Survival rate for stage II, grade 3 IDC lymph nodes involved

[mela1967]

Hi,
My mom had every year a mammogram including this year in April and always it was an issue with her right breast which showed a benign tumor that was not growing but nobody said anything about her left breast. We are very frustrated and worried because we did all the check ups we were supposed to but nobody thought about her having an MRI which probably would have shown the cancer. My mom , 65 years old was diagnosed 2 weeks ago with breast cancer on the left breast with lymph nodes involved . She had a mastectomy on the left breast + axillary lymph nodes dissection on 11/3 . The pathology report states:
1. Infiltrating ductal carcinoma
2.Metastatic carcinoma present in 4 out of 8 axillary lymph nodes.
Microscopic description:
- max diameter of neoplasm: 0.7 cm
-margin of neoplasm: infiltrative
-histopathologic grade ( Bloom Richardson): II
                        Nuclear grade : 3
                        Mitotic rate: up to 6/10 hpf
                        Tubular differentiation: poor
-Angiolymphatic invasion : yes
-other breast lesions:small focus (0.4cm) of high grade ductal carcinoma in situ in random section from lower inner quadrant.
- lymph nodes metastasis: yes 4 out of 8 axillary lymph nodes
-pathologic TNM stage : T1b, N2a, MX

Questions:1. Does my mom have 2 types of cancer IDC and DCIS and what is the prognosis of beating this?
                2. What is the best treatment out there for this type of cancer?
                3. What are the stats of survival rates?
                4. How is possible to have cancer when nobody in our family ever had cancer?
                5. MX means no distant mets? My mom had a CAT scan with contrast and it was ok. Which other test should be done to ensure that she does not have mets in her bones or brain?
               6. What are the odds that me and my sister to have the same type of cancer considering the fact that I have the same type of benign tumor in the right breast exactly like my mom?
                

[Cleveland Clinic]

Dear mela1967:  1.  Your mother does not exactly have 2 types of cancer but rather different components to her cancer. IDC is invasive ductal cancer and DCIS is ductal carcinoma in site (a non invasive cancer – kind of a precancer).  It is very common for these to coexist in the setting of breast cancer.  2, 3.  Treatments will be best determined by your mother’s oncologist.  There are many factors that go into this including hormone receptor status and HER 2 status which are not yet known.  The oncologist will be best equipped to have the discussion regarding prognosis and the benefits of treatment within the context of her specific situation.  4.  Most breast cancer is not hereditary.  With our current body of knowledge, only about 4% are genetically based.  5. The terminology “MX” simply means that it is unknown whether or not there are distant metastases. At the time of the pathology report, it is likely that the pathologist did not have access to any CT scan reports and therefore used the MX designation. It is not always routine to perform scans to check for disease in the absence of any symptoms.  You might discuss this with the oncologist to see if there is any reason to perform additional scans such as bone scans or brain scans in her situation.  6.  You and your sister now have a somewhat increased risk of developing breast cancer based solely on the fact of your mother’s diagnosis.  The benign tumor in the right breast apparently had nothing to do with your mother’s left breast cancer.  So, it is unclear what the relevance of your benign tumor may be.  You may benefit from a discussion with your own physician or a genetics counselor who can more clearly outline your risk and offer suggestions for surveillance.