Aa
Differentiating IBC from other breast cancers.......
I just turned 30. I got my pathology report yesterday....and I am very confused. Let me start by outlining my clinical symptoms.........
-swelling of the breast
-swelling and pain in underarm (with obvious lumps)
-reddish tone to breast that is more like small capillaries and not like a sunburn
-pits (dimpling) in skin that resemble acne or chickenpox scars
-loss of color in areole
-hardness and lumpiness of areole
My mammo and ultrasounds showed 2 enlarged axillary nodes...thickening of skin....density of both breasts with symptomatic breast "slightly more dense" and "no suspicious grouped microcalcifications".
My pathology report reads:
"Multiple sections of breast tissue show five of the six slides taken to contain areas of high grade intraductal carcinoma in situ with a mixture of patterns. Portions of the tumor show apocrine features with a cribriform pattern within the ducts while other areas show cancerization of lobules. No invasive tumor is identified. In situ tumor is present immediately adjacent to several of the inked margins".
The surgeon scheduled me for a mastectomy on 5/19 . He said he would do lymph node biopsy (staging?) in operating room and would remove them accordingly.
I am confused! If this is a simple DCIS...then why a mastectomy? Why no tumor mass? Why would there be lymph node involvement (possibly)? And most importantly- why would all my clinical signs point to Inflammatory Breast Cancer....and my mammogram would fail to point to DCIS (calcifications)? Shouldn't the pathologist be reviweing dermal tissue as well?
-swelling of the breast
-swelling and pain in underarm (with obvious lumps)
-reddish tone to breast that is more like small capillaries and not like a sunburn
-pits (dimpling) in skin that resemble acne or chickenpox scars
-loss of color in areole
-hardness and lumpiness of areole
My mammo and ultrasounds showed 2 enlarged axillary nodes...thickening of skin....density of both breasts with symptomatic breast "slightly more dense" and "no suspicious grouped microcalcifications".
My pathology report reads:
"Multiple sections of breast tissue show five of the six slides taken to contain areas of high grade intraductal carcinoma in situ with a mixture of patterns. Portions of the tumor show apocrine features with a cribriform pattern within the ducts while other areas show cancerization of lobules. No invasive tumor is identified. In situ tumor is present immediately adjacent to several of the inked margins".
The surgeon scheduled me for a mastectomy on 5/19 . He said he would do lymph node biopsy (staging?) in operating room and would remove them accordingly.
I am confused! If this is a simple DCIS...then why a mastectomy? Why no tumor mass? Why would there be lymph node involvement (possibly)? And most importantly- why would all my clinical signs point to Inflammatory Breast Cancer....and my mammogram would fail to point to DCIS (calcifications)? Shouldn't the pathologist be reviweing dermal tissue as well?
As it turned out....I sought a 2nd opinion from UCLA assoc. prof. of oncology practicing in my area. He recommended a sentinel node biospy. Surgeon conceded and agreed to small needle lymph node biospy, followed by dissection if negative. The small needle cytology showed cancer.
I have been officially diagnosed with IBC.
Rather than the mastectomy (simple) I was scheduled for on 5/19, I had a core biopsy of positive node and laterally through underside of my breast, and a port-a-cath implanted. I go for CT scans of abdomen, chest, and pelvic regions today, and bone scan tomorrow, and start treatments on Friday.
Perhaps a surgeon's point of view is different than the oncologists point of view? In my case.....I think a second opinion diverted what could have been a grave error in my case.
I have been officially diagnosed with IBC.
Rather than the mastectomy (simple) I was scheduled for on 5/19, I had a core biopsy of positive node and laterally through underside of my breast, and a port-a-cath implanted. I go for CT scans of abdomen, chest, and pelvic regions today, and bone scan tomorrow, and start treatments on Friday.
Perhaps a surgeon's point of view is different than the oncologists point of view? In my case.....I think a second opinion diverted what could have been a grave error in my case.
Hello
A) my wife noticed a small lump under her arm and it stayed the same size for almost 1.5 year. After 5 monthes of her pregnancy, the lump grew like crazy. She was diagnosed with breast cancer 8x7cm. The skin was red. It was clinically diagnosed as IBC. The tumor was biopsed along with the Skin and it showed negative for IBC. So the clinical observation was reversed. My wife said that before the tumor turned red, she slept on the her side where the tumor was and the next day it started to turn red. Note that the cancer is confined to the breast. She had a bone scan, and an liver and abdominal ultrasound, both of which showed negative for cancer?
1- what is ur comment on this ?
B) after on week, she started chemo and thank God she had a great response. The doctor told us (on the 3rd cycle) that only 4 cycles ar needed.
After the completion of the 4th cycle, she had an ultrasound, and it should the tumor with size of 1.8x0.7cm.
2- what does this say for future prognosis? After all, only God knows.
C) after the completion of the 4th cycle, my wife gave birth to a healthy boy. After two weeks of the delivery, the doctor scheduled a lympectomy on the following week.
3- Now that my wife is off chemo for 3 weeks, is it safe to wait for that long (she is to be operated on this week)?
Your comment is highly appreciated.
Thank you in advance
A) my wife noticed a small lump under her arm and it stayed the same size for almost 1.5 year. After 5 monthes of her pregnancy, the lump grew like crazy. She was diagnosed with breast cancer 8x7cm. The skin was red. It was clinically diagnosed as IBC. The tumor was biopsed along with the Skin and it showed negative for IBC. So the clinical observation was reversed. My wife said that before the tumor turned red, she slept on the her side where the tumor was and the next day it started to turn red. Note that the cancer is confined to the breast. She had a bone scan, and an liver and abdominal ultrasound, both of which showed negative for cancer?
1- what is ur comment on this ?
B) after on week, she started chemo and thank God she had a great response. The doctor told us (on the 3rd cycle) that only 4 cycles ar needed.
After the completion of the 4th cycle, she had an ultrasound, and it should the tumor with size of 1.8x0.7cm.
2- what does this say for future prognosis? After all, only God knows.
C) after the completion of the 4th cycle, my wife gave birth to a healthy boy. After two weeks of the delivery, the doctor scheduled a lympectomy on the following week.
3- Now that my wife is off chemo for 3 weeks, is it safe to wait for that long (she is to be operated on this week)?
Your comment is highly appreciated.
Thank you in advance
when dcis is so extensive, anything less than mastectomy leads to a high rate of recurrance; and recurrance can be of the invasive type. Likewise, when so extensive, the possibility of invasive cancer exists currently, so doing a lymph node sampling at the time of the mastectomy is reasonable. Not all dcis has calcifications. Finally, I agree IBC is possible based on your description, and skin sampling by the pathologist should be done.
Dear highaim, Because of the several areas of DCIS the recommendation for mastectomy rather than breast conservation surgery. Not all DCIS shows calcifications on mammogram. The lymph node testing is likely based on the clinical symptoms (enlarged lymph nodes, breast swelling etc.) as well as the several areas of DCIS.
If the biopsy revealed inflammatory breast cancer, the treatment plan would likely change to looking at chemotherapy first, before surgery to the breast. As several biopsies were done, ask about whether a biopsy of the dermal tissue layer had been included.
If the biopsy revealed inflammatory breast cancer, the treatment plan would likely change to looking at chemotherapy first, before surgery to the breast. As several biopsies were done, ask about whether a biopsy of the dermal tissue layer had been included.
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