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Breast Cancer  (Expert Forum)
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Two different pathology reports
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Cleveland - OH
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.

Two different pathology reports

by Penny12, Jun 30, 2007 12:00AM
I am  a healthy 60 year old woman.  Had a lumpectomy on May 2.  Started radiation on June 21 for the 33 day regime. First path report statistics are as follows:  Infiltrating ductal carcinoma, tumer size was .8 cm, grade 1,(well differentiated) no lymph node involvement, pT was Tlb, pN was NO, pM was MX, no evidence of her-2 gene amplification. Estrogen +, progresterone -.  The second path report was done at a differenct hospital as requested by my oncologist on June 15.  The conflicting results are as follows: Tumor size 1.1, grade 2 (well to moderately differentiated).  Dr wanted to start me on chemo and then radiation.  Since I was scheduled already for radiation, I elected to start this treatment.  Oncologist said I could still do Chemo after radiation.  He has sent off slides for the oncotype testing in Calif.  
1  Can you do chemo after radiation and would you recommend it based on the info I have provided.
Thank you in advance for any info you can provide.

by Cleveland Clinic, Jul 02, 2007 12:00AM
Dear Penny12:  The short answer is that yes, it is possible to do chemotherapy after radiation therapy.  The question is Whether chemotherapy is needed and what the benefit will be.  Chemotherapy is often recommended when tumors are over one centimeter.  Are the two pathology reports based on the same tissue? Or different tissue?  This information may help to clarify.  The oncotype dx test may help by providing information as to how likely your tumor will be to recur.  Without reviewing all of your information first hand, we cannot make a specific recommendation as to whether or not you should receive chemotherapy.  You may wish to discuss the information with both oncologists to determine the one you are most comfortable with moving forward.
Member Comments (2)

by lizziecee, Jul 01, 2007 12:00AM
To: Penny12
Hi Penny - sorry I don't know if you can have chemo after radiotherapy. At my breast care centre of excellence in England, their protocol is chemo for all invasive tumours over 1 cm., and then radiotherapy, as I had.   Hospitals do differ though. Hopefully the nurse here will respond Monday with her invaluable experience. I do have a friend who had chemo before surgery, but not radiotherapy before surgery. Interesting question.
Take care.
Liz.
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