Finished Chemo and have residual tumor and multiple micromets

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ann273
ann273 Member Posts: 209

Hi everyone,

I am a 28 year old patient who just finished chemotherapy. After a radical mastectomy of my right breast, the path report showed 11 lymph nodes positive, all with less than 2mm of cancer in them. I have browsed a number of topics in the stage III forum and cannot conclude if multiple micromets is a possibility. Until surgery, scans (PET, MRI and ultrasounds) only showed 1 positive lymph node of 2cm. I am completely stumped and depressed. After being relieved to finish surgery and chemo, I feel like Im back at square 1. Can anyone share stories of micromets and how they are viewed in comparison to fully positive lymph nodes?

I am 95% ER+ve, 75% PR+ve and Her2 -ve

Comments

  • wrenn
    wrenn Member Posts: 2,707
    edited February 2014

    it's late so you might not get many responses tonight but I wanted to say how frustrating this must be for you.  I can't imagine going through all that and still having to worry.  I don't have answers but someone else will soon.  I just want to send you hugs. XO

  • ziggypop
    ziggypop Member Posts: 1,071
    edited February 2014

    Hi ann,

    I'm so sorry that you are dealing with this - nobody should have to but especially a 28 year old. I don't know if I can answer your questions or not, I do know that, yes, you can have multiple micro mets, and such small amounts (they are less than 200 cells) are unlikely to show up on any imaging) 

    I have a couple questions, did you have chemo first and then surgery? Did they do an AND(an auxilliry node dissection)?

    I'm asking because I had chemo first, which shrunk a 9 cm tumor down to 4 cm, and reduced the number of positive nodes, but I still had macro mets and micromets in some nodes. That did not and does not make me feel hopeless at all, it was a reason to do radiation - to get any stray cells that may have been left & when they did my RADS, they did the breast, armpit and the supraclavical area (since that's the next place the cancer should go from the armpit). I'm not sure how micro mets are viewed in comparison - I do know that there is less there to treat and therefore treatments are more likely to be effective - but also those nodes with micro mets were removed from your body - so that is a very good thing. I know that treatment just seems to go on and on, but you are not at square one, not at all. You have done a LOT to make sure that that cancer has been killed or removed from your body, the treatments now will be to make sure that any little cells that are left will be killed off as well. 

    Many, many hugs, ann. More people will be along soon to add to what I've said. Please stick around here, it's a great place for support and info and you can cry, whine, laugh, complain, whatever - everybody here gets it. 

  • art133
    art133 Member Posts: 30
    edited February 2014

    Hello.. my mom was diagnosed breast cancer july 2013. I dont know what type of cancer it is. The skin is red, I dont know this redness caused by the large tumor or because it is ibc? Because my mom tumor around 7cm. Anybody with large tumor can help? I am very worried about her condition. 

    In addition, my mom had neoadjuvant before surgery. So the pathology report after surgery showed that none of the lymph nodes positive. I think its because she responded well to chemo. The tumor also shrink from 7.6 to 1cm. 


  • ann273
    ann273 Member Posts: 209
    edited February 2014

    Thanks for your replies!

    @ziggypop - yes, I did have chemo and the initial 2cm lymph node was reduced to  an an approx 2mm micromet. I also have some residual tumor. My onc has been saying ll along that considering I am

    Highly Er+ I wouldn't have a great path response, but I am just surprised to see so many micromets. I am just not sure if 11 micromets are the same as 11 positive lymph nodes. 

  • ziggypop
    ziggypop Member Posts: 1,071
    edited February 2014

    I'm not sure if 11 positive nodes are the same as 11 nodes with micromets. I think that in general they would be called 'positive' since they do have cancer in them albeit a small amount. But the real importance is not what things are 'called' or how they are 'classified'. What is important is what they really are and what that means in terms of treatment and actual prognosis (not the prognosis you get from plugging numbers into cancer math). In a very 'real' sense, it certainly is 'better' that they found that there was some spread to 11 nodes than that you knew beforehand that there was 2cm of cancer in 11 lymph nodes. The other thing is that on those sites that figure prognosis, you can enter in any amount up to 10 and it 'counts' the same, and then at eleven it 'changes' - which doesn't make much sense. 
    The MOST important thing is that they got those nodes out of there & being that you are highly er+ (I am too) the hormone therapies will likely work very well for you. At some point I found that I just had to say to myself "It is what it is - I'm going to do my best to do the most aggressive treatments called for because that actually has an impact, and then I'm going to do my best to let it go and not stress over it." I can't say that I'm always successful at that, but it's gotten better over time & I bet it will for you too. ((((hugs))))  

  • Laurie09
    Laurie09 Member Posts: 313
    edited February 2014

    Ann, first {{Hugs}} to you. 

    I had disease in 7 nodes, the largest was 8 mm AFTER chemotherapy.  I'm currently 5 years out - today is 5 years for me since diagnosis.  

    There is hope even with spread to nodes.  

  • ann273
    ann273 Member Posts: 209
    edited February 2014

    Thank you so much for your replies ziggypop and Laurie. It really helps to get some answers.

    I was very positive when I was diagnosed in August, it is just so difficult to see that I have a more advanced cancer than what I expected. I am very happy to see that dealing with it gets better with time. As of now I am paralyzed with fear. I am newly married and my husband is just as young as I am. Though he is supportive through this, I wish to understand my prognosis better so I can advise him to live a fuller life, decide whether I want to get back to working at my stressful job or look for a lighter option. I guess the more experiences I hear about the more confident I will feel. Thanks again for replying so soon and all the support.

  • Lucca06
    Lucca06 Member Posts: 69
    edited February 2014

    Ann, I am so sorry you are having to deal with this at such a young age it is brutal.  I am just coming up 3 years from diagnosis and was in a very similar position after diagnosis, neo-adjuvant chemo and mastectomy in 2011.  Not quite as young 43, but with a 2 children of 1 and 3.  At diagnosis I was told one node but after my mastectomy, the pathology was 9 out of 18 nodes positive for either micromets or a single cell.  I was totally devastated and just crumbled after remaining strong for all the months before.  Counselling, yoga, self help reading, changing my diet all helped get me back to a better place but ultimately one comment from my onc really focused my thoughts.  When I asked her about managing the fear, she said you have gone through all this because you want to live so you need to find a way to do that and enjoy each day. It certainly didn't happen overnight but gradually over the next few months my mind stopped tormenting itself and thought about it less & less. The tougher place you are in physically (i.e.post ops) definitely affects the mental but once you feel well and can get busy doing things you love it gets easier.  You are still very much in the 'thick of it' as my breast care nurse said, it does take time but you will get there.  Just take one day at a time.

    In terms of positive nodes vs. micromets the answer is I don't know.  I think my immediate instinct was to google but then I decided it would not change anything and statistics are just that.  Try and focus on getting well and healthy which you do have control over.  The other thing my nurse used to say is 'be kind to yourself' which only now nearly 3 years later to I really understand what she meant.  Take care.

  • ann273
    ann273 Member Posts: 209
    edited February 2014

    Thanks Lucca. I do hope it gets better with time. Its been less than a week that my path report has been out and I can still barely function. 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2014

    Hi ann273,  I just want to say that I'm so sorry you are facing this disease at your age.  My youngest daughter is 27 and I can't imagine her going thru what you have been thru.  The one good thing about being stage III is that your your treatment team will throw everything but the kitchen sink into your treatment. I know you are feeling really bad right now and that you can barely function.  We all can relate to this.  Just take each day at a time and take heart that you have a treatement plan.  Knowing that your team has a plan for you will give you some feeling of control in all of this.

    Oceana

    marvelous-nicole-rodriguez.jpg (180×119)

  • hopeful123
    hopeful123 Member Posts: 191
    edited March 2014

    Dear Ann- I think the imaging techniques are not as accurate and cannot determine micromets. So the fact that you have micromets doesnt necessarily mean you didnt respond to treatment. You still have radiation and Tamoxifen to keep things in check. You are luminal A it appears, and this has one of the best prognosis. I know of two people who are close friends one Stage IIIb and another Stage IIIc who had a similar pathology to yours at diagnosis and are  5 and 8 years out. Keeping you in my thoughts and prayers. 

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