Home   Recent Questions   Testimonials   FAQs


This question was answered on Tue 02, Dec 2008 04:58pm by Dr Heinrik M, MD

Invasive Ductal Carcinoma Stage IIA Grade 3


    
Asked by shybird (Female; 52; Please see below in 'Question'; Relevant drugs:Fioricet, Maxalt-MLT, Synthroid, Protonix, Lexapro. For Chemo: I believe it is TAC? Not sure. ) on Tue 02, Dec 2008 09:42am

Medical History: Age: 53 Race: White Age at first menstruation: 16.5 years Age of first birth child: 20 Number of births: 2 Surgical Menopause in 1999: Age 44 HRT Patch used since 1999 Medical Conditions: Hypothyroidism Depression Rebound Migraines GERD Osteopenia I was diagnosed with Grade 3 poorly differentiated Invasive Ductal Carcinoma breast cancer. I have had a lumpectomy...my tumor ( pT1c) being 1.5 cm., with one (out of 12) sentinal nodes positive with MESTASTIC carcinoma and focular extracapsular extension. Stage IIA 0/9 Axilliary node disection negative for carcinoma. Had to have another surgery to produce clean margins, which was listed as 1.6mm. (anterior) Angiolymphatic invasion is present. Solid and Cribriform type with comedo necrosis. E-Cadherin Positive ER and PR . Currently undergoing treatment. My questions: 1.) Does Angiolymphatic mean that the cells have travelled through my lymphatic system AND blood system? 2.) Poorly differentiated usually means poor prognosis. (quote) Does 'poorer prognosis' mean that I have a higher risk of mestastisis? 3.) My oncologist did mention that she likes wider clear margins than what my surgeon got for me, but I have small breasts. Why do you think she feels this way? 4.) Researched that E-Cadherin develops into mestastic sites 45-50%of the time. Since one node positive, is that my mestastisis? TOr does the risk mean for distant? 5.) Since I am estrogen positive, my oncologist recommends to stay away from animal fats. She said that fat turns into estrogen. I love cheese, and I love sweets. Once I am put on the estrogen blocker drug, will that also stop the food estrogens? 6.) Give it to me bluntly and truthfully, doctor, because I am not getting that from my oncologist. She uses the phrase 'there is no crystal ball'. Her computer was down to give me the Adjuvent Online scale. (And I do not know if that is what oncologist's use or not, but I've read about it.) If it is, could you email the grafts with my percentages, please? I need and want to know everything, so my mindset can be ready for all of what is ahead for me.

Actions: | Forward |
Answer


Name 

Email 

Security code
Enter the text as shown above


E-Mail me when someone replies to this post
Answer by Dr Heinrik M, MD  on Tue 02, Dec 2008 04:58pm:

Hi, 1.) The Angiolymphatic invasion is meaningful for those who do not have pathologic evidence of cancer spreading into the lymph nodes. Hence, you may consider this as pre-nodal, meaning the cancer has not reached the nodes, but seems to be going there at the time of surgery. 2.) A poorly differentiated cancer generally tends to grow faster, so that the odds of relapsing would also be higher. In your case, it may be a 10% difference at 10 years time. 3.) It is hard to say how far the cancer really has spread, if the margin was as near as less than a millimeter from the cancerous lump, there is a high risk for regrowth in the surgical area, because of the risk of residual disease left. This is true for most cancer surgeries. 4.) E cadherin is an area of active research, at present it may help distinguish subtypes of breast cancer (whether ductal or lobular). Specific impact on overall outcomes beyond that known for ductal or lobular cancer is not well characterized. 5.) Its not easy making dietary recommendations, as in general most people don't really stick to it more than 2 years down the line. Perhaps a simpler advice would be to maintain your weight, or to avoid getting heavier. 6.) The adjuvant online is a good estimate (or guesstimate if you will). If you use it, the odds of getting cancer in ten years without any further treatment after surgery would be about 35%, with chemotherapy and hormone therapy this could be lowered to 15%. It would also be interesting to know if you are HER2 positive or not. Perhaps this is something to discuss with your doctor. Stay positive.

Detailed answer for your question: Available in paid version. - Click to pay.
Second opinion from another doctor: Available in paid version. - Click to pay.
               

If you find the site useful, please consider making a donation.  Click the button to donate.   

Please rate my answer (select the stars, no need to log in.)  


Follow up:

Clarification by shybird on Fri 05, Dec 2008 06:05am:
I am just a bit confused as to the research that I've done on the  E-Cadherin Gene, and your answer
(#4).

As you know, the E-Cadherin gene is known as the tumor suppressor gene.  A mutation of this gene is linked to
breast, lung, stomach, and bladder cancer.  I already have developed the breast cancer.

83% get stomach cancer by the age of 80.
50% get metastasis of breast cancer.

Given my health report, these percentages do not sound good to me.  

Can E-Cadherin be repaired by what the chemo is doing? 

Also, I am not HER2 positive. Only ER and PR.

Thank you for your follow-up. 

Comments:

Comment by Dr Heinrik M, MD on Mon 19, Jan 2009 09:19am: On repairing cadherin: The chemotherapy would seek to kill the aberrant cancer cells – it will not likely return the function of the cadherin (not likely that the chemo will trigger production of missing cadherin). However, the process of killing the cancer cells may involve using metabolic pathways that trigger other tumor suppressors to become active – so indirectly – the function of the cadherin is taken up by another protein. On the risk of Cadherin: The information I have is for cases of hereditary breast and gastric cancer. A study done in 1999 did not show any increased risk (Int J Radiat Oncol Biol Phys. 1999 Aug 1;45(1):73-83.) this was actually a small population with less than a hundred cases. I am unaware of any large prospective study in which patients with E-cadherin were followed up to look at how many developed breast or gastric cancer. The converse has been reported: among those with established HEREDITARY breast or gastric cancer, there seems to be an increased incidence of mutations in CDH1 (which encodes the E Cadherin protein). This data however, wouldn’t really apply to you as you do not seem to have a hereditary type of cancer.
Comment by Dorothy on Fri 13, Nov 2009 01:55am: my daughter has just been diagnosed with ductal carcinoma gr3. She is 38 years old, is type 1 diabetic and has krohns disease as well. What type of questions do we ask the doctor. The lump in her breast is 1,3cm.
Comment by bobby s, md on Fri 13, Nov 2009 12:23pm: Hi Dorothy, You need to ask the doctor the stage of the tumor, the hormone receptor status (ER, PR, HER2), the overall prognosis based on her pathology and radiology findings, and about the treatment plan. Mention her diabetic and Crohn's status as well, and ask about surgery, chemotherapy, radiotherapy; the side effects, risk versus benefit, etc. Also, ask about support services, both for patient and care-givers. Ask about availability of suitable clinical trials. Lastly, you should have a discussion on the financial aspects.

This question is open for comments.  Please share your opinion.

Comments


Name 

Email 

Security code
Enter the text as shown above


E-Mail me when someone replies to this post
Other cancer questions you might be interested in.
  1. Do i have testicular cancer?   (Answered) - Viewed 3314 times   I noticed a pain in my left testicle. The pain becomes terrible sometimes and it shoots up into my lower stomach. I noticed a sm...
  2. pain meds versus liver damage  (Answered) - Viewed 4776 times   My 57yo brother in law was diagnosed in October with lung cancer with mets to the bones, brain and liver. His lung ca was Stage...
  3. Lung adenocarcinoma of a scar left by a past asymptomatic histoplasmosis infection in a nonsmoker 79yr female  (Answered) - Viewed 2648 times   What is the time line and occurrence of lung scarring and calicification of lymph nodes from a previous Histoplasmosis infection...
  4. stages of cancer - Stage IV cancer in the adrenal gland near top of kidney  (Answered) - Viewed 3035 times   my father-in-law has stage 4 cancer in the adrenal gland near top of kidney due to cancer from his lung. how many stages of can...
  5. Hodgkin's disease - Survival rate for Hodgkin's disease  (Answered) - Viewed 3316 times   my sister has stage 4 Hodgkin's at age 44, what kind of survival rate can we expect? We also lost a sister to Pancreatic at age...
  6. carcinoid syndrome  (Answered) - Viewed 3600 times   i have got carcinoid syndrome,i am 54 years old,it is all over my abdome,in my eyes,in my liver,and i am awaiting results of a ...
  7. life after surgery without chemo but using natural products and diet  (Answered) - Viewed 2558 times   I refused chemo for stage111C colon cancer.I had the surgery to remove the tumor of which they got it all.My Ct scan after surge...
  8. prostate cancer - diagnozed PC prostate needle biopsy adeocarcinoma 4.7mm in core biopsy stage   (Answered) - Viewed 2708 times   diagnozed PC prostate needle biopsy adeocarcinoma 4.7mm in core biopsy stage T2a gleason 7 psa 11.6 june 2006-- Aug 2007 ...
  9. Enlarged spleen after colon caner - Liver problem or cancer?  (Answered) - Viewed 8883 times    my wife 43 had colon cancer stage 3 with 1 node surgery in july 2007 after 12 chemos folfox 4 in january ct showed enlarged s...
  10. Toxicity due to chemotherapy - What does Grade 1 constipation and Grade 1 PPE mean?  (Answered) - Viewed 2982 times   I have undergone 18 weeks chemo for recurrent disease of cancer of the oesophagus. Toxicity from my chemotherapy includes gr...
  11. cancerous breast tissue? - Cancerous tissue in breast:: Is it Stage I breast cancer   (Answered) - Viewed 2741 times   my mom has just found out that she has cancerous tissue in her breast but no lump is cancerous tissue the first stage in cancer ...

 
What users are searching right now on Ask an oncologist now:
how20long20will20you20live20if20u20leave20lung20cancer20untreated     IgG20lambda20in20beta20region     bladder20mass     herceptrin     nothing is free ha     when20to20worry20about20myelocyes20and20metamyelocytes20in20the20blood     thigh20lump     hpv20infection20is20said20to20be20limited     hiihaveaoval     ImmunofixationstudiesrevealedtwotraceconcentrationbandsmigratingintheGAMMAregionwhichappearasIGGLAMBDAmonoclonalproteinWhatdoesthismean     lumpectomy     abscesses     cancer thyroid     highiga     ovary20pain20swelling     normal range of kappa and lambda     does252520one252520lung252520take252520in252520more252520air252520than252520the252520other     SirmymotherhadbeenreportedModeratelyDifferentiatedDuctalCarcinomawhensheselfrecognizedalymphonherleftbreastdoctorsugestforanoperationSirwillshebefineafterthat     enlarged spleen bladder     breastcancer4849252520Enter252520your252520comments252520here252520scheme     Two20Igm20Monoclonal20Antibodies20immunofixation20Protein     WelcometoWigsLaceOfferingwigshairextensionsfalls     Is it possible to have IFE fir MM when SPEP and UPEP were both     platelet20morph     bleeding20after20sex     large20liver20cysts     acutelymphoblasticleukemia     ovarian252520cancer2525203252520prognossis     waiting for lumpectomy     had252520endscopy252520everything252520252520is252520cleared252520no252520cancer252520no252520scar252520tissue252520but252520it252520stills252520feels252520like252520something252520is252520stuck252520in252520my252520throat     is lung cancer an infectious or noninfectious disease     ii have a large lump in genital area i am a male and im not a virgin     measuringupto10mminshortaxisdiameterwhichisliklynofurtherreactiveadenopathy     prostrate cancer     blood20in20semen     IhadiliaclymphomasurgeryfridayHecouldnotremovethetargetnodetumor4070ResultchosennicknamemhgojdldxregisteredregisteringonlymodeisON     IgG Lambda monoclonal protein     what is pacreatic     subcutaneous     IgGlambaproteininurine     Areplypsdangerous     whatisatypicmalignancyinthebreasts     high20white20count     Free kappa lt chains s     what causes calcium spots on lower back and arms     recurrence20of20stage20320colon20cancer     iggkappamonoclonalprotien     daily20periods     whitespotandshodowonleftlungshowedinxray     LUNG     igotalivercystislivercystdan     askovariancancerquestions     bartholinscysts     Grano Cyte 34     ig20g20lambda20protein     borderlineenlarged     signs20of20breast20cancer     uterinecancertreatment     whatisiggkkappalightchain     CEA BREAST CANCER     anal cancer survivor symptoms     is20it20cancer     increasedgammaglobulinsbandspresent     howcanyoutellyourdianoisedwithlungcancer     pma     cystinthechin     multiplemyelomaandamyloidosis     when you throw p does that mean youre about to die     ANA20titer     tissue     10yearsafterbreastcancerpaininrightsidewhentwistingtotheright     Nochemohairloss     LambdaLightchainmyeloma     My204220yo20counsin20recently20diagnosed20with20stage20420breast20cancer20She20has20not20started20chemotherapy20yet20because20test20has20revealed20that20she20has20a20mass20in20her20ovary20She20is20going20for20biopsy20to2     EnlargedspleenaftercoloncanerLiverproblemorcan     usingtaxoltaxoteretoearlystagebreastcancerwithnodenegative69020inurlnode20positiveness     Ovarian252520Cancer     waiting20for20lumpectomy     How long does Mitomycin C remain in the system I had an extravasion following an intravesical in fusion of Metomycin resulting in holes in the bladder and systemic side effects predominately almost total hair loss The surgery was 3 weeks ago     marking252520clip     Drugsmedicine20to20reduce20the20amount20of20mestrection20flow20and20the20days20of20mestruction     cushingandchrons     what20is20monoclonal20protein     What20does20IgG20Lambda20monoclonal20protein20detected20in20serum20immunofixation20test20mean     join     treatmentformultiplemyeloma     igm monoclonal     breast252520dimple     whatcausessharppainundermyleftbreastshoulderandback     soft20tissue20density     lymphnotes20cancer     BUNhigh     whenyouthrowpdoesthatmeanyoureabouttodie     ductal epithelia hyperplasia     abnormalpapafterchemo     1605157516071609 157516041578160715751576 157516041578160715751576 15751604170515761583     periceliac20lymphadenopathy     ifihavefreekappalightchaininthehighnormalrangedoihavemyeloma     varicocele tumor     increased20igm20decreased20igg     

©2011 - Ask an oncologist now  |  All Rights Reserved
The site is not a replacement for professional medical opinion, examination, diagnosis or treatment. Always seek the advice of your medical doctor or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information written by any author on this site. No health questions and information on askanoncologistnow is regulated or evaluated by the Food and Drug Administration and therefore the information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor. Posts made to these forums express the views and opinions of the author, and not the administrators, moderators, or editorial staff and hence askanoncologistnow and its principals will accept no liabilities or responsibilities for the statements made.

Home | Terms & Conditions | Contact Us | Frequently Asked Questions | Disclaimer | Privacy Policy | Advertise with us
Stats