QuestionQUESTION: I was diagnosed with brest cancer 3 years ago, Lumpsectomy, chemo and radiation - being on Tamoxifin to date.
Just discovered a lump in my armpit which has moved to the fron of
my hand in under 3 weeks.
Pathology report : Positive confirming ductal carcinoma ?
Histology report - Grade 2 duct carcinoma
I have been told by my oncologist that it is Cancer - What I want to know is what stage is this cancer at?
ANSWER: I have to assume from your question that a biopsy has been made from the lump in your arm pit and that cancer has been found there. Correct? If so it has probably been found in a lymph node there. In that case your case is now a stage 3. For a more detailed definition I do need a lot more information from you including your recent pathology report.
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QUESTION: My Histopathology report.
CLINICAL HISTORY
An adult female patient with previous history of lumpectomy for breast carcinoma, now presenting with a highly spiculated and striated mass in the right axilla, measuring 15 x 9mm. The graphic impression is that of malignancy, core biopsies have been performed.
MACROSCOPY - Five needle cores ranging from 5 - 15mm
MICROSCOPY
Histological examination confirms the presence of core biopsies representing fibroadipose breast tissue with an extensively invasive mammary adenocarcinoma present. The tumour is composed of nests of tumor cells, with single cells present. Tubule formation is poor. The tumour has induced a very intense desmoplastic stromal response. No definitive lymphoid tissue is present and thus may either represent a soft tissue deposit/metastasis, or complete obliteration of the tumour by metastatic carcinoma. Pleomorphism is only modest at worst, and mitotic activity is low to intermediate, giving a BRE score of 6 - 7 (grade 2 duct carcinoma).
DIAGNOSIS
Biopsy, right axilla: (1) Grade 2 ductual carcinoma, probably representing a metastasis, although true tymph nodal tissue is not identified.
SUPPLEMENTARY REPORT
Appropriate immunohistochemical stains have been performed on the tissue submitted and in the presence of adequate controls, these stains have been proved as follows:- Results of Immunohistochemical stains
Marker
- Oestrogen receptors - Proportion of positive cells > 66%
Intensity of staining (1-3) 3+ Positive
Allred score 8/8
- Progesterone receptors - Proportion of psitive cells >66%
- Intensity of staining (1-3) 3+ Positive
- Allred score 8/8
- Her2 Overexpression - Corrected Score (0-3+) 2+ Equivocal - SISH Requested
E-CADHERIN POSITIVE CONFIRMING DUCTAL CARCINOMA
Above my Reports :
Should I be at stage 3 - How many stages are there, will I need to take the red chemo? How successful is it ? Will I need surgery thereafter ?
Radiation cannot be done as I had radiation previously on the same side.
What is my life expectancy? Thank you so much.
ANSWER: Thanks! Based on your pathology reports I can actually see 3 possibilities here. 1. Your original cancer has spread to a lymph node in your arm pit (this seems to be the interpretation your pathologist favours). If that is the case it must however have grown out of that lymph node destroying it in the process (since there is no lymph node tissue to be seen) and growing into surrounding tissues. In that case it is more serious than just a stage 3. 2. That it has in some other way than via the lymph system spread to your arm pit. That too is more serious than a stage 3.
3. What is written in the report made me think of yet another possibility. Breast gland tissue is actually transformed sweat gland tissue. It is rather common for women to have so called aberrant breast tissue in the arm pits (sometimes even with menstrual pains there). As I read your report it may be an entirely new breast cancer starting in such breast tissue there. The probability of that is not big but it is not impossible. If so this is an entirely new cencer. That would not be too bad. I agree that more radiation is impossible. Treatment must be surgery and chemotherapy. Your prognosis depends on which of these alternatives it is. By comparing your old cancer with this one it may be possible to decide what it is. Discuss this idea of mine with your doctor! Good luck! P.S. There are 4 stages. THANK YOU!
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QUESTION: FISH results : HER2 - NEGATIVE
starting Chemo next week - apparently starting with the Red Chemno.
Does this give an idea the stage of cancer I have ?
Thanks you have been a great help.
AnswerNo that depends entirely on which interpretation you have of what has been found. It can be anything from a stage 4 to a new cancer originating in extra breast gland tissue there. In that case it is a new cancer staged somewhere around 1 or 2. Have you discussed this with your doctor? You should!
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