Pathology: It's overwhelming before meeting with the surgeon

Posted by debby100 @debby100, Feb 6, 2023

Hi just had a 2 tumor lumpectomy and sentinel lymph node removal. I am waiting to meet with surgeon Friday. In the meantime I’m able to read the the tumor report online . I know you shouldn’t Google stuff but I need to get familiar with things I’m not aware of till now. My k167 is high -LvI present-DCIS
High estrogen positive
Doing a fish test . A lot to take in

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@debby100
" My k167 is high -LvI present-DCIS
High estrogen positive
Doing a fish test . A lot to take in"

ki67% is a measure of how fast cells are dividing. 10% or less is low, and 20% or more is high, meaning a more aggressive cancer
https://www.verywellhealth.com/ki-67-tumor-marker-test-430609
LVI is lymphovascular invasion meaning there are cancer cells in either lymph vessels (not nodes) or blood vessels or both. You can ask if this is "focal" (local, better) or "extensive."

Do you have DCIS in addition to IDC or ILC . The latter are invasive. It sounds like you have both DCIS and invasive cancer. DCIS has not left the ducts yet, unless invasive, so still contained.

The FISH test is to confirm HER2 status or resolve an equivocal. If you are HER2+ you do chemo and some special meds for HER2. Outcome is much better these days. If negative you will do hormonal meds (and maybe chemo?).

IF your estrogen (ER) is high that is good news! You may be able to avoid chemo and rely on meds that address hormones. Is your PR positive?

If your HER2 is negative, your doc will do a test called the Oncotype Dx that will tell you what your risk of recurrence is with hormonal meds and also whether you would benefit from chemo. Many of us don't do chemo these days, but we cannot predict for you and your doc will use the Oncotype and/or pathology to come up with a plan.

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@windyshores

@debby100
" My k167 is high -LvI present-DCIS
High estrogen positive
Doing a fish test . A lot to take in"

ki67% is a measure of how fast cells are dividing. 10% or less is low, and 20% or more is high, meaning a more aggressive cancer
https://www.verywellhealth.com/ki-67-tumor-marker-test-430609
LVI is lymphovascular invasion meaning there are cancer cells in either lymph vessels (not nodes) or blood vessels or both. You can ask if this is "focal" (local, better) or "extensive."

Do you have DCIS in addition to IDC or ILC . The latter are invasive. It sounds like you have both DCIS and invasive cancer. DCIS has not left the ducts yet, unless invasive, so still contained.

The FISH test is to confirm HER2 status or resolve an equivocal. If you are HER2+ you do chemo and some special meds for HER2. Outcome is much better these days. If negative you will do hormonal meds (and maybe chemo?).

IF your estrogen (ER) is high that is good news! You may be able to avoid chemo and rely on meds that address hormones. Is your PR positive?

If your HER2 is negative, your doc will do a test called the Oncotype Dx that will tell you what your risk of recurrence is with hormonal meds and also whether you would benefit from chemo. Many of us don't do chemo these days, but we cannot predict for you and your doc will use the Oncotype and/or pathology to come up with a plan.

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Thank you so much for reply.Yes it is both invasive. I will know more Friday when I meet with surgeon. I am so hoping to avoid chemo.

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@debby100

Thank you so much for reply.Yes it is both invasive. I will know more Friday when I meet with surgeon. I am so hoping to avoid chemo.

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@debby100 what is your ki67% and what is your PR (progesterone)?

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Well 1 tumor listed 18%
The other was13%
Next to the word ki67% was 44%
Pr was low I can’t remember at the moment
Nuclear grade was listed high
Necrosis Present
4 lymph nodes. No cancer

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@debby100

Well 1 tumor listed 18%
The other was13%
Next to the word ki67% was 44%
Pr was low I can’t remember at the moment
Nuclear grade was listed high
Necrosis Present
4 lymph nodes. No cancer

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Well 1 tumor listed 18%
The other was13%

@debby100 Are these estrogen scores?

Good luck on Friday! Do you meet with an oncologist or just the surgeon? Let us know what you hear!

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@windyshores

Well 1 tumor listed 18%
The other was13%

@debby100 Are these estrogen scores?

Good luck on Friday! Do you meet with an oncologist or just the surgeon? Let us know what you hear!

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Hi
Friday surgeon said yes I’ll need chemo. After first biopsies nov 17 the outlook was surgery radiation and hormone blocker . Surgery was Jan 26 after the tumors were tested I am now Her2 positive.
IDC
2 more cancer spots and 45mm underneath
LIV. …..Present
Nuclear grade high
Things are different now this is harder to accept than I originally thought.
Monday go to oncologist for the plan

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This is hard to accept, and please do give yourself grace. I had an original pathology very much like this, and I remember it like it was yesterday. Since my family was all busy the afternoon and evening after I got the news……well , you know the old saying “when things get tough, the tough go shopping”. 😂
The funny part of that is I bought a patent leather red purse and anyone who knows me knows I would hate that purse. I carried it as a badge of courage through my treatments then gave it to a friend who loved it, to do the same.
I am 18 years on the other side of that day, and there have been some twists and turns along the way, but I don’t regret any of the treatments, no matter how hard because they have gotten me HERE❣️.
How are you feeling today? Do you know anymore about your treatment plan?

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@auntieoakley

This is hard to accept, and please do give yourself grace. I had an original pathology very much like this, and I remember it like it was yesterday. Since my family was all busy the afternoon and evening after I got the news……well , you know the old saying “when things get tough, the tough go shopping”. 😂
The funny part of that is I bought a patent leather red purse and anyone who knows me knows I would hate that purse. I carried it as a badge of courage through my treatments then gave it to a friend who loved it, to do the same.
I am 18 years on the other side of that day, and there have been some twists and turns along the way, but I don’t regret any of the treatments, no matter how hard because they have gotten me HERE❣️.
How are you feeling today? Do you know anymore about your treatment plan?

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Hi you made me laugh 😂 I too love retail therapy 💕I’m feeling great physically I rebounded from lumpectomy quickly.
Yup the picture keeps getting wider more and more details.
12 weeks chemo (march3) once a week
Rest 4-6 weeks
Radiation m-f 5-6weeks
Her-2 med in the port every 3 weeks for 52weeks
The 5 year estrogen blocker pill
Took the chemo room tour yesterday got a lot of details about blood work stuff. I’m so glad to hear your 18 years on the other side of it !!
I’m single with a blind special needs son(30) and I just have to ok💕ty for reaching out
God bless you

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@debby100

Hi you made me laugh 😂 I too love retail therapy 💕I’m feeling great physically I rebounded from lumpectomy quickly.
Yup the picture keeps getting wider more and more details.
12 weeks chemo (march3) once a week
Rest 4-6 weeks
Radiation m-f 5-6weeks
Her-2 med in the port every 3 weeks for 52weeks
The 5 year estrogen blocker pill
Took the chemo room tour yesterday got a lot of details about blood work stuff. I’m so glad to hear your 18 years on the other side of it !!
I’m single with a blind special needs son(30) and I just have to ok💕ty for reaching out
God bless you

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I hope the tour was helpful. I just accompanied a friend with a similar treatment plan, to her oncology appointment, and I think more info and a tour would have helped her.

It is hard when you have a child who has special needs. I can relate. I am 8 years out from cancer treatment. Good luck!

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@debby100

Hi you made me laugh 😂 I too love retail therapy 💕I’m feeling great physically I rebounded from lumpectomy quickly.
Yup the picture keeps getting wider more and more details.
12 weeks chemo (march3) once a week
Rest 4-6 weeks
Radiation m-f 5-6weeks
Her-2 med in the port every 3 weeks for 52weeks
The 5 year estrogen blocker pill
Took the chemo room tour yesterday got a lot of details about blood work stuff. I’m so glad to hear your 18 years on the other side of it !!
I’m single with a blind special needs son(30) and I just have to ok💕ty for reaching out
God bless you

Jump to this post

Please feel free to tag me at anytime. I have probably taken most or all of the meds you will be taking. I did radiation as well. Looks like my chemo will be different at least in the timing. I took taxol, Adriamycin, and Cytoxin every three weeks, for 6 treatments. Then got the herceptin a few years later as it had not been approved for front line therapy yet. I also had a physical oopherectomy between chemo and radiation.
Prepare yourself for some hard, but it isn’t impossible and can buy you a lot of time with that son of yours. 😁

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