Multifocal how bad is it?

This must be incredibly overwhelming to face losing a breast.

I am not sure I can answer your question but I had DCIS in 2 places in my breast. They found it using a diagnostic biopsy rather than an MRI.. When I had surgery They found two small IDC tumors grade 3. My situation was similar in that I had a mastectomy but I had clear nodes( I would insist they do a sentinal node even for DCIS) and They sent the small tumors for testing. I was able to have a TE explander placed during the surgery and scheduled reconstruction 6 months later. I am telling you this so you don't panic. Your doctor should have a look at your lymph nodes. Its likely they are clear. I know it is hard to tell you this but I cried the whole week I was waiting for results. It was later as I was farther on this journey I realized that its ok to take things one day at a time and not panic until you have all the data. Its ok to slow down and get all the information and understand what is going to happen with your breast. Write down your questions and make sure you have a good BS who will answer them.

Yes I had 2 tumors one IDC one ILC multicentric and focal. I had mastectomy no lymph nodes and no radiation. Chemo was recommended from high oncodx but I didn't do it. 4 years no problems just se from exemestane.

http://nomograms.mskcc.org/breast/

http://nomograms.mskcc.org/breast/

Konakona - you can use this Sloan Kettering Breast Cancer nomogram (above link) to calculate the chance of being sentinel node positive. I had multifocal invasive ductal carcinoma (IDC). In my case when I plugged my information into the calculator being multifocal did increase my chance of being sentinel node positive - but my sentinel node biopsy came back negative. (When the sentinal node biopsy nomogram asks for the size of the largest tumor , put in the size of the largest invasive tumor (not the size of a DCIS tumor))..

If you want information about breast reconstruction (breast reconstruction options, how to choose a good plastic surgeon, etc) a great resource is the latest edition of Kathy Steligo's "Breast Reconstruction Guidebook"

http://www.breastcancer.org/community/gift-shop/bo...

http://www.breastrecon.com/

Konakona:

Your initial stereotactic biopsy showed DCIS and IDC as I recall.

I thought you had an MRI only (imaging only) last week, not an MRI-guided biopsy. Were the additional areas of suspicion identified by MRI actually biopsied or not?

BarredOwl

Konakona,

I had 3 small areas in my left breast with IDC but no node involvement. I also had paget's. I hope your nodes are clear and I wish you the best of luck in your surgery.

Konakona, multifocal and multicentric are use to identify characteristics of the IDC (same tumor or different tumors). Re the lymph nodes, did the MRI identify suspicious areas in the axillary section? I would ask the surgeon if a sentinel node test will be completed before the surgery.

I had multifocal (same kind of tumor but spread in the breast). When I did the u/s the technician looked at the armpit nodes and one of them was enlarged. The same result was provided by the MRI but the number of nodes had increased to two. I had mastectomy and all the nodes removed.

I think the direction is to do more sentinel node testing to identify node involvement. Ask your surgeon.

Good luck with the surgery (it's not bad) and wish you a quick recovery!!

Konakona I had 2 multifocal tumors in the same breast. My doc told me it increases your chance of lymph node involvement a little bit. He said he thought my nodes were clear and they were. They used to stage it by the combined size but found it overkill. Now they stage it by the largest invasive cancer and of course node involvement. Try not to worry that much about the multi focal issue as it does not change prognosis very much if at all. Good luck and keep us posted...

Just chiming in to say I agree with BarredOwl.

I think we were dx at the same time, Kona. I also have IDC, with some DCIS. On my MRI last Monday, the radiologist came back with this:

In the left breast from the 7:00 position 8 cm from the nipple the biopsy-proven malignancy with intermediate and rapid initial uptake and washout is identified. There is extension anterior to the mass. It extends anteriorly measuring in total 3.3 x 0.3 x 2.1cm. The extension anterior may represent ductal carcinoma in situ therefore if clinically warranted MRI guided biopsy of the most anterior extent may be performed.

I'm having MRI guided biopsy on Wed. I'm still hopefully I can get away with a lumpectomy.

If you'd prefer not to have a mastectomy, I'd definitely ask for a biopsy.

Amy

Great news on the node! Glad you through the surgery! I just got my date.. 1/5. I hope you're healing well!

Amy