Surgical pathology changed stage due to Multi-focal tumors
I went today for my post-op appointment and received my surgical pathology report. My stage changed from clinical 2 to pathology 1. On the mammogram and ultrasound, the tumor was estimated at 2.1cm. On the surgical pathology report it stated that the tumor was multi-focal. This means that there was actually 3 tumors that started from the 1 tumor. In staging, they use the largest tumor size and not all the sizes combined. Also, the grade of the tumor changed from grade 1 on the biopsy to grade 2 on the surgical pathology. Has anyone else had this same diagnosis of multi-focal or grade changing?
Comments
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Mine was thought to be one 3 cm tumor based on imaging but after surgery it was discovered to be two tumors--one 2 cm plus another smaller one. It's very surprising to think one thing and have it turn out to be another. The grade didn't change from biopsy to surgical pathology that I'm aware of.
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Mine did change from 2 ILC tumors to 1 IDC and 1 ILC. Neither my mo or surgeon were concerned. Each were almost the exact same size. They were only 4cm apart and in different quadrants, multicentric. I had a mastectomy and the pathology said multifocal but 95% certain that they were synchronised separate tumors. No indication of any cancer between them. I could have had 2 lumpectomies. I also had a suspicious area on ultra sound that turned out to be normal. But I won't have that detailed information if I chose lumpectomy . I kind of wondered why 2 biopsies initially said both were ILC.
I only received one oncodx number 34. I am glad with my decision not to do chemo, but I have to say they really down play the risk of taking amromatose inhibitors. I still feel side effects from them after being off for 1 year.
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Meow...Congratulations on being done with treatment! However you bring up a good point about having permanent SE from anti hormone treatment. Many women do not realize that this is possible mostly because most doc don't tell you! Just think we should all be aware of it no matter what treatment options you decide on. Getting all the facts is the only way we can make informed decisions...
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ladies with changed staging due to multifocal tumors - I have multicentric multifocal - 2 biopsied invasive mammary carcinoma “with lobular features” and MRI showed 4 other similarly sized sub-centimeter tumors. The quadrant spread could be two quadrants or three...not sure.
Anyway - interested in how you ladies are doing now. I’m having BMx and had always planned to from the diagnosis.
A little concerned about the stat that only 10-12% of patients have multifocal disease and the one that says of these, 52% have lymph node involvement and 48 do mot
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my mammogram showed one tumor , when I did digital mri they found three more and they actual surgery picked up another one. Rather upsetting. The docs didn’t want to do oco-type cause they thought would be false positive so I did three month of chemo with dense dose at the end. (Also because one of my tumors was acting more aggressive then normal. I start 7 weeks of radiation in a bit but it’s too with proton instead of photon
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Djsalem - what’s oco-type? There is an Oncotype test done - I had one - that evaluates your particular tumors so there is no false positive involved. It’s specifically used to see if chemo would be beneficial. They calculate a score and your chances(%) of a recurrence based on your tumors.
That’s scary stuff with all those tests.
Diane
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I had my pathology change from grade 2 to grade 3 on my first BC bout after surgery.
And I was multifocal too after surgery so I went from stage 1 to stage 3a. (one bigg tumor!).
I am still here, 13 years later even though I had positive nodes. I did chemo,rads mastectomy, ovaries out and hormones.
This time around, in the other breast, I had initially 2 tumors at ultrasound and MRI and 5 tumors after surgery. Grade did not change. Remained at grade 2. My oncotype dx was 14 so it was recommended no chemo this time. Only arimidex.
I feel the affects of the arimidex now after 14 months. My hips, ankles and especially my knees are starting to hurt. My skin is super dry. Sigh....
But I am still here...
wallan
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Yes I was on anastrozole about that same period of time the pain was cumulative. I hated exemestane I had severe dry eye and weight gain.
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oh, you guys...thank you so much for chiming in with your multifocal stories. Wallen, so glad to hear you didn’t have to have chemo this time and that you stayed at stage 2 this time.
As an update to my comment above Aug 12, I ended up having 7tumors, all made of the same thing, so it's multicentric IDC “with lobular features." Two 5mm, two 7mm, two 17mm, and one 9mm. No lymph node involvement.
I hope more research is done on multifocal and multicentric breast cancer. It seems like currently we might just be “along for the ride" in the single-tumor camp in terms of treatment and surveillance.
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I was told 2 weeks ago I had DCIS after my biopsy report, I was told to have the lumpectomy with maybe a few radiation treatments the size was 0.4x6 in size, very small. Had to have a breast MRI, next day went to see the surgeon..
He now tells me things have changed since seeing this MRI, its called a multi-focal tumor the size is 8cm now, he says to remove the breast, along with the lymph node, no treatments needed after that, I am overwhelmed over this news, why remove a breast when it is 0 staging , it just seems so drastic to me, sort of like removing a hand because it has an infection in it. I have seen that some women now are choosing to do nothing with DCIS..
Another thing I have not talked with a oncologist yet, I was told it was useless to do that until after surgery..I am having a really hard time comprehending all this...Would appreciate your thoughts
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I am not a doctor obviously, but I believe with 8 cm DCIS, there is no way of knowing if there is any Invasive cancer embedded in it without taking it out. And in my opinion, the surgeon should not be suggesting no further treatment. That is for you and your oncologist to decide after you have been given the options available.
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Thank you so much for responding back to me, this has really sort of slapped the wind from my sail so to speak.....
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Joy, unfortunately we still are at the level in treatment of cancer removal of all tissue. 8 cm is large, but I wish I knew that plastic surgery was as good as it is when I had my mastectomy. I had a DIEP 4 months after and was astounded at the results. Better than pictures I had seen. There are scars but after 2 years the are so minimal. The one large scar on abdomen is below bikini line on me so not a problem for me anyway.
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Thank you for commenting...I think I am just so overwhelmed with the whole thing and very confused why I need to have my breast removed for something that is not cancer~
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