Pathology results...

Hi Everyone,

So my mum was diagnosed with TNBC last July. Tumour was 5cm and 2 suspected positive lymph nodes. She completed neoadjuvant chemo of 9 x weekly PC and 3 cycles of EC chemo. She had an MRI scan halfway through and the tumour (after 9 weekly PC) had only shrunk by 5 mm, which we were a bit upset about.

After chemo, she had a single mastectomy and full axillary node clearance.

Today we received the results from the pathology report, and the tumour was actually 6 cm, and 4/18 lymph nodes contained cancer.  80% of the tumour was dead, with 20% residual, and they got clear margins.

Not sure how to feel about these results. I’m thinking either they got the measurements of 5cm incorrect, or the tumour grew during EC chemo, and also spread to more lymph nodes?

I’m pleased about the clear margins, but also struggling to understand how the volume can decrease by 80%, but it can also grow at the same time?? all very confusing.

It has been suggested radiotherapy next for chest wall and collar bone, but no mention of Xeloda/Capecitabine, which I thought was given for residual cancer.

Everyone I have spoken to have replied with a sorry/pity look on their face and I’m worried this does not provide a good outlook for the future, especially as cancer in lymphatic system.

Any advice/positive stories of something similar?

Thanks :slightly_smiling_face: x

Hi. I had my mastectomy and axillary  clearance at the beginning of January. Before, my consultant and surgeon had said they were pleased with my progress and my lump felt smaller. But apparently when they took out the tumour there was a ‘significant’ amount of active cancer cells,  which meant i had only had a partial response to chemo. I couldn’t understand it either because the tumour felt smaller! I’m classed as high risk of recurrence. But I think it’s good that they got clear margins for your mum and radiotherapy should hopefully clear any cells that could be left over. That’s what I was told! Will she be having any other treatment too? 


It must be very hard to support a parent through something like breast cancer (though my mother had it twice and failed to mention the first till she’d almost finished treatment - she was of that hardy generation who “didn’t make a fuss”!!!). I’m so glad she wasn’t around when I was diagnosed at 67. She’d have blamed herself. What does your mother feel about all the statistics? Perhaps she has adopted the approach I adopted - head down, get through it, ask as few questions as possible and trust the experts.

I just wanted to say that radiotherapy makes a significant difference. My oncologist maintained it was the most effective of all the treatments - this was halfway through the most awful experience with chemo so his pronouncement wasn’t well-received at the time!

The other thing I wanted to comment on was about “cancer in the lymphatic system.” It seems to me that that is a healthy thing. I had 19 out of 21 lymph nodes infected but no tests have revealed any spread beyond. Thank god for lymph nodes. They are there to catch and contain infection and that’s what they’ve done. Maybe you could change your perspective and, instead of seeing it as a threat, see it as your mother’s body acting as it should when under such a ruthless attack. 

I accept I may be being naive but does it matter that the original estimates were out? The fact is, now she has had her mastectomy and axillary clearance, your mother is cancer-free and that’s something to be celebrated (though, having gone through the same gruelling chemo regimen as her, she may not feel like celebrating yet!). She has further adjuvant treatment ahead to reinforce the chemo, plus she’ll be started on an AI for 5 or 10 years and maybe have zometa infusions every 6 months. It’s gruelling but it seems to work. Worrying about her prognosis and % improvements in tumours that were removed with clear margins (and I suspect you’re looking into potential survival rates?) isn’t going to help you, let alone your poor mother. Try to trust the experience of your mother’s MDT?

No one has a guarantee that cancer treatment is going to work/going to keep one cancer-free for the rest of one’s life. We really have to live with hope. This feels a bit sanctimonious, for which I apologise, but it does reflect how I feel - if the results show the treatments are working, be glad and don’t waste precious energy fretting about what you can do nothing to change.

I wish your mother all the best with her radiotherapy. If it helps, I found it a doddle after chemo xx