Stage 1b questions...why 1b and not 1a?

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dtorrent
dtorrent Member Posts: 17
edited April 2015 in Stage I Breast Cancer

So I am just waiting around another week for the Oncotype results, playing Dr. Google and looking over my pathology report for the zillionth time. My tumor was 8mm ILC, and there were additional larger areas of pleomorphic LCIS.

My node biopsy came back all clean, and my stage is pT1b pN0. My tumor grade is 6/9, which the pathologist calls grade II/III.

My question, and I know I should just ask my doctor but it's Saturday...why 1b and not 1a?

Everthing I have read says 1a is up to 2cms and no node involvement. 1b is up to 2 cms and small groups (less than 2mm) of cancer cells in the lymph nodes. My report says nothing about any type of micro things in the lymph nodes.

Has anyone else had a similar staging? Thx!

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  • Moderators
    Moderators Member Posts: 25,912
    edited April 2015

    Hi dtorrent,

    Not sure, but perhaps this could be helpful: Stages of breast cancer. You will probably need to discuss this on Monday with your doctor.

    We're thinking of you!

    The Mods

    Stage I

    Stage I describes invasive breast cancer (cancer cells are breaking through to or invading normal surrounding breast tissue) Stage I is divided into subcategories known as IA and IB.

    Stage IA describes invasive breast cancer in which:

    • the tumor measures up to 2 centimeters AND
    • the cancer has not spread outside the breast; no lymph nodes are involved

    Stage IB describes invasive breast cancer in which:

    • there is no tumor in the breast; instead, small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – are found in the lymph nodes OR
    • there is a tumor in the breast that is no larger than 2 centimeters, and there are small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – in the lymph nodes

    Microscopic invasion is possible in stage I breast cancer. In microscopic invasion, the cancer cells have just started to invade the tissue outside the lining of the duct or lobule, but the invading cancer cells can't measure more than 1 millimeter.

    Learn about what treatments you can generally expect for stage IA and IB in the Options by Cancer Stage: Stage IA and IB page in Planning Your Treatment.

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited April 2015

    I found this:

    T1: The invasive part of the tumor in the breast is 20 millimeters (mm) or smaller in size at its widest area. This is a little less than an inch. This stage is then broken into three substages depending on the size of the tumor:

    • T1a is a tumor that is larger than 1 mm, but 5mm or smaller
    • T1b is a tumor that is larger than 5 mm, but 10 mm or smaller
    • T1c is a tumor that is larger than 10 mm, but 20 mm or smaller.
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  • dtorrent
    dtorrent Member Posts: 17
    edited April 2015

    Thanks Melissa, I saw that too. But it seems to directly contradict everything else on 1b that I have read! Oh well...I will have my Oncotype results next Friday and lots of questions for my MO.

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  • Nan54
    Nan54 Member Posts: 93
    edited April 2015

    T1b and Stage 1b are two different things... If you have no cancer cells in your nodes, then you are indeed a stage 1a (but, a T1b because of the size of your tumor - per the info in Melissa's post above).

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  • Suladog
    Suladog Member Posts: 952
    edited April 2015

    I was T1b, no nodal involvement everything clean, 7mm, grade 2, evidently the dividing place for 1a and 1 b as explained to me at UCSF was above 5mm no nodal involvement is t1a, between 5mm and 1 cm no nodal involvement is T1b, they were very divided as to whether or not to do chemo with me as Dr Esserman said I had very little disease. However once the Farber report came out we decided to do chemo, but as my oncologist says , it's a bit overkill in my case but better safe than sorry. Hope that help

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  • dtorrent
    dtorrent Member Posts: 17
    edited April 2015

    Suladog, thanks for the info. What is the Farber report?

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  • Suladog
    Suladog Member Posts: 952
    edited April 2015

    Dana Farber study dtorrent,

    The Dana Farber cancer institute released a study result in Dec 2014, which said that it was recommended that even under 1 cm HER2+ breast cancer w/ no nodal involvement could benefit from 12 wks taxol and herceptin followed by Herceptin alone once every 3 wks for the next 9 months . I completed the Taxol part a week ago and am now doing just the herceptin.

    I posted the link above just click on it


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  • Jeeper4
    Jeeper4 Member Posts: 70
    edited April 2015

    Suladog, thank you for the link. I will ask about the study when I go for a 2nd opinion MO. My HER2+ is not being addressed and the devil on my shoulder keeps saying "why are other Stage 1, Grade 2, no nodes being treated with Herceptin and you're not"? I do feel like I am in no man's land since my pathology described my cancer as a single focus of micro invasion in a background of dcis. DCIS is not treated with Herceptin (to my knowledge) and a big % of dcis is + BUT my HER2 test was run on the micro invasive tissue slide. Ugh! This HER2+ stuff terrifies me.

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  • dtorrent
    dtorrent Member Posts: 17
    edited April 2015

    Thx for all the info!

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