Today I received my pathology results following my lumpectomy on the 15th January. I give below some important information:
No vascular invasion. No lymph node involvement. Closest relevant margin: Posterior = 0.5mm. All other margins = 3mm or more. ER status 8, PR stats 5, HER2 status negative. Invasive Grade 3 (T3 P3 M3), Whole tumour size 25 mm
PATHOLOGICAL STAGING : pT2
comments: Right breast WLE containing 25mm of Grade 3 invasive ductal carcinoma, with focal intermediate grade DCIS. Peri neural invasion is noted.
The Invasive tumour is 0.5mm from the posterior margin.
Should I be worried about peri-neural invasion?
Should I be worried about the posterior margin of 0.5mm? Seems too close for comfort? Would this be regarded as a positive or negative margin?
I have sent a message to my breast cancer nurse since I wasn’t told about the peri-neural invasion (whatever that means for me) and I only vaguely picked up on the proximity of the posterior margin of 0.5 mm to the tumour at my follow up appointment last week. That seems too close to me? Seems it was close to a muscle or to the chest wall but that my surgeon removed all malignant breast tissue.
Would be grateful for any help or comments. Does any of this make sense to anyone? First time I have seen Grade 3 IDC with focal intermediate grade DCIS
I don’t know if this helps….I had IDC grade 3 with high grade DCIS and LVI.
DCIS is a non invasive cancer, and is graded using the terms low, intermediate and high. So, I suppose if they used the same scale as invasive cancers, your DCIS would be described as Grade 2.
The doctor told me, when presented with both the priority is to treat is the invasive tumor as that is more serious of the two. During an informal chat, I asked if the invasive cancer had developed from the DCIS - he said highly likely but could not be proved. Hence, DCIS is still important and needs to be treated.
I don’t know much about your “peri neural invasion”, I had LVI (vascular invasion). From what I can gather they are of a similar nature. I believe both are about rouge cells, outside the boundaries. The medical profession or their guide lines, don’t regard LVI as important, although I beg to differ. I was given radiotherapy, but you may be offered chemo to tackle that.
Definitely ask questions about your results when you next see them. They tried to dodge my questions on LVI, so be prepared to stand your ground if you ask about PNI - they may follow the same guidelines. Hope you get all your answers x
Sal, thank you for your helpful message. Yes when I read about vascular invasion and now peri neural invasion, it doesn’t sound too healthy, does it. I suppose it depends on the causes and what it means for us individually.
Oh this is all so complex but it would be nice if our doctors/nurses could find a way to tell us simply and completely what was found in our pathology. I don’t like having to find out for myself about these additional findings when I am supposed to be making an “informed” decision on whether or not to take up certain “recommended” treatments. I am (was) minded to do nothing more after a successful lumpectomy, but now I am really not so sure and may well have to go along with one or more of the treatments recommended.
I wish this would all go away. I am too busy as a carer (hubby has early vascular dementia) to think about myself. Perhaps this is helping me by taking my mind off my own troubles. We all have different ways of coping, don’t we.
Thank you for caring Sal and I wish you all the best too xx
Jill, thank you. I agree, if I don’t hear from my personal breast cancer nurse in the coming days, I will ask the Nurses here some questions or ring them. I am slowly reading stuff online, but not getting too depressed or influenced by what I am reading. Who can really predict what the future holds, but at least if we are fully “informed” we can make the best decisions. Hope you are doing well Jill xx