Monday, June 29, 2009 lovevoice asks

Q: I need your help

hello everybody , I need your opinion about my mother breast cancer ..
in the following Pathology report :Specimen : tru-cut biopsies from right breast .
Gross : received 7 gray-tan soft needle biopsies measuring from 1 to 1.7 cm.
Microscopic : sections show invasive malignant epithelial proliferation made up of solid cords and nests or cribriform in dense fibrous stroma with neoplastic infiltration of peripheral fat tissue . Tumor cells are cuboidal basophilic with large pelomorphic hyperchromatic nuclei with features of abnormal mitosis . Neoplastic permeation of lymphatic vessels.
Diagnosis: Invasive Duct Carcinoma ( NOS ) ; Grade II ; Right Breast.
Neoplastic Permeation Of Lymphatic Vessels.

Now i want to know how much the danger is and what we can do ..
sorry i talk from syria .. and i'm really lost i don't know, everytime we ask new Doc. everytime we get new Opinoin ..
help me please ..

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Answers (1)

PJ Hamel, Health Guide

6/29/09 10:29pm

Hi - I'm not sure what your medical facilities are like in Syria, but here in America, this is a very treatable cancer. Please read our Guide to Understanding Your Pathology Report, to begin. This will help you understand her diagnosis. Then, please read our IDC FAQS, which will give you an idea of the treatment she might get. In this country, if her lymph nodes aren't involved (couldn't tell from the information you gave), she would have a lumpectomy and radiation (radiotherapy); or a mastectomy, with perhaps chemo, if the cancer is particularly aggressive. Both would be followed by long-term hormone therapy, if her cancer is hormone-receptive.

What are the doctors giving you conflicting opinions about? Her initial surgery? It's important to find a doctor you trust, and stick with him/her. Your mother will have a long-standing relationship with this doctor, so it's best if there's trust there.

I wish youboth luck going forward - PJH

lovevoice

7/ 6/09 2:54pm

thank you for your reply ..

we made aThank you for your answer , we made a Modified radical mastectomy from a week ago , and we take the removal to analysis ,
Here is the new Pathology report , hope that you can help me to find my mom's real situation ..
Sorry I'm in a very bad mood please help me ...

Pathology Report

Gross description:
Received a breast measures 17x15x6 cm, covered by a piece of skin measures 15x2.5 cm, the nipple show no gross lesions. On cutting a hard yellowish gray tumor mass is present in the central lateral portion of breast measures about 3.5 cm in diameter with irregular outlines , the rest mammary tissue shows slight fibrosis . sections : representative :
A: the deep resection margins . B: the cutaneous resection margins. C: the nipple.
D: the tumor . E: the rest mammary tissue .
F: the axillary tissue measuring about 9x6x4 cm, where 19 lymph nodes could be palpated through the adipose tissue varied from 0.2 to 0.9 cm in diameters.

Microscopic description :
Sections of the tumor show invasive epithelial proliferation composed of nests cords and sheets of neoplastic ductal cells showing large hyperchromatic nuclei , prominent nucleoli and numerous mitoses , no glandular differentiation is noted . the stroma is desmoplastic with lymphocytic infiltration . Foci of intraductal comedocarcinoma and lobular canerization are seen . scattered microscopic calcification are noted.
The non-neoplastic mammary tissue shows foci of fibrocystic disease. The nipple is uninvolved. All the resection margins are free from tumor.
Metastases to (3) out of (19) axillary lymph nodes , the rest lymph nodes show sinus hsitiocytosis and fatty change.
Diagnosis:
- Invasive Ductal carcinoma , ( NOS ) type , Grade ( III) of the right breast .
- All the resection margins are free.
- The nipple is uninvolved .
- Metastases to ( 3 ) out of ( 19 ) right axillary lymph nodes.

PJ Hamel, Health Guide

7/ 6/09 3:14pm

Hi - This sounds like a fairly typical IDC diagnosis; please try to relax. IDC is the most common form of breast cancer, and with good care, your mom should pull through this as millions of women have. I'm guessing they'll advise her to have some form of chemo. You don't say if the cancer is hormone-receptive; that's something to ask the oncologist. If it is, she'll have long-term (5 years) hormone therapy, which will reduce her chance of recurrence further... You'll both get through this together, and discover strength you never knew you had. Good luck - PJH

lovevoice

7/ 7/09 4:57pm

thank you so much for replying ...

the result of hormone-receptive will appear after a week from now ..and what if yes the cancer is hormone-receptive .. will my mom stay without hair for 5 year ?

and what do u mean by " hich will reduce her chance of recurrence further " she gonna die ? !!

today we asked to make bone scan .. what if the bones were infected ?

can you tell me which stage was ur IDC ?

thank you a lot i know i ask too many question ...

PJ Hamel, Health Guide

7/ 7/09 5:36pm

Hi - No problem, you don't ask too many questions! Hormone-receptive is a GOOD thing - it means she'll be able to take hormone drugs to reduce her risk of the cancer coming back.

If your mom gets typical chemo treatment, she'll lose her hair after about a month, and it'll gradually grow back once she ends chemo - it'll take several months for it to come in short, and probably a year for it to be "back to normal" (unless hr hair now is really long, in which case it'll take longer).

Your mom has every chance of living a long life, without the cancer coming back. However, there's always a chance it'll come back; that's what's meant by "recurrence," that the cancer returns. Please ask her doctor what her "risk of recurrence" is; he/she will be able to telly ou pretty specifically.

If the cancer has spread to her bones (the bone scan will show that), then she'll receive more intense chemo, and take different drugs, than if it hadn't spread.

I didn't have IDC; I had ILC, which is similar, but is harder to detect, occurs in both breasts more frequently than IDC, and involves taking different chemo drugs.

Good lock to you both - stay positive! PJH

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