Surgical Biopsy Results

PolkaDotPurse · April 2016

Hello Everyone,

I haven't posted much but have been scouring the message boards since my diagnosis. I feel like I'm taking a crash course on breast cancer since it was never on my radar before (43 years old, no family history). I was hoping that someone wouldn't mind looking at my surgical bx results. I have not met with the MO or RO yet. Oncotype test ordered today. I understand that radiation will be in order and most likely, Tamoxifen. Chemo will depend on the Oncotype score, as I understand it.

Invasive Component:

IDC, 1.2cm, Grade 2 of 3, Nottingham Score: Tubules - 3, nuclei - 2, mitoses - 1 = 6/9. Mitotic Rate: 3/10 HPF (HPF diameter = 0.55mm), Focal lymphatic invasion present, all final margins uninvolved.

In Situ Component:

DCIS, intermediate grade, 0.5cm, all final margins uninvolved.

ER Positive 90% tumor staining

PgR Positive 95% tumor staining

HER-2 Status 0/No overexpression

Edited to add:

One benign sentinel lymph node (0/1)

Pathologic Stage: pT1c pN0(sn)(i-) MX

If there's a more appropriate thread to post this to, please let me know. Any feedback would be appreciated. Thank you all so much.

farmerlucy · April 2016

Your diagnosis looks very similar to mine. Overall 1a is better than other posibilities, though I'm sure it doesn't feel like it. Cancer sucks. Glad you are moving forward. Hang in there. Believe it or not there will come a time when you don't think of cancer 24/7.

ChiSandy · April 2016

Except for the fact you had lymphovascular microinvasion and DCIS along with the IDC, you had only one sentinel node removed and you were more highly ER+ than I was, your results look almost identical to mine. Had your tumor been <1 cm, they might not even have ordered OncotypeDX--like me, it was size and size alone that puts you in the gray area which the test can to rule in or out the need for &/or benefit from chemo. Unless you have any medical reason to skip anti-hormonal therapy, you will also certainly be recommended to take that as well (in your case, because you’re almost certainly pre-menopausal, tamoxifen with or w/o ovarian suppression rather than an AI). Because you had a lumpectomy with negative nodes and clear margins (stage IA) you will be offered radiation. If you need chemo, the chemo almost always comes first,

No such thing as “good” breast cancer, but this is just about as good as it gets. Good luck!

windingshores · April 2016

I also had focal lymphovascular invasion and a similar picture. The "focal" is important and MD's will be reassuring. None of us knows for sure what will happen, of course, but this looks like it will have a good prognosis. Get a copy of your Oncotype report (online or from medical records or the MD office) because it explains things pretty well. And the company, Genomic Health, will also answer questions: their customer service people are well-trained.

PolkaDotPurse · April 2016

farmerlucy, ChiSandy, and winding shores:

Thank you so much for your input. I am grateful for the good news, no doubt. However, I am worried about whatever the oncologist will recommend in terms of treatment, especially after reading the potential SE. This whole experience has been a lesson in trying not to worry so much......still learning.

Thanks again.

jenn32214 · May 2016

Can someone please explain the meaning of the word focal here, and why its a good thing?

Thanks

PolkaDotPurse · May 2016

Well, my OncotypeDX test was either lost or never performed. I found out at my first appt with the MO. He said he wasn't sure where the breakdown occurred. Not much I can do except wait another 2+ weeks.

Jenn32214 - I did read that focular meant "small". I asked MO about the invasion and he said the OncotypeDX test score will trump the focular invasion in term of how to treat.

windingshores · May 2016

"Focal" means it is confined to the area near the tumor and is not "extensive", which means it spread to areas further from the original site. Same root as "focus."

Surgical Biopsy Results

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