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Tuesday, March 29, 2011 Craig asks

Q: My wife was diagnosed with invasive ductal carcinoma a few weeks ago.

Hello,

 

My wife was diagnosed with invasive ductal carcinoma a few weeks ago. She had a lumpectomy and we received her pathology report. I was wondering if anyone can comment or point me to some useful information to better understand the results.

 

Here are a few findings:

 

Tumor size: 0.7 cm

Nuclear Grade 1-2/3 without luminar necrosis

Histologic Grade: Nottingham 1/3

Tubular Differentiation: 1/3

Nuclear Pleomorphism: 1/3

Mitotic Count 1/3

Margins uninvolved

Distance from closest margin: 3.5 mm

ER >90% PR > 90% HER2 IHC -1+ negative

 

They also removed two lymph nodes and found something in one. This is what worries me.

 

Negative for histologic features diagnostic of metastatic tumor. Immunoractivity with epithelial marker, cam 5.2/ae1, in isolated tumor cells (2 separate cells) measuring less than 0.2 mm.

 

Does this mean the cancer has spread?

 

Thanks for your help.

 

Craig ...

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Answers (1)
PJ Hamel, Health Guide
3/29/11 8:28am

Hi Craig - First of all, I'm sorry you're both having to go through this. Thankfully, the majority of women with breast cancer successfully go through treatment, and go on to live long and healthy lives.

 

First, please read our Guide to Understanding Your Pathology Report. You'll find that it'll enable you to interpret most of what you've written above. Basically, it sounds like you wife has a very common diagnosis, and thankfully, a "good" diagnosis - in other words, the cancer isn't aggressive, and will respond to hormone therapy. It's always good to have NO lymph node involvement, but it sounds like your wife's is very, very minimal; latest thinking is that these "micrometastases" really don't influence long-term outcome.

 

The tough question will probably be whether or not to have chemo. Ask her doctor if she's a candidate for the Oncotype DX test, which predicts pretty accurately how much good chemo would do her. And, if you both feel on the fence about this decision, please read our post on choosing chemo; it may help you make up your mind.

 

Finally, check out our post on treatment, which has links to all kinds of useful information you'll both want to be researching in the weeks ahead.

 

Best of luck to you - and please come back here anytime with questions, or anything else. We're here to support you. Take care- PJH

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By Craig— Last Modified: 03/29/11, First Published: 03/29/11