Clarification of Path Report

[Evy50]

I recently had a lumpectomy and saw my surgeon for f/u and results of path report. He was not very talkative as far as expaining to me what the results meant.  In other words when I asked what grade my type of cancer would be considered he stated I just told you it was metastatic.  Ok and that means what?  From what I've been reading it could still be II,III, or IV right?  Path report from sample of left breast mass (3.2cm poorly differentiated invasive ductal carcinoma), left axillary lymph node (metastatic carcinoma in one of three lymph nodes) and left breast sentinel node (no tumor seen). Path report  states the following:Histologic type: IDC, Total Nottingham Score Grade III, pT2, pn1a: metastasis in 1 to 3 axillary lymph nodes, extracapsular nodal extension present, pMX, margins uninvolved by invasive carcionoma. ER - 0%, PR - 0%, Ki-67-91%, and HER-2/neu - 2.7 (overexpression).

Based on this would you be able to give me some idea of what stage I am?  Does metastatic automatically mean stage IV? and if so, is it because it spread to the lymph nodes?    I have an appt with the oncologist next week.  I just want to be prepared.

Thanks in advance for your help.

[mamaboulet]

Make sure you get an oncologist who is more communicative than your surgeon, arm yourself with knowledge, and take a friend to your onc appointment to have a second set of ears for all the overwhelming info you will get. And get those questions down on paper so you don't forget some of them.

[PaulMD]

Hi there.

No metastatic does not necessarily mean stage IV.  In your case only the lymph nodes had metastasis and if you have no other tumors in your other organs (lung, liver, brain, etc), then you can be staged anywhere between II to III depending on how large your primary tumor is.  You oncologist may recommend chemotherapy with Herceptin (for being HER2 overexpressing) and radiotherapy.

For more information regarding your stage and treatment, you can visit the National Comprehensive Cancer Network website:

http://www.nccn.org/patients/patient_gls/_english/_breast/contents.asp

Hope this helps.  Regards and good luck with your treatment.