12 cm tumor with no lymph node involvment
Dr said this is an odd case. To have a tumor that is an ulcerated and fungating invasive DC that is 13.5 x 10 x 6.4 cm, and no lymph node involvement, and also no vascular invasion is unheard of. Is this something that i should have retested by another Dr.? I am also triple neg. Here is my pathology report. Just think it is quite odd to have such an aggressive Large cancer no invading nodes or vessels.
13.5x10x6.4 cm idc ulcerated and fungating invasive ductal carcinoma. With invasion into the deep skeletal muscle focally extending to the deep inked margin of resection. 12 lymph nodes negative for metastatic carcinoma.
nottingham combined 3 tubule formation, 3 nuclear pleomorphism, 3 mitotic rate
tumor focality-single focus
ductal carcinoma in Situ-not identified
lobular carcinoma in Situ-not identified
vascular/lymphatic invasion-not identified
pNO:no regional lymph node metastasis
total lymph nodes examined:12
margins invovled by carcinoma Deep, extent of involvement: focal
distant metastasis:cannot be assessed.
pathologic staging: pT4b pNO
Ki67 (30-9) 95%
occupying apprx 70% of the breast
the mass grossly appears to invade the aforementioned skeletal mucsle and come within less than 1mm of the margin of resection. the mass is contiguous with the aforementioned area of exophytic tumor extention of the anterior skin surface and comews within 0.5 cm of the margin. the mass grossly appears to involve all 4 quadrants of the breast. residual fibrofatty breast parenchyma is present predominantly along the superior aspect of the specimen with a scant amount along the medial and lateral aspects. The center of the mass is yellow, soft, and necrotic. No intaparenchymal or laterally located lymph nodes are grossly identified.
Comments
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I have no experience with this but just wanted to bump this. It really sounds miraculous that there has been no spread. Many places will do a second opinion on the pathology, Johns Hopkins come to my mind.
http://pathology.jhu.edu/department/services/secondopinion.cfm
Perhaps some of the folks on the triple negative thread might be able to help.
I hope you get some answers soon.
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I would have lots of questions, and I would want to be sure that the people answering them were top-notch, as in major academic medical center/NCI-designated Cancer Center. And then, even if I were sure, I'd want a second opinion.
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I definitely agree with Outfield that a second opinion with an NCI designated Cancer Center is in order.
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