is chemo needed

[stud88]

Pls. see below for results
My wife aged 36 years  had Wide Local Excision(Lumpectomy) last week.
Specimen size 8x6.5x0.4,margins 0.6cm from tumor.
Tumor description:on serial sectioning a large 4cm cystic cavity filled with
blood is identified.A 1.5x1.5x1 irregular hard grey white nodule is seen
adjacent to cystic cavity and protuding into it.
Skin is free of tumor.Multiple lymph nodes are resected from axillary fat
largest measuring 2.5 cm
Histological diagnosis:Infiltrating duct carcinoma,grade 2.Right Breast
Histological Grade:Grade 2
Tubule formation :10-75%
Nuclear Grade:Moderate pleomorphism
Mitotic count:10/hpf
Perivascular or perineural invasion absent
Margin:Closest resected margin is involved
Intraductal component:Extensive dcis with cibriform and micropapillary
pattern
Classification in tumor:Occassional foci of microcalcification present
Regional lymph nodes are free of tumor(0/32)
Pls. explain the results and how I should proceed,like does she needs
medicine/  radiotherapy  or she needs chemo.Chances of reoccurence.
thanks for your help...
Pls. advise asap
Thanks

[PaulMD]

All of the prescribed treatments should be done as soon as everyone is able.  Remaining cancer cells are multiplying microscopically without us knowing.  I believe the best course of treatment is already presented by your doctor, but I still believe that an additional surgery can still be discussed with your doctors (if the patient is amenable or her medical condition can tolerate another surgery).  Regards.

[stud88]

also pls. advise how urgent is treatment

[stud88]

Oncologist has suggested to go for radiation for 25 days followed by chemo quantity depending on er,pr and her neu results.Possibly harmone therapy after that.
Is there an alternative cure and is this stage life threatening

[PaulMD]

Hi there.

Not only does she needs chemotherapy, but I believe that she needs another operation to clear up the margins.  A positive margin is an adverse prognostic feature that can mean the increased likelihood of recurrence.  An operation can be another lumpectomy, or a mastectomy altogether.  These options should be discussed with the surgeon.  The large size of the primary tumor warrants adjuvant chemotherapy.  If the tumor is also tested for ER and PR and is found to be positive, she may need hormonal treatment as well.  Radiation can also be given due to the size of the primary lesion.  All of these treatments are all directed on lessening the chances or tumor recurrence or spread. I suggest you discuss all of these options with her oncologist.

I hope her treatment will be uneventful. Regards and God bless.