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This question was answered on Mon 11, Aug 2008 06:36am by Dr Paul S, MD

Breast Cancer IDC, What treatment would you recommend for this pathology?


    
Asked by sanddollars (Female; 47; Pre-menopausal, IDC - had bilateral mastectomy with implant reconstruction in July, otherwise great health; Relevant drugs:None - Considering TC chemotherapy, will be on Tamoxofen. ) on Sat 09, Aug 2008 04:22pm
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I was diagnosed with IDC and had a double mastectomy and reconstruction. I had a 9mm lesion, Grade 1 (Tubular formation 1, Nuclear Grade 2, Mitotic rate 1), ER+(86%) PR+(68%) Her -. The Ki-67 score was 4%. There was some (

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Answer by Dr Paul S, MD  on Mon 11, Aug 2008 06:36am:

Hi there. It is good that you are being treated in a well respected, tertiary cancer center. These centers have well defined and evidence based protocols, and their own nomograms are a proof of this sophistication. In the absence of such nomograms, axillary node dissection is generally warranted. For node positive cancers, it is recommended that you receive adjuvant chemotherapy. After the chemotherapy, treatment with tamoxifen will further decrease the chance of recurrence. I have enclosed a pdf copy of the NCCN (National Comprehensive Cancer Network) practice guidelines for the treatment of breast cancer for your own reference. All in all, I would agree with the treatment plan laid out for you by your good doctors there at MSK (Adjuvant chemotherapy then hormonal therapy with tamoxifen). Regards and God bless.
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Follow up:

Clarification by sanddollars on Mon 11, Aug 2008 04:15pm:
Thank-you for the practice guidelines.  They did raise one follow-up question:

My path report read:  In permanent sections in one lymph node, several small areas of metastatic carcimas are
identified: (1.5mm, 1.25mm,and .5mm each).  Would this be classified as N1(mi) since each are less than 2mm,
or N1 since they total more than 2mm?

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