Pathology after Chemo

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Walden1
Walden1 Member Posts: 202
edited May 2018 in Chemotherapy - Before, During, and After

I did chemo before surgery and my pathology report shows chemo effect, but some residual IDC with Remaining Dcis. Hoping someone out there can shed some light on one statement in the report. It says "there is significant retraction artifact, but no obvious lymphovascular invasion". My Oncologist says "this is a good finding: retraction artifact means the IDC shrank and pulled away from the surrounding tissue". Wondering if anyone else had this in their report and how their oncologist explained it. I'm not sure if it means some cancer cells died so the tumor shrank, or IDC cells where simply damaged and shrunk down.

Looking for reassurance that some of the IDC cells where killed, as opposed to simply damaged. My pathology report alsosays the " tumor shows treatment effect" Does effect mean cancer cells were damaged or actually killed? If there are damaged cancer cells floating around will they repair themselves and become a threat, or are they damaged enough not to be a threat? Anyone else with this in their pathology report get clarification from their oncologist?

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  • beauz
    beauz Member Posts: 207
    edited May 2018

    Hi warden,good news that your tumors responded to chemo. I have none of these in my post surgery pathology report. my guess is that it could be the pathologist's way of saying after chemo there's no obvious lymphovascular invasion, but don't know or not sure about before chemo because tumors have shrunk so much.

    I am also curious if you have restaging of the remaining cancer in your post surgery report, in particular grade of the residual tumor. The grade of the residual will partially tell the treatment effect. Mine is virtually the same as before chemo as shown in my profile, even though I could feel my tumor was getting smaller.

    My surgeon spent about half an hour or so just talked about positive margin thing, recommending more chemo, not more surgery. After he handed me the report I realized that there are whole heaps of other bad things in the report that he didn't mention. I had to wait for three more weeks to get an appointment with MO for further clarification. My MO only told me that my weird lump wouldn't have changed my treatment plan at all. He consulted his colleagues in major hospitals and gave me option of Xeloda. None of them addressed my issue of extensive lymphovascular invasion.

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  • Walden1
    Walden1 Member Posts: 202
    edited May 2018

    Hi Beauz,

    Looks like you recently finished your treatment, congrats! Will you do hormonal therapy too?

    Good question about grade and staging. My path didn't have any of those details. I asked the pathologist himself and he said the chemo changes the cancer cells so it's not possible to comment on grade anymore. Doesn't make sense to me though because I have heard from a few people that their grade change was noted in pathology or at least a comment like “not viable". Also the report only commented on the largest dimension of tumors, so I don't know what shrinkage actually occurred. I did notice some shrinkage in palpitating but that's all I know. The report does mention I'm RCB 2, which is another way of saying I had a moderate amount of residual IDC. My doctors don't seem to need further clarification to recommend more treatment. They do feel the report is brief though, and one suggested the type of answers I'm looking for might not be visible in the sample. I've read online that retraction artifact is linked to positive nodes, but I’m not node positive. My MO and RO say it's a sign the cancer “shrank" for lack of a better word. I find that disparity totally confusing.

    I'm sorry you had to wait so long to get clarification. Sounds like they planned to treat you aggressively so the findings didn't change your plan. My doctors seem to be treating me aggressively as well although the pathology was mostly “good" in their words. I feel I'm in a grey area for many of the treatment decisions, so given my age my doctors recommend the more aggressive approach.

    I'm pretty disappointed that radiation is being recommended now. It would be nice to know that I wasn't being over treated, but I feel I need to do everything possible for my little boy. To be honest, I was hoping to hear from others on this forumwho had radiation after mastectomy with zero nodes, just to give me reassurance. Haven't heard from many people yet, but it's not completely unheard of with larger tumors.

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