Poorly differentiated 6 cm tumor - prognosis?

God Bless you for the quick response.  Waiting on pins and needles for the biopsy results of sites on the right breast that were biopsied yesterday.  If positive we're ready to meet with our surgeon.  If not they want to do another biopsy tomorrow using MRI guided needle.  We haven't gotten formal biopsy results from the left breast -we were just told it's bad news, it's cancer, and the mammography doc mentioned the larger size/poor cell differentiation.  My mind/emotions are racing. Should I start the second opinion wheels rolling, etc. etc.  Having trouble eating/not crying just walking along the street.  Everything is so raw now, and feel so alone.  Your comments were a lifeline in the middle of night.  Thank you, thank you.

Yesterday got back results that right breast biopsy was negative - first glimmer of light.  Need to go for MRI-guided biopsy of same area to make sure tomorrow afternoon.  Think we've selected a surgeon to see hopefully Friday - feel good about that.  Finding it hard to juggle work.  Emotions all over the place but actually got some good sleep last night.  Worried about how we'll handle news of what stage the cancer is/how aggressive it is or isn't/what we're facing.  Still trying to think about stepping over that rock on the path. 

So, that's a good step in the right direction. Now you're waiting for the pathology report on the other breast? That will tell you a LOT about the cancer, including stage, and whether it's hormone-receptive and/or HER2-receptive (or neither), all of which will impact the direction her treatment takes. Waiting is hard; but you'll get through it. You WILL step over that rock, because you'll have lots and lots of hands reaching out to help you - both of you. Friends, family, and the community at this site. Keep in touch, OK? We're here for you. PJH

Thank you, PJ.  Haven't personally seen the path report done on left breast - will be sent to surgeon.  Tomorrow's biopsy results on right breast may or may not be ready by time we meet with surgeon on Friday - but will have first results on right breast which were negative.  We haven't been told anything about pathology other than "poorly differentiated" comment.  Thanks for being there.

Good for you - it's hard to know how "to be" right now.  Tears are so close, the fear so huge.  I don't want to be pollyannish, am trying to keep my wife on an even keel as much as possible keeping the normal routine as much as possible.  Another incredibly difficult thing in the mix is the heroic job my wife has been doing for the last 3 years caring for her 84 year old father with Alzheimer's in our home...another complication we'll deal with going forward. 

Hi Allen, Hope you do not mind me jumping in. My BC had spread to stomach and colon, I was advanced stage 4. I made it and so will your wife. You are in shock and cry if you want to ,then after that give your wife the biggest hug and kiss. Positive thoughts to you ,your wife and her Dad. This is a wonderful forum and the experts keep us all going.

Not only don't I mind - your support made my morning.  It's taking it hour by hour right now until we know what we're up against.  Thanks for the advice.  Will do my best to keep it positive.  I do a lot of positive healing imaging while she's asleep and my arms are around her. 

There's no right way "to be."  I hope you get good news from the biopsy, but whatever happens, just share your authentic emotions with your wife.  My husband and I tended to take turns falling apart.  Someone has to hold it together long enough to schedule appointments, get supper, and ask the follow-up questions at the doctor's appointments.  The coping skills you have been learning caring for your father-in-law will serve you well in this situation.  

Allen, where there's life, there's hope - never were truer words spoken than about cancer. Treatments are improving SO rapidly... esp. for breast cancer. Did you know there are just about 2.5 million breast cancer survivors in the U.S.? That's a LOT of women who've gone through this and are living proof that cancer can be beat. I trust you'll find lots of support at this site; we're here for you. And there's no "should" about cancer and how you feel: validate your feelings. You're entitled to them, and they're right for you, whatever they are. Try to move past the fear; try to hold onto the hope and good, "Pollyanna" feelings. Both will come and go... We're here - sometimes even at 2 a.m.! One question: is your wife being treated at a good cancer facility? Please take a look at our government-endorsed list of Comprehensive Cancer Centers, which are the top 40-something dacilities in the U.S.... Best of luck to you both - to all three of you (Dad too). PJH

Allen, one more point. My Husband and I always had a close relationship. I know this may sound odd but Cancer brought us even closer. During my chemo we were like a couple of newly weds. I guess it makes you realise how valuable life is.Every day now is a gift, I do not waste a moment thinking about 'That' time but look to the future and all it holds.God Bless.

Great advice - I know what you mean about the closeness.  Living through the Alzheimer's with her father has also brought us much closer - through all the pain that horrible disease entails. 

Yes - our surgeon is at a top-40 comprehensive cancer center.  Thanks for asking.  It is so subjective and my wife feels good about it.  Am grateful for the progress made today.

Excellent, Allen - I was cared for at a CC Center, and was very, very happy with every aspect of treatment. One hint: when it comes to choosing an oncologist, be sure you find someone you both like and trust, someone you feel comfortable with. You'll most likely be dealing with this doctor for many years (given the long-term drugs, etc.); it's REALLY helpful to have a comfortable relationship. Thanks for staying in touch - PJH

Have gotten glowing recommendations about the oncologist by a few people - works as a team with the surgeon we're seeing.  He saved a friend's life with a very difficult case.  Just got off the phone with his assistant who called me back at 7:30p - said he's very busy and travels a good deal but that someone from the team will always be there for us.  She sits close to the surgeon's assistant.  Also the center is very close to our home which helps.

All sounds good, Allen - you're definitely on the right track, as far as "the details." Hope the meeting with the surgeon goes well - PJH

Having a rough night.  Despite the good news about the right breast I'm dreading the meeting with the surgeon.  I have my wife's path reports in my bag and they're burning a hole in my psyche.  I feel like the words we'll hear at our 9:30am meeting with our surgeon tomorrow morning will change our lives - and I'm horrified to hear those words..."stage ____" - has spread to the ____"  I feel embarassed to say it because you all have been so brave in the face of the same situation.  Please pray for us.  I'm so worried about my wife...and feel so helpless. 

Those middle of the night fears are always the worst, Allen. The sun comes up, and your spirits rise with it. I'm betting your surgeon will prove very reassuring. You'll find a whole team of doctors and associated medical personnel rallying around you both - it's amazing how many different people will care for your wife. And it's gratifying and heartening how smart they are - how much they know, how hard they work. Since you have her pathology report already, you may want to take a look at our Guide to Understanding Your Pathology Report - I think you'll find it helpful. Good luck today - PJH

You were so right.  Just got back from the hospital - had a nice lunch and took a walk.  We were reassured in so many ways.  My wife has invasive ductal carcinoma in the left breast - but her lymph nodes felt very normal - a good sign.  Her cells are poorly differentiated - but no vascular invasion seen - another good sign.  You were also right about the MRI.  Our surgeon is not convinced that the entire 6cm area seen as possible tumor is in fact diseased.  Similar areas on the right breast are normal.  We will do an additional MRI-guided biopsy - currently scheduled for Nov.5th - at the margins of the suspicious area to see if they might be fibrocystic or glandular.  She looked at the MRI's with a radiologist and there is a good chance of this.  Right now we are Stage 1 clinically - possibly Stage 2.  No signs of metastisis so far.  Grade 3 (not sure what that means).  I feel like pinching myself - we were giddy and we had just left a hospital for a diagnosis that is still breast cancer.  Crazy but it's like you said - we see the path ahead again.  Thank you so much for the encouragement.

Well, that sounds excellent (if you can apply that term to cancer!) Really. If her lymph nodes are clear, I think she'd probably be a definite stage I. In which case she could hopefully avoid chemo, though the "poorly differentiated" and grade 3 (which is a sign of aggressiveness) might point her in that direction, as a "just in case" measure. When/if you get to the point of deciding about chemo, ask if she can have the Oncotype DX test, which gives a good indication of how effective it might be, and is a helpful way to make the chemo decision, when it's unclear whether it's necessary. Also - be prepared. You're both going to be called no to make an awful oot of tough decisions. Funny, but oncologists and cancer surgeons always give you so many choices, when what you REALLY want is for them to tell you what to do! Hey, have a good weekend - PJH

hope you dont mind if i send this.  I have been following your notes, prayerfully, for you and your wife.  I Had my biopsy today and am sitting here with the ice pack, while typing. i was overjoyed to get your last message. you have been on a rollercoaster ride so far.  your wife is so lucky to have you.  My husband has to be gone alot, so i am alone today. Someone has to pay  the bills. I will continue to pray for your wife and all of those women that i have been sitting in the clinic with, waiting fearfully. you are in my prayers.  please pray for me. 

God will give you strength - believe it. PJH

Trying so hard to believe it.  I keep hugging her tighter...visualizing a healing.  Should have more news Friday.  I will take that strength.

Hope your biopsy went well.  We are in a very strange limbo state since our appointment with the surgeon...waiting for our biopsy on Thursday.  My mind plays tricks...maybe our first biopsy was a mistake.  I'm hoping so much for good news...moreso every day and fearful of what we'll find out.  Am praying for you too.  Thankfully my boss understands and I have been able to stay close to home since all of this happened. 

So Allen, you've got probably another week to wait - I'd doubt they'd give you the biopsy results right on the spot, right? The process of developing a diagnosis can seem to take forever... it's a relief to finally get into active treatment. So hang in there - you're stronger than you know. And I'm glad you've got an understanding boss... PJH

You're right - better to get ready to wait another week.  It does seem like an eternity.  I keep wishing for the time "before" the "c" word.  Have a hard time accepting our new reality.  I tend to be a bit OCD so the mere thought of circulating cancer cells in my loved one's body makes me a little crazy.  It's so exhausting to keep behaving as normal as possible for our son and friends.  I appreciate the encouragement. 

Time heals - believe it or not, you get used to this new reality, and you gradually settle back into life. Life won't be the same - it'll hopefully be better, as you're seeing how very precious it is. Cancer can change your life - if you let it. Thanks for staying in touch, Allen- PJH

My wife just got a phone call from her surgeon with the biopsy results.  It wasn't the news we wanted.  The biopsy found microinvasions of DCIS radiating out from the tumor in a 7cm area of her left breast - but the good news was it looks like we've caught this early - Stage 1 or 2.  Our surgeon said that it will have to be a mastectomy - not lumpectomy.  My wife sounded surprisingly good on the phone.  We have an appointment with the plastic surgeon tomorrow at 9am.  The surgeon said we could wait until after Thanksgiving but we're going to say we're willing to do earlier if possible.  I would have gotten more details from the surgeon but I'm in a back seat at the moment - still trying to be as helpful as I can.  My wife's personality is more one of trusting the surgeon and not needing all the specifics.  Feel numb after days of waiting - but relieved to have news even if it wasn't what we wanted. 

Well, still, Allen - DCIS is totally curable. In fact, I was reading some research yesterday that said doctors have just about decided to downgrade DCIS from cancer - not call it cancer, call it a "condition." So I think the mastecotmy is the right choice, just because the lumpectomy might not give her the cosmetic results she'd like. So onward and upward - I think things are (pretty much) going your way! PJH

Thanks for getting back so quickly.  It sounds like the 1.7cm tumor is the only part that is invasive ductal carcinoma.  She said we would have to wait until the surgery and sentinel node biopsy to find out about radiation and chemo.  Now I'm wondering if we should remove the right breast too - cystic changes there are apparently benign.  And if we should go for reconstruction...

She's right, you still need more information till you decide on chemo/radiation.

I had a similar diagnosis to your wife, as far as tumor size; and with invasive lobular, I have a greater chance of it appearing in the other breast. I chose a lumpecotmy; when the cancer turned out to be too widespread, I had a mastectomy, and reconstruction. I left the other breast alone.

Only you guys can decide how worried you'll be about a new cancer in the other breast (it wouldn't be a recurrence - it would be a new cancer). But for me, I figured, IF I get a new cancer - think how much farther along the treatment will be! I'm glad I kept my breast - 8 years out, it's nice to have one that still feels natural (rather than stiff, numb, tingly).

Lots of decisions coming up, Allen. Stay in touch... PJH

Rough emotional day - feel like someone has been pummeling us.  We met with the plastic surgeon.  Dry, clipped, unemotional...sure he has to be.  He recommends a saline implant - tissue transfer too dangerous given my wife's previous deep vein thrombosis after a double knee replacement.  My wife is tempted to not have reconstruction - why reconstruct something that will never replace the real thing?  Also she was small breasted until breast feeding our whopping 9 pound son for over a year.  I'm worried she isn't really thinking about how unbalanced/inconvenient it will be...she's more "devil may care." 

I'm encouraging her to have surgery ASAP, she was thinking of doing mastectomy after Thanksgiving.  I want her just to focus on herself right now.  Lots of tears today - mourning the impending loss of her breast.  Also wondering about removal of the right breast prophylactically since she has been diagnosed with DCIS/IDC in left breast.  The web-surfing I've been doing can get to be very scary - like a black hole emotionally sucking me down. 

I feel badly for my son...he's very worried too.  Now I'm dreading the sentinel node biopsy and what we'll find out.  Just trying to breathe tonight.  Trying to work at my job...but not any where near my normal focus/productivity.  I've always completely concentrated on my job - very demanding.  Now I'm so distracted.  Sorry for so much whining.  I know it will get better...just not there yet.