll: Tumor in Lower Quadrant?

Comments

Categories