How is BC staged when you have multiple tumors?

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jmute
jmute Member Posts: 34
edited June 2015 in Diagnosed and Waiting for Test Results

Doctor just called and gave SOME results from my wifes double mastectomy. Doc said she had 2 tumors but he got clean margins and nothing had spread to the lymph nodes.


I'm just wondering if when we get the full pathology report do you add up the size of the 2 tumors or would 1 tumor be this stage and another be another stage?

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  • muska
    muska Member Posts: 1,195
    edited June 2015

    I think if one of the tumors is IDC (invasive) and the other - DCIS (non-invasive), she will be staged based on the characteristics of the IDC. In other words, staging is based on the tumor that has progressed more.

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  • dltnhm
    dltnhm Member Posts: 873
    edited June 2015

    Jmute,

    According to my understanding with personal experience, you do not add the two tumors sizes together. Prior to surgery, each imaging showed more cancer. My breast MRI showed an area very close to the original tumor that was located with mammograms and ultrasound. My surgeon explained that if that area turned out to be actually all part of the original tumor, then my stage would change based on that larger size. If there were two distinct smaller tumors then the stage would not change. The final pathology revealed the original tumor and a separate area, not connected. Unfortunately, I was staged higher based on the characteristics of my tumor and # of positive nodes.

    This is my understanding, but your wife's medical oncologist is the expert.

    Diana

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  • jmute
    jmute Member Posts: 34
    edited June 2015

    thanks for the replies, we've got our fingers crossed both tumors are small and indolent

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  • Lolis197138
    Lolis197138 Member Posts: 512
    edited June 2015

    In my experience because I had multifocal cancer the size of all the foci were added as it was the same cancer so my stage was based on the sum of all the foci (the largest one was 2.5cm) and my nodes obviously. If your wife has multicentric (each foci has a different cancer) I don't think it would be added as it might have different characteristics.

    Wishing for good results. 

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  • ironmagnolia
    ironmagnolia Member Posts: 85
    edited June 2015

    My personal experience with bilateral breast cancer is that the worst of the tumors is how you are graded. I had one tumor in each breast, one was stage 1 grade 1 the other was stage 1 grade 2. So, my prognosis was based on the worst of the two, or stage 1 grade 2.

    I thought I was toast when I was told I had bilateral breast cancer. But apparently my prognosis is based on stage 1 grade 2 ER+ PROG+ HER2 - . Highest Oncotypes were 15 & 19, no invaded nodes, so no chemo. Lucky, I guess.... :)

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  • inks
    inks Member Posts: 746
    edited June 2015

    Two different cancer centers staged my multifocal and multicentric cancer differently. One went by the size of the largest tumor the other one counted some of the lesions in a lump since there was not enough healthy tissue between them. If there is at least 0.2-0.5cm of healthy tissue between the tumors then the tumors are mesured separately.

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  • besa
    besa Member Posts: 1,088
    edited June 2015


    In my case with multiple invasive tumors in the same quadrant of the breast, the size of the largest invasive tumor is used for staging-

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  • besa
    besa Member Posts: 1,088
    edited June 2015

    In my case with multiple invasive tumors in the same quadrant of one breast (multifocal breast cancer.) I was staged using the size of the largest tumor. They may stage the tumors separately if they are in different breasts or in different quadrants of the same breast (multicentric breast cancer). (DCIS, no matter what the size, is always stage 0.) If there are distinct areas of DCIS combined with distince areas of Invasive bc in the same tumor - my understand is that only the invasive portion will be used for staging.

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  • scvmom65
    scvmom65 Member Posts: 88
    edited June 2015

    I had 8 tumors, all invasive, but 2 were one type of cancer, 6 were another. I was still staged 1b and that was determined on the size ( they were all small but used the largest one for staging), how agressive each cancer cell was, and the space between healthy tissue and the cancer cells. I was concerned about the number of tumors also but my surgeon said with invasive cancer it is not unusual to have multiple tumors.


    Best of luck to your wife!


    Anna

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  • Ridley
    Ridley Member Posts: 634
    edited June 2015

    I had either 8 or 11 areas depending on the pathology department. Both idc and ilc. All grade 1 except for a teeny spot of less than 2 mm that was removed with my subsequent mastectomies (which was grade 2). The staging was technically done on the largest tumor, but my oncologist told me it was more important to focus on the biology of the tumors vs the stage. He said my recurrence risk was higher than someone who had a single tumor, and at the same stage, but not as high as it would be if they added the sizes all together

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