Contradicting test results

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Insun
Insun Member Posts: 12
edited June 2014 in Stage III Breast Cancer

Stage 3 breast cancer. Had neoadjuvent chemotherapy due to large size tumor. Had MRI after 4th chemo showed pathological complete response. Had two more chemo and a mastectomy. My pathology report after mastectomy said Residual Cancer Burden III -chemoresistant. Had several foci of tomorrow largest one being 1.8cm. I also had 6/21 lymph nodes positive (after chemo).


I need some explanation. My oncologist said pathology report is the gold standard.

I have been very good so far, managed to stay positive and optimistic. I need some encouragement, please.

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  • hopefour
    hopefour Member Posts: 459
    edited February 2013

    I had surgery first than chemo so I am not knowledgeable about your situation, but do know others that had positive nodes after chemo and are doing well. If you are PR+ hormone treatment is a very effective treatment. But, I do want to welcome you and let you know this board has lots of wonderful woman who are very knowledgeable and compassionate. My sweet friend had 6 positive nodes after surgery and she just celebrated 5 years!! Hopefully someone better than me will come along and help you!!

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  • Insun
    Insun Member Posts: 12
    edited February 2013

    Thank you hopefour for your encouragement. Thank you.

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  • stride
    stride Member Posts: 470
    edited February 2013

    Insun, I wonder if the MRI gave inaccurate results? What type of chemo did you have?

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  • Insun
    Insun Member Posts: 12
    edited February 2013

    Stride, I had Taxotere, carboplatin and herceptin. (TCH)

    I can understand MRI giving not so accurate result, but this is totally two different extreme report. My pathology report said several foci of tumors largest being 1.8 cm. MRI can miss those? I wonder. Or did I have a complete response to chemo and then it all came back? The time between two tests are two months.

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  • TectonicShift
    TectonicShift Member Posts: 752
    edited October 2014

    Yes, MRI can miss those! I had tumors in my lymph nodes over 2 cm, and they did not show up on MRI at all! Did not find out about them until surgery.

    The path report after surgery is the accurate one. MRI and other scans are not perfectly reliable. Pathologic complete response is pretty rare. But it sounds like MUCH of your tumor did disappear, which is great! Just some of it was resistant to chemo.

    It does not mean you won't be fine. Lots of people have more than 6 nodes and are fine five and ten years later and more. But you must do everything the oncologists say to give yourself the best chance at staying in remission.

    What is your grade? (1, 2 or 3? or a mix?) Sometimes tumors that are grade 1 and/or 2 are resistent to chemo. But they are also less aggressive tumors. It's usually grade 3 tumors that have a complete pathologic response. But they are more aggressive too.

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  • kar123
    kar123 Member Posts: 273
    edited February 2013

    Unfortunately MRI can miss even large tumors as it did in my case.  I had neoadjuvent chemo and it shrunk my tumor from about 6-7 cm to about 3.5 cm.  They were able to palpate the mass and estimate how large it was (even though at first I was told it was just fibrocystic disease).  After surgery, the pathology showed that chemo "swiss cheesed" my tumor and all that was left was about 3.5 cm.  I had 1 node 9mm and 1 node micromets.  Surgery and radiation will take care of anything the chemo did not get. I believe in my heart that chemo blasted any tiny cells that may have escaped my nodes.

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  • Insun
    Insun Member Posts: 12
    edited February 2013

    Hi tectonicshift. I am grade 2. When I read that the tumor is chemoresistant, I panicked. I feel like I should do more chemo, but my oncologist said no.

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  • Insun
    Insun Member Posts: 12
    edited February 2013

    Knowing that some tumor was resistant to chemo, I wonder if neoadjuvent therapy choice was the right one. Could the cancer have spread during the chemo, I wonder.

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