How often do they get Staging wrong before surgery
Hi, I was just diagnosed with Stage 1 Luminal A grade b 7mm invasive carcinoma with a ki-67 of 5%. It is estrogen/progesterone positive at 92 and 86 percent respectively. They would not have found it if I had not pushed for an MRI before core biopsy as the 2 suspicious masses would have come back negative but this one undetectable area lit up like a christmas tree. My question is how likely is it to have spread to my lymph nodes or do Docs get the initial diagnosis wrong? Surgery is Friday and I am freaking out that I will wake up with bad news, I underwent genetic testing and it all came back negative. They did not see any lymph node invasion on MRI or in initial path test after biopsy
Thank you. Freaking out in Denver
Comments
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welcome to BCO and sorry about your diagnosis. I don't know how often the staging changes, but they found a positive lymph node during my surgery that wasn't apparent before. So it changed my stage. But they prepared me for how nothing was certain until final surgical pathology came back. They can't know for sure from the MRI on the lymph nodes no matter the skill of the doctor reading the results.
That said, it turned out ok. I was given radiation to the area. You somehow get through it all.
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Staging can't be finalized until surgery to remove tumors and biopsies of lymph nodes
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I had mammograms, ultrasounds and an MRI prior to surgery and they still found an extra 1cm tumor in my breast that did not show up on any of that screening!
At the time I was shocked and thinking I was an unusual case, but no - line Jo said, it isn’t until after surgery that you can get a definitive diagnosis
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most of the times the docs get clinical staging right but they can’t be sure till surgical biopsy results are in. In my case, clinical staging was 1 but post- surgery biopsy revealed more than they were expecting and stage was upgraded to 3a after additional scanning was done.
MRI before surgery did not show anything in lymph nodes
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Hi Kymberli36...For me the waiting for surgery & test results was worse then actual final dx. I feel for you. Its a maddening time. You've come to a good place for support here. Wonderful experience group of people.
Yes, in my case dx did change after lumpectomy. However, @ my consult with BS I was told there would be 15-20% chance of having another type of BC in there, which would change my dx. I went from Stage0 (core biopsy) to stage 1A (lumpectomy). Still very good prognosis, but did change treatment. I just finished my final chemo round yesterday, moving on to radiation soon. Doing well, & looking forward to the future, despite those doubts & fears I'm sure will creep into my head @ times. You are @ one of the hardest times during this process. Once you know more you will be ready to fight. Hopefully you have a good team..Dr's, Nurse Navigator, Social worker, etc. that will communicate well with you. This eased my fears ALOT!
Good luck to you on this journey, Hugs, Cyn
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Yes unfortunately you don't know until you have the surgery. My doctors were all wrong from the get go so I ws shocked every step of the way with each result as I didn't know any better. I was told by radiologist it's small and tiny 6 mm's. Had MRI and the report echoed doctor small 6 mm's with no lymph node involvement.
During surgery 1 sentinal node showed micromets. Post surgical pathology showed tumor was 3 cm's So more than three times size I was told and there were 2 of 4 sentinal al nodes with micromets. I asked odds of further nodal involvement and both oncologist and surgeon said slim to none. Well wrong again. I made them do a full Axillary Node dissection and surprise again 2 of 14 additional nodes were fully positive and loaded with cancer. Not one doctor along the way told me that what they initially thought could be wrong. I thought I was stage 1a and in the end 3a. I wish they had never said anything at all in the beginning about size / lymph nodes status and justbwouldve said we don't know. I feel like some treatment and timing decisions were made based on the initial 'assumptions' that were all incorrect. I would rather have gone in not assuming anything as the shock would have been better to handle. I would've prepared for the worst and hoped for the best and instead I had one surprise after another. Never ever again willl I take what a doctor says as word.
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Hi, my initial staging was incorrect, it went from a Stage IA to IIA. After surgery I was informed that there were an additional 2 tumors that did not show up on my mammogram, sonogram or MRI. I was lucky that the cancer did not spread to my lymph nodes. Hang in there, waiting is the hardest part. Once you know for sure you can than move ahead with a plan. Keep yourself busy in the meantime doing things you enjoy.
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Thank you everyone. So sorry for the changes in your DX. My biggest fear. I have also heard where someone was Stage 4 that became stage 2. The MRI showed invasion in her neck but it turned out to be an overactive thyroid. It's the uncertainty that is creating the biggest fear for Friday!
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well don't feel bad - my pathology report come back with not one, but two major errors on it! My Radiologist pointed them out & changed them in my records after talking to the Pathologist. Also my oncologist & radiation oncologist both tell me different stories of my cancer. Thinking about going to Mayo
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First and foremost we all understand your fear factor. It’s the one thing other than a BC DX we all have in common.
Let me add my story to the mix. I had a lumpectomy and when the Path report came back it showed a micromet in the SN. My BS was surprised. I was stunned.
Also my oncologist said my BS staged my tumor incorrectly. It should have been 1b instead of 2a.
Bottom line is obviously they can get it wrong at least initially.
Diane
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is there anyone out there that has had a lumpectomy to the left breast followed by radiation & the radiation group doesn't believe deep breath inspiration is beneficial to protecting your heart when having radiation to the left breast
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Hi BadLuck,
Did they have any other strategies to try to protect your heart?
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BadLuck, I would run to find a different radiologist. Their reluctance probably speaks to the fact of not having the equipment for gated breathing and they probably haven't used this protocol. FWIW I had lumpectomy left side and they used the gated protocol (breathing) and I am just fine.
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They never even mentioned the deep inspiration breath hold technique to me at all. I did slot of reading & then discovered this technique that Mayo & other clinics use to protect the heart for patients getting radiated to the left breast. They told me they aren't set up to do that but may start that procedure around the first of January. I also read about another technique where the patient can lay on their stomach & the breast hang down through an opening where which is safer than the old traditional way of laying on your back with arms up over your head & head turned sideways.
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I had 33 radiation treatments on the left breast and they never mentioned that to me either. I am 7 years out this past August.
Diane
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LeesaD - the same thing happened to me and I also wish they had just said they didn’t know - or that anyone had even suggested things could change so much. My BS was so confident that I was a 1A With no nodal involvement. She couldn’t even look at me when my surgical path came back with a bigger tumour and 10 (!!) positive lymph nodes. Just like you said - I would have so preferred to prepare for the worst and hope for the best instead of getting knocked down over and over again with bad news.
Kymberli36 - as others have said, the waiting is the worst part. Once you have all the results you can move forward with a plan. Until then it’s so hard. Sending you lots of support and comfort while you wait and hoping for good news
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