Mom Diagnosed & Questions.

Eric, Hi so sorry to hear about your mother's diagnosis. First, I am in no way a medical person, just a patient. By reading that report, it seems your mother has LCIS (not cancer but I would call it a pre cancer). Which has become invasive. The grade 1 is good news. The Allred scores are telling you that it is hormone positive and Her2 is negative. Also good, or should I say better than some other sub types of breast cancer.

Are you located in the US? If so, what will probably happen on Monday is they will do an exam and order an MRI. This gives them more image and sizing of the tumor. They will do blood work. They will need to know her menopausal status. There is also a blood test for this if she's still not all the way into menopause. After the MRI results and blood work, they may have you back and at that point surgery will be scheduled. After the surgery, there will be another pathology that will determine the further treatment. As well as having a big decision as to what surgery to have.

I tried to keep that short, because it is a whole lot to take in at the beginning. We'll be here to try and help.

Edited to say that with the language barrier, they should allow you to be on the phone during the appt. if covid restrictions will not allow you or someone to be with her.

Just a note, not every hospital or medical center does MRI. My cancer clinic is a NCI designated cancer center, and they don't routinely do MRI. So while that is very possible, it is not guaranteed by any means.

I'm sorry to hear about her diagnosis. Will you be able to go to the doc appt with her?

Hi Eric, and welcome to Breastcancer.org,

We're so very sorry to hear of your mom's diagnosis, but we're really glad you've found us. As you can already see, our Community is full of amazingly helpful members, always willing to offer information, advice, encouragement, and support -- we're all here for you both! And, your mom is very lucky to have a loving son such as yourself to help look after her!

To address your note about questions to ask the doctor -- there's a great page on the main Breastcancer.org site on Questions to Ask Your Doctor About Your Diagnosis. As well, the Your Diagnosis section will be helpful to explain what each piece of the pathology "puzzle" means for your mom's treatment. It's very helpful to read up on to start to learn some of the breast cancer "language" that is always a bit confusing as you begin to navigate this new world.

We hope this helps get you started here. Please let us know if there's anything at all we can do to help!

--The Mods

Hi Eric,

So your mother has both ILC and LCIS - having an invasive and in situ cancer together is very common, since most invasive cancers develop from in situ cancers. The more serious condition is the invasive cancer, and the diagnosis, prognosis and treatment plan will be based on this.

As MountainMia mentioned grade 1 is good, as is having a mitosis score of 1 - this means that the cancer cells are not particularly aggressive. The hormone status of the cancer is ER+/PR+/HER2-, which means your mother will almost certainly be prescribed anti-hormone therapy, either Tamoxifen (if she is pre-menopausal) or an aromatase inhibitor (if she is post-menopausal or undergoes ovarian suppression). These meds are usually taken for at least 5 years and sometimes 10 years.

Next up will be surgery. Whether a lumpectomy or mastectomy is recommended depends on the estimated size of the area of cancer. If a lumpectomy is recommended, radiation always follows. Rads isn't usually necessary after a mastectomy but might be if the area of cancer is close to the chest wall, or extremely large, or if there are any positive lymph nodes. Even if a lumpectomy is recommended, your mother could opt for a mastectomy or even a bilateral mastectomy.

The information to come after surgery are the total tumor size and whether there are any positive nodes. This information will help determine whether or not chemo is recommended. With an ER+/HER2- cancer, there is also the Oncotype test, which assesses the genetic make up of the cancer cells. An "Oncotype score" is assigned to the cancer, and with that, there is an associated risk of metastasis and a recommendation as to whether chemo would be beneficial in reducing that risk, or whether anti-hormone therapy alone will suffice. The Oncotype test is sometimes done on a biopsy sample but more often is done after surgery.

So, with all that, step one will be the surgery decision. As MountainMia mentioned, the surgeon may or may not recommend a MRI prior to surgery.

Good luck to your mother on Monday. Glad you will be able to join, even if it's just be phone.