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Breast Cancer (Expert Forum)
Pathlogy Report
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Pathlogy Report
by NM_southwest, Oct 20, 2002 12:00AM
final dianosis:
Left breast excisional biopsy:
Infiltrating duct cell caricnoma, poorly diffentiated. estimated maxium dia, 1.8 cm. modified richardson-scarf-bloom classification grade 3(with tublar componet2, nuclear pleomorphism and nucleoli 3 and, mototic activity 3). this tumor is associated with extensive ductal intrespitheltal carcinoma grade 3 (comedo type). the lesion is suspected - at least in itsintralductal component to infriltrate surgical margins. there is scanty amount tissue necrosis. no lymhovascular infiltration identified.
block "c" will be sent for evaluation of hormonal receptors.
our question would be, could we just do lumpectomy/radiation and hormonal therapy? we do not have the lymph nodes status that won't be done till the lumpectomy. also no info on the hormonal receptors yet. our doctor is recommending doing lumpectomy to get clear margins also testing the lymph nodes, and going adjuvent therapy. what does this all mean? would choosing a treatment be determined by the status of nodes and receptors?
Left breast excisional biopsy:
Infiltrating duct cell caricnoma, poorly diffentiated. estimated maxium dia, 1.8 cm. modified richardson-scarf-bloom classification grade 3(with tublar componet2, nuclear pleomorphism and nucleoli 3 and, mototic activity 3). this tumor is associated with extensive ductal intrespitheltal carcinoma grade 3 (comedo type). the lesion is suspected - at least in itsintralductal component to infriltrate surgical margins. there is scanty amount tissue necrosis. no lymhovascular infiltration identified.
block "c" will be sent for evaluation of hormonal receptors.
our question would be, could we just do lumpectomy/radiation and hormonal therapy? we do not have the lymph nodes status that won't be done till the lumpectomy. also no info on the hormonal receptors yet. our doctor is recommending doing lumpectomy to get clear margins also testing the lymph nodes, and going adjuvent therapy. what does this all mean? would choosing a treatment be determined by the status of nodes and receptors?
Doctor's Answer
by CCF-RN,MSN-rf, Oct 20, 2002 12:00AM
Dear NM_Southwest: Whether or not a lumpectomy can be done depends upon the size of the "lump" in relation to the remaining breast tissue - in order to provide a good cosmetic result. All margins must be clear, something you hope to accomplish during the lumpectomy but the possibility exists that positive margins could still exist, necessitating an additional surgery. In other words lumpectomy + radiation therapy is a perfectly good option and has similar survival to mastectomy. Additional treatment, chemotherapy, is determined by the size of the tumor, the aggressiveness of the tumor and the lymph node status. Based on the estimated size of your tumor, chemotherapy will likely be recommended.
