Do I have to figure this out by myself?!

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MrsH
MrsH Member Posts: 96
edited June 2014 in IDC (Invasive Ductal Carcinoma)

I am reading my biopsy report and trying to understand what it all means. I know that no one will know anything for sure until after surgery, but I am trying to figure out if I will need radiation after surgery so I can do immediate reconstruction, or not.

Here is the dilemna. My 1st biopsy states the tumor "appears moderately differentiated". The biopsy of lumps 2 & 3, also cancerous, state the "IDC is moderately to poorly differentiated."

To me that changes the game significantly. Why is the onc not saying, get this tumor out and don't worry about reconstruction? My Ki67 was 20, so maybe that's why, but prognosis on well-dirrentiated is 100%, moderately is 57% and poorly is 22%. BTW, tumor sizes are 12mm (#1), 13 mm (#2) and 15 mm (#3).

Am I not understanding this correctly?

Any insight would be much appreciated :-/

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2013

    mrsh - prognosis of what?  The differentiation is regarding your grade, which appears to be 2 or 3, depending of which tumor is being referred to.  The radiation decision would be based on nodes, or skin or chest wall involvement, not necessarily on grade.  You could have a SNB prior to surgery to determine whether or not there are nodes involved and that would answer part of your question.  Where does imaging show the tumors to be?  You could also do neo-adjuvent chemo, then surgery.  You need to understand that there are no absolutes in cancer treatment - there will always be unanswered questions and risk along the way, regardless of which path you choose.  You need to decide if you want to have surgery, have immediate recon, and roll the dice on radiation.  There are a number of ladies who did recon and then had rads - it can present problems, but doesn't always.  There are ladies who did surgery, then rads, then down the road did recon successfully.

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  • Beesie
    Beesie Member Posts: 12,240
    edited January 2013

    What are you referring to when you say "prognosis on well-differentiated is 100%, moderately is 57% and poorly is 22%"?  

    Edited to add: SpecialK, we were posting at the same time, with the same question!

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  • MrsH
    MrsH Member Posts: 96
    edited January 2013

    Prognosis of successful treatment of disease. The higher the grade, the worse the prognosis. At least that's my understanding. I'm I miss-understanding? I hope so. And I know there are multiple factors involved, I just got freaked out thinking there might be a 22% chance of survivsl.



    Tumors are in 2 quadrants. Two are "kissing cousins" close but not sure if connected. Another is 5 cm away.



    Thx for the input :-)

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  • Beesie
    Beesie Member Posts: 12,240
    edited January 2013

    Grade is one factor in prognosis.  There are many many others, including hormone status (yours is favorable), tumor size, nodal involvement, etc. etc..  

    Where ever did you get the information that grade 3 breast cancers have only a 22% survival rate?  That's completely incorrect. 

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2013

    mrsh - that would mean that almost 80% of those with grade 3 tumors are not successfully treated - the statistics don't bear that out.

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  • MrsH
    MrsH Member Posts: 96
    edited January 2013

    I'll look and see where I got it, clearly I misunderstood - thankfully! And thx for setting me straight :-) I feel better now, so much better!!

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  • MrsH
    MrsH Member Posts: 96
    edited January 2013

    Ok, sorry, this is where I got my numbers, but it was related to g.i. cancer. - can't believe I didn't see that, but honestly, in my haste to make sure my kids got to karate, I was looking for quick answers. Won't do that again :-/

    http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=47&abstractID=34037

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