the right way oncology

[rafek]

My wife has a DCIS in her left breast and she did a mastectomy and the Microscopic Description is as follows:-
1-Extensive DCIS of intermediate to low grade with two foci of early invasion. One is of conventional invasive type and the other is of mucinous type. There is accasional foci of lymphovascular invasion.
2- Fibrosis, adenosis and cystic changes. The nipple shows DCIS but with no Paget's disease.
3- Eleven reactive lymph node but with no tumor spread.
4- Muximum tumor size is 8.0cm.
Note:-
Estrogen receptos: positive in 85% of tumor cells.
Progestrone receptors: positive in 95% of tumor cells.
HER-2/neu over expression: Negative (Score 0).

We have consulted two Oncologists and they were in different openions of taking the radio and chemotherapy or not.

Please advise what is the most safe and cured way to get rid of this damned desease.

Mohamed Rafek
May Satea ( my wife's name)

[raman10790]

hello everyone!
my mother MRS. KIRAN (age 44 yrs.) is sufferring from breast cancer. she had gone through a BCS surgery 10 days before.The IMPRESSIONS of her histopathology report are as follows:

infiltrating duct carincoma(NOS) welll differentiated.
base unremarkable
R B Score-2+1+1=4  (grade 1)

lymph odes-(4/7) reveal metastic duct carincoma perinodal spread seen in three of nodes. remaining nodes show reactive changes.
pTNM-T1 N 2 Mx

// can anyone please tell what is the exact nature and stage of this type of cancer at this juncture and what type of further treatment is suggested i.e what type of chemotherapy drugs..

please reply

sincerely
raman

[katarina777]

Oh, and what were the opinions? did one recommend either or both chemo and radiation, and the other ?. (just if you feel like sharing this, because I would be interested in knowing)

[katarina777]

I had chemotherapy before sugery, and it turns out that the component of DCIS did not respond at all to the chemo, zero. Of course the breast was removed totally as well.

I am not sure what it means to have reactive lymph nodes.

I don't know if my comment is at all useful either, but I was thinking that maybe the oncologist who does not recommend chemo has a point.

I would also seek a third opinion.

KATRIN

[SueYoung55]

I would still do the chemo and rads. Thank you for explaining and best wishes to you and your wife.

[rafek]

Dear Sue,
Maybe I disexpress the size of the tumor,
the 8cm is represented the tumor of 1.5cm and the spread of microcalsification area
the problem was the fine spread of the microcals without being clustered or accumilated that led to the decision of the mastectomy.

Mohamed.

[rafek]

Dear Japdip,

still don't understand your comment, is the reactive lymph nodes draw to either chemo or radio therapy?

the 8cm is represented the tumor of 1.5cm and the spread of microcalsification area

[SueYoung55]

Hello Mohamed Rafek,

Are you quite sure it's DCIS with an 8 centimeter mass? I agree that I'd get a 3rd opinion. If the mass was 8 centimeters I would for sure go after chemo and rads.

I wish there was a way to get rid of this disease, we all do. Unfortunately that's not a word used with breast cancer. Your lovely wife May Satea was smart to get a mastectomy. That removes almost all breast tissue and lessens the chance for recurrence.

If the mass was really that large I'd be aggressive with the treatment.

I wish you and your wife all the best and want to thank you for helping her through this terrifying time.

[japdip]

While we are unable to advise any specific method of treatment over the internet I will tell you that if you have received opposing opinions from two sources you are entitled to seek a 3rd opinion from an independant Oncologist. I can't imagine with the reactive lymph nodes that either Chemo or Radiation would not be advised. The size of the tumor would seem to warrant an aggressive form of treatment.  Kindest regards to both you and your Wife.