Rare Cancer at Breast

My original diagnosis was Invasive Ductal Carcinoma...after my surgery (mastectomy) my pathology came back as small cell neuroendocrine carcinoma, primary to the breast, no evidence of ductal or glandular carcinoma.  Triple Negative for ER, PR and HER2.  Have you ever seen this?  My oncologist has not and has told me its rare, my reports, etc. are being sent to a pathologist that has actually written articles on this particular cancer of the breast.  My question is if you've seen this, what am I looking at for staging, etc. I know my grading is 9/9 and 3 for Bloom Richardson.  My tumor was 5cm, but with no lymph node involvment.  My internal mammory lymph node is enlarged (which they told me that before my surgery) So now my question is even though the lymph nodes under my arm were clean..would it make a difference with these other lymph nodes because the cancer I have is rare for the Breast..should that be looked at more closely?  Thanks for your time.  

[BhumikaMD]

Hi,

You need to discuss with your doctor about the further line of management in your case.

You would need to discuss about the surgery, chemotherapy and radiation therapy required in case of a patient with small cell neuroendocrine carcinoma.

Small cell neuroendocrine carcinoma is an aggressive neoplasm for which no treatment protocol is defined with certainty due to the small number of cases described. Modified radical mastectomy with axillary lymph node dissection seems to be the treatment of choice, with adjuvant radiation, chemotherapy, or both, based on the clinical stage and presence of metastasis.

Let us know about what your doctor advises and if you have any other doubts.

Also post us about how you are doing.

Hope this helps.

Regards.

[jinkz]

hi, is it true that your initial diagnosis is INVASIVE DUCTAL CARCINOMA?
then after you undergone mastectomy, your doctors find out that there's no evidence of ductal carcinoma??
how does it happen?

i really wanted to know if the mastectomy really helps to cure IDC?
because my mother has it and her doctor wanted an immediate operation, but until now..we can't decide what to do..can you help me on this?

you can send me a mail..here's my address:
jinkz_013***@****


thank you

[BhumikaMD]

Hi,

How is your mother doing now? What has her oncologist advised?

The prognosis of invasive ductal carcinoma depends on its histological subtype. Mucinous, papillary, cribriform, and tubular carcinomas have longer survival, and lower recurrence rates. The prognosis of the most common form of IDC, called "IDC Not Otherwise Specified", is intermediate. Finally, some rare forms of breast cancer (e.g. sarcomatoid carcinoma, inflammatory carcinoma) have a poor prognosis.

Regardless of the histological subtype, the prognosis of IDC depends also on its staging, histological grade, expression of hormone receptors and of oncogenes like HER2/neu.


Treatment of IDC is surgery to remove the main tumour mass and to sample the lymph nodes in the axilla. The stage of the tumor is ascertained after this first surgery. Adjuvant therapy usually includes chemotherapy, radiotherapy, hormonal therapy (e.g. Tamoxifen) and targeted therapy (e.g. Trastuzumab). More surgery is occasionally needed to complete the removal of the initial tumor or to remove recurrences.

Let us know what the oncologist and breast specialist advise in your mother's case.

Post us if you have any other doubts.

Regards.

[OL224]

Yes, its true, from the biopsy that was the diagnosis and then I had the mastecomy and through the pathology that was done on the tumor itself, they have now found that I have small cell neuroendocrine carcinoma primary to the breast, which is very rare.  Either way I would of had a mastecomy whether it was IDC or if they found that I had this other cancer first..surgery would of been the same.  Now the chemo and treatment after is going to be different.  Not sure what, but I am seeing some other specialists next week.  I'm only 41 yrs old and I have a husband and 2 small children so I'll do whatever it takes to get better and get this behind me!!

[BhumikaMD]

Hi,

How are you doing now? Have you seen the oncologist and breast specialsit about the plan of management in your case?

Let us know about how you are doing and if you have any doubts.

Good luck.

[OL224]

I'm just waiting for my appointment at this point, which is next week on the 26th.  Two other pathologists are reviewing my case, which have knowledge to this particular type of cancer.  So we'll see how it goes from there, hopefully they'll be able to answer my questions and get my treatment plan together (e.g. best chemo drugs for this, etc).  My original oncologist mentioned the Cisplatin and VP-16 and possible radiation.  So more or less I'm just waiting to see if these other Dr.'s and oncologist agree with that course of treatment and what my odds are of this coming back, since it is an extremely agressive cancer and where its rare to the breast, so many questions and hopefully they'll be answered next week.  Thanks!

[BhumikaMD]

Hi,

Keep us posted on how your appointment goes and what is advised.

Let us know about how you are doing.

Good luck.