Invasive ductal carcinoma (IDC): Anyone else?

I am 47 years old next Saturday.

Here is my history:

8/15 - Had a random mammogram. Didn't do one since 2016
8/17 - They called me to come back for another mammogram and ultrasound
8/23 - A second mammogram was performed + ultrasound. The radiologist told me that I have three masses in my left breast, one is cancerous. It was the hardest day (days) in my life.
9/7 - Had a biopsy at Mount Sinai
9/9 - Received the report that said: two cancerous masses in my left breast: Ductal Carcinoma in Situ, invasive, Her2 - negative, ER - positive. Tumor sizes under 2.5cm one and the other under 1.5cm
9/21 - Met with the surgeon Dr. Elisa Port from Mount Sinai. She is a good surgeon, but I would like to see Dr. Alexandra H.
10/13 - Meeting with Dr. Alexandra H. - Memorial Sloan Kettering. It feels right to meet her for a second opinion. I might choose her as a surgeon.

I’m sorry that this is something you must go through… as we, in this group, all have. It’s a traumatic experience to be told what we have been told!

I think you are definitely on the right track to get a second opinion about treatment options. MSK is a good place to get that. Mount Sinai is also a great option.

Best of luck on the 13th. Warm hugs 🌸

When do I have to schedule the Oncotype DX test ?

Your surgeon or oncologist will make the referral. I had my result before surgery based on my biopsies. In my case they had enough tissue to do the typing.

The oncologist was looking to see my numbers ( aggressive or not so aggressive). Had my numbers been higher she would have suggested chemo before surgery to shrink any nodes to minimize a major axillary removal.

Ask about this on the 13th. Often it’s done with surgically rendered tissue.

🌸

What does it mean surgically rendered tissue?

My understanding is that Oncotype is done after the surgery. But it make sense to do it before the surgery to see if the tumor is aggressive.

There is another test called Ki 67 proliferation index.

When I asked the surgeon on September 21st about Oncotype and Ki67, she told me that they do it after surgery. Not only, but if she finds positive nodes they don't do Oncotype. Mount Sinai.

What does it mean surgically rendered tissue?

My understanding is that Oncotype is done after the surgery. But it make sense to do it before the surgery to see if the tumor is aggressive.

There is another test called Ki 67 proliferation index.

When I asked the surgeon on September 21st about Oncotype and Ki67, she told me that they do it after surgery. Not only, but if she finds positive nodes they don't do Oncotype. Mount Sinai.

@anjalima and @polianad22

Again, Oncotype is done for 1-3 positive nodes and chemo is not assumed.

From the Susan G. Komen site: Oncotype DX helps predict the chance of metastasis and the likelihood of benefit from chemotherapy for early breast cancers that are all of the following [14,32-34]:

Tumor size smaller than 5 cm
ER-positive (and will be treated with hormone therapy)
HER2-negative
Lymph node-negative or 1-3 positive lymph nodes

100 rounds of chemotherapy? Did you do lumpectomy or mastectomy?

Oncotype is recommended for those with 1-3 nodes positive.

Ki67% is actually one of the proliferative factors included in the Oncotype but there are several. My ki67% was high but my Oncotype was low so I called Genomic Health to ask them. Also I had grade 3 and they told me 30% of grade 3's have low Oncotypes.

Many docs don't order the ki67% because it is considered unreliable. I still wonder if healing biopsy tissue threw mine off.