pathology report clarification

Hi,
My patholigy report states for two samples taken:  speciment #1:Fatty breast tissue with foci of in situ ductal carcinoma, nuclear grade 3 over 3 with focal comedo necrosis and calcifications.  No invasive carcinoma seen.

Specimen #2: fatty breast tissue with focus of in situ ductal carcinoma, nuclear grade 3 over 3, no invasive carcinoma seen.

Clinical History:  Right breast microcalifications, rule out malignancy

I know that grade 3 is agressive.  my tumor is anywhere from 1.5 to 3.0 or less.  will my grade determine my choice on lumpectomy or mastectomy.  I have it on one quadrant 7 o'clock.  I'm worried about the aggressiveness of this disease.  I don't have the BRCA gene, but have 2 sisters with cancer who have the BRCA gene, as well as  aunt, uncle and cousins with the gene who all had recurrances.  

I also have sclerosing adenosis with fibrocycstic disease and was once told by my OBGYN that there is a higher incidence in breast cancer with this disease.  I am also loaded with microcalcifications in both breasts for years.

I'm really worried.  stage zero though, grade 3 over 3 with focal comedo necrosis and caldifications.

thanksl


This discussion is related to Understanding pathology report help.

[japdip]

True and final grading of the tumor won't be done until it is removed. I would (if I were you) see an Oncologist as to which path you should follow now unless a definite recommendation has been made by your Breast Surgeon. The decision for Lumpectomy vs. Mastectomy should be made after your complete history plus the current findings have been correlated by one of the above mentioned Physicians. Taking into consideration your family history plus the fact that you mention having many calcifications in both breasts a recommendation of Mastectomy wouldn't surprise me though.   Regards ....

[lisamatthew]

thanks.  Here's what scares me.  My relatives who have had mastectomy's are being screened for cancer still i.e. MRI's, and/or mamogram (mammogram) for the one with reconstructive, but one cousing who has a mastectomy and reconstructive doesn't' get scanned.  I don't have the gene, and I'm worried about how they would monitor me if I have a mastectomy (other than just blood work).  I'm told by many survivors, they don't get scanned.  I worried if I remove my breasts it won't have anywhere to grow if it returns (except in my chest muscles or bone.  (my sister's tumer recurred outside of her chest on her skin)....I know I probably should be opting for a mastectomy.   Breast surgeon says lumpectomy, another surgical oncologist says lumpectomy, but I have a feeling the oncologist I will be seeing tomorrow will say mastectomy (which I just may end up doing).  thanks.

[japdip]

You can certainly be scanned or followed by Ultrasound as well as blood work following Mastectomy. Also having a Mastectomy does not mean that you are completely free from Breast Cancer although the chances are greatly reduced. Often it's a matter of choice whether to be scanned on a regular basis or not. I personally chose NOT !! Many, including my Surgeon as well as myself believe that you do not live one day longer whether your recurrence is found by scan or by symptom. As a rule the Oncologist will follow the patient's wishes for follow-ups after treatment has been completed. Please keep us posted when you find out more information.  Kindest regards ....