Poll on Final Pathology Report

Hi Mommy2Six,

I was dx'd with a 1.7cm, grade 1, IDC just sub-areolar upon initial ultrasound and FNB. The ultrasound and physical exam did not show any suspicious lymph nodes, and hence I was clinically diagnosed as Stage 1 IDC. I then requested a MRI to help determine whether we could conduct a nipple-sparing mastectomy. That MRI showed the same lesion in addition to a new lesion that was just anterior (above) the original tumor, measuring 0.3mm and with a suspicious linear expansion directly into the nipple. The MRI still did not show any suspicious lymphatic invasion, so I still remained Stage 1.

Thus, prior to surgery I agreed to have the nipple cored IF the surgeon could not find a clean margin. Post-operatively I was was not surprised to see that she did have to remove the nipple, but the areola is intact.

Upon final pathology, the grade of the breast tumor changed to grade 2, with very concerning combination of cell types, the size remained the same, however they also confirmed lymphovascular invasion. Finally, the biggest surprise was that my sentinel node was filled with a 1.3cm tumor. However, the other 3 pulled during surgery were negative.

I then consented to a SLND - she pulled 6 more and they were all negative as well. Praise God!

So, now I am Stage 2a and preparing for chemotherapy beginning the week after Thanksgiving. However, because they only found 1 positive lymph node (1-3 is the 'grey area'), I do not have to do any radiation at this time.

This is one story of a change, but there are many, many more that either stay the same or are even downgraded upon final pathology.

Fight the good fight!

Akitagirl

Hi hummingbird - when do you expect your oncotype score back?

R.

I've come to look at initial diagnosis as a 'tentative' diagnosis which is updated as more facts become available. It is common that the initial tentative diagnosis changes, often to the worse but sometimes for the better.

Happy birthday to you too! Yes, funny how your perspective totally changes. My ultimate goal is try not to worry about the things that I have no control over and keep thinking positive thoughts. We will get through this!!

i was surprised, given that core biopsy showed my tumour to be aggressive, that the size didn't change for the 2 months between ultrasound and surgery. What did change was that post op pathology showed the tumour to have 2 types of cells. Also, the surgeon removed 6 lymph nodes because 5 "lit up" as being positive with the blue dye but pathology showed them all to be negative.