Please help me understand this pathology report

marshal
marshal Member Posts: 8
edited September 2016 in DCIS (Ductal Carcinoma In Situ)

I had a bilteral mastectomy with direct implant on 9-2-16 My surgical pathology report shows DCIS 3 cm cribiform and micropapillary. Nuclear grade 2-3 and necrosis focal. Margins are negative for malignancy. Distance of DCIS to closest margin 0.6 cm to deep margin and 0.8 cm to anterior inferior margin. Number of lymph nodes with isolated tumor cells (<0.02 mm and <200 cells): One Size of Largest Metastatic Deposit (if any): Cluster of ten cells. Is this a bad report and should I be concerned about these cluster of 10 cells. It does show estrogen and progesterone positive. My oncologist mentioned I would be on arimidex because I had a hysterectomy in 2007 and I also have Factor V Leiden. He also mentioned possible radiation on the axillary node but he wants to discuss this at the tumor board this week and he is sending the path report for a second reading. My mind is paralyzed with fear and I am falling into such a deep depression. It has been a bad 4 years for me as far as seeing relatives and parents pass away with a lot of suffering and pain. My biggest fear is recurrence and I know that is the common fear for all of us. Please help me make sense of this pathology report. Thanks!

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  • fredntan
    fredntan Member Posts: 1,821
    edited September 2016

    Hey why dont you get a second opinion? you know you can travel to far off wonderful places for expert opinion for free. as long as your insurance allows you can go to City of Hope in LA? and or that place in Houston.....forgot its name....MD Anderson


    http://www.corpangelnetwork.org/ these people will take you there. no garantees/its free. helps if you live near big city/going to big city

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  • calidancer
    calidancer Member Posts: 88
    edited September 2016

    This may be useful information and hopefully will ease your mind a bit...Dr Lagios is a DCIS expert.

    http://www.breastcancerconsultdr.com/perspectives/...

    Seems it may be possible for some neoplastic cells to travel to the nodes without yet having made the final change to invasive.

    If you can't get thru the whole article skip to the first paragraph of the summary.

    Best wishes


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  • Beesie
    Beesie Member Posts: 12,240
    edited September 2016

    marshal, it's natural to be worried because of the isolated tumor cells (ITC) but from everything I've read about it, and from all the cases I've seen here over 11 years (and there have been many) I don't think you should be concerned.

    Up to about 15% of women with pure DCIS are found to have ITC in their nodes. ITC are so small that those with ITC are considered to be node-negative and remain Stage 0. The usual assumption is that the ITC landed in the nodes through displacement, i.e. the cancer cells were accidentally placed in the nodes by a surgical instrument. The studies that I've read about women with DCIS and ITC show no difference in prognosis.

    Let us know what the tumor board says.

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  • marshal
    marshal Member Posts: 8
    edited September 2016

    Thank you that article was very informative.

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  • marshal
    marshal Member Posts: 8
    edited September 2016

    Thank you that article was very informative.

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  • marshal
    marshal Member Posts: 8
    edited September 2016

    I apologize I meant to send the informative article response to calidancer.

    I do want to thank you Beesie for your response. I have read many of your posts and I find them to be so well written and informative. I will keep you informed regarding the tumor board response which should be 9-29-16. Do you have any opinions regarding the 10 clustered cells? It seems that is what my oncologist thinks is strange. What are your thoughts about radiation on axillary node?

    Thanks again!!

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  • marshal
    marshal Member Posts: 8
    edited September 2016

    September 29, 2016 I met with my oncologist to discuss his meeting with the tumor board. Three pathologists shared their view regarding my case. The pathologists comments were that because of the size and the extent of the dcis that was in the breast, it is reasonable to believe that there are microinvasive components. He also said that chemo would not benefit me but since I am very fearful he would treat me more aggressively such as suggesting radiation. It is a given that I will be taking arimidex. The onc considered my stage to be a 0* or stage 1A since some of the dcis has small invasion. Next week I will be meeting with the radiology onc to discuss risks and benefits of radiation. My concern is that I have reconstructed breasts and I am worried about the implant. The area to be radiated will be the axillary lymph node. Is there anyone else who has had a similar diagnoisis like mine

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