What stage breast cancer do I have?

[Ruffian7]

I have recently been diagnosed with breast cancer but I can't get a straight answer on what stage I'm in.  I have 1 tumor 3-4 cm and another one close by that is less than 1cm.  The total "cancerous area" is around 6cm.  I had a biopsy of 3 lymph nodes and all were cancerous.  I've had chemo and am about to schedule surgery for a partial mastectomy and lymph node removal.  All the info I see says Stage III is a tumor over 5cm with lymph node involvement.  I have 2 tumors that are each smaller than 5cm but the cancerous area is 6cm.  So where do I fit?

Thanks for any information.

[Ruffian7]

OK.  I had my surgery and there was bad news and then there was bad news, lol.  There was still cancer, invasive and non-invasive polka dotted throughout the breast.  9/14 lymph nodes were positive for metastatic carcinoma.  My Dr. says only that this is very significant and not in a good way.  I did another PET scan today to see if it's spread and she's starting me on Gemzar/Carboplatin.

I REFUSE to die this way, I just like to know where I stand.  Any info is appreciated.

Thanks bunches.

[Cleveland Clinic]

Dear Ruffian7:  In general, when there is more than one tumor in the same breast, the largest is considered for staging purposes.  There are also qualities about lymph node metastasis that help to determine stage.  Your doctor will be best equipped to comment on this as it pertains to your situation.  Further, as you have had preoperative chemotherapy, the staging may be different clinically (before surgery) and pathologically (after surgery).  It is possible that you could be “down staged” by the chemotherapy.  Your doctor will be able to better explain this.

[Ruffian7]

Argh.

I asked my oncologist.  She said "Stage II, Stage III, lets just focus on getting you better."  which I totall agree with.  I'd just like to know where I stand.  I already know the cancer had spread to the lymph nodes, like I said.  All 3 nodes tested came back positive for cancer.  What I'm confused about is the fact that I have 2 tumors and not 1 large one.  I asked the Dr. who did the biopsy if it was better or worse to have the 2 smaller vs the 1 large and she said in her opinion it was worse because it means the cancer is "creeping through the ductal system seeding itself."

I understand the whole "focus on getting better" philosophy, but the problem with not being up front and honest with patients is, we (I) will often imagine a scenario worse than reality.  I'm a numbers girl, I like to know the odds of a given situation, doesn't mean i'm going to just throw in the towel.

Thanks for your response.  I guess time will tell.  Meanwhile I am certainly focused on getting better :-).

[japdip]

Many factors figure into the Staging of Breast Cancer. Your Oncologist would be the best person to answer your question about this. Since you haven't had your final surgery and removal and testing of lymph nodes there may not be an answer until all Pathology reports are finalized following the surgery.   Regards ....

[katarina777]

Often, the surgery brings new surprises. A biopsy is really only done on a small amount of tissue, and when you have surgery, they examine a whole lot more. In my case, I had chemotherapy as well before surgery, and even an MRI before the operation to check on my lymph node status. It was negative. When they opened me up, a bunch of lymph nodes were actually positive.

Hope this helps.

PS: it's not only the size of the tumor that defines the stage.