Fin says on 17 Aug 2011 17:46
I’ve just received my results the snb was clear and hormones triple negative. My tumour was mainly dcis with 15mm of grade 2 cells. the surgeon got all the margins first time and the grade 2 cells were inside the tumour. Has anyone out there had a similar diagnosis? What treatments should I expect to be offered by the oncologist?
Thanks
Fin
Hi Fin
the treatment can also depend on the size of the tumour, your age and other things like whether there was an cancer cells in the lymphatic vessels or blood vessels around the tumour (this is usually called lymphovascular invasion or LVI for short).
it is possible with a grade 2 tumour with no LVI and under 2 cms that you wouldnt need any chemo and just go on to have radiotherapy, however if you are in your 30s then they may still want to give it… the criteria does tend to differ ever so slightly up and down the country.
i had a triple negative tumour when i was 40, it was grade 3 and i had LVI but neg SNB. the tumour was 19m but it was surrounded by DCIS and the whole area was 28mm… after my WLE i was recommended to have epi-cmf chemo for 6 months before rads.
take care and let me know how you get on.
Lulu xx
Hi Fin,
I had Triple Negative Grade 3 of 13mms surrounded by DCIS to 21mms overall. As not suitable for radiotherapy (lung disease) I had had a mastectomy and axillary clearance, nodes negative, had good margins, two instances of lymphovascular invasion.
So similar but not identical. 65 at diagnosis last summer.
I think it will depend on your age, the younger you are the more they will want to consider chemo as well as rads
Surgeon was surprised I wanted chemo but I felt that as Triple Neg chemo was the only other thing I could throw at it, and oncologist agreed. Had FEC6, not fun but doable as they say.
Hi Lavendar Lassie
Thanks for the info - it does seem that triple negative responds to chemo. Were your gade 3 cells inside the dcis? All mine were in the middle of the dcis. I do think that to have both is a bit over the top when they had good margins and my lymph nodes are clear! I will probably go with whatever they recommend - I’m thinking about getting a second opinion. Will let you know what consultant says on 6th Sept.
Thanks
Fin
Dear Fin,
Yes, the actual cancer which was Grade 3 was surrounded by high grade DCIS, which was a bit of a surprise as the DCIS had not been seen from the diagnostic screening mammogram or the ultrasound used at the time of outpatient biopsy. This does happen and particularly with high grade DCIS apparently.
About to ask (again) at my first annual review how they can be sure I do not have high grade DCIS on the other side.
The oncologists usually work out what difference in survival and risk of recurrence would be achieved by adding in chemo, and advise for or aganst chemo depending on the numbers they come up with.
In the meantime, celebrate negative nodes!
Hi
Thanks - that is very helpful. I’m 58 and otherwise very healthy so I would imagine I will get offered the lot. Interestingly they only picked up the dcis on the initial biopsy and the grade 2 when they did the biopsy on the lump after the WLE. I am very aware that it could be much worse.Will let you know how I get on.
Thanks
Fin