Tumor Invasion to Pectoral Muscle?

@margaretb I did have my original diagnosis in almost exactly the same spot. In fact it was a golf ball attached to my chest wall and rib, by the time it was removed. Didn’t really show on a mammogram and even though you could see and feel it. The needle core just came back as necrotic tissue.
My surgeon removed it, scraping the bone and removing what he described as half of my breast. It came back er+, pr-, her2+. Grade 3 and very aggressive. I was young (30s) so I chose to read, and read some more, until my eyes were on fire. I accepted, chemo, radiation and yes I took tamoxifen for 5 years and anastrazole for 10. There are side effects, but I am still here to complain about them almost 20 years later.
The one thing that my surgeon said that has always stuck with me is “the only good decision is an informed decision”
I can’t say the decisions I made are right for you, but they were right for me. I feel like I might be the toughest geezer in my circle of friends, but I still enjoy my life.
Do you have access to library materials for researching your type of cancer and treatments?

So have done a lot of research- I am a patent attorney and sometimes file biotech cases so no problem reading technical papers, I read technical literature all day long at work as part of my job. Right now mostly using Google Scholar and I can access full text of most articles through a subscription I have access to. It seems (in general) chemo is quite good on agressive tumors as it attacks cells that are dividing rapidly (like your hair!). But not much on very slow tumors like mine. Read some of the original studies on Femara and, seriously, in the population being studied the risk was reduced from 6% to 3% so not sure, at 59, that it's worth it for such a small reduction. Radiation seems more promising, but still not super optimistic about that either. And, yeah, so much for mammograms...the images I looked at from my last one (the fancy 3D kind, did in March) don't even go down that far- I mean, think about where your breast is positioned and, no, it's not looking at your sternum...the guy doing my biopsy kept saying "strange" and then the mammographer would answer, "very strange" guess they didn't know I can understand a lot of Chinese.

I am dragging all my files to a private pay doctor outside the national health system for a second opinion and there are some other places that will do second opinions. Have not yet met with the pharma oncologist, 100% he will recommond AI, strongly ER positive (over 90 percent). Everyone is on the fence about chemo (surgeon, radiologist) will see what he says (and what chemo drugs) then run and do research on my own. Typically after any appointment, I go down to medical records and get whatever latest report (pathology, MRI, CD with scans) so I can read it myself. They print it out for me in English, very kind.
In general, I don't get to speak to doctors very long- while the system gets you instant appointments and biospy results to surgery was exactly 2 weeks (did all the scans in that time), the doctor sees about 100 patients in a 4-hour window (the surgeon) and other doctors I have dealt with at least 50-70 patients in a 3-hour window. But, everyone gets seen, everyone gets treated, I can't really fault their system. Not to mention the incredibly low cost (I have maybe spent 200 dollars-US- so far).
Just not a lot of literature discussing pectoral muscle invasion with tumor cells still in the margin, I guess in more tumors it's not that deep and easier to get a "clean" margin. And the one I read not that optimistic (attached here) but only a couple of data points (Johns Hopkins studies).
Thank you so much for sharing your story, gives me a little bit more optimism.

Oh, also attaching a very poor MRI image (a photo of a low-quality printout, I didn't have a CD reading, coworker printed this out for me)- this is a cross-section, it is kind of hot-dog shaped I think, running down the sternum.

@margaretb have you considered asking for a second opinion at the Mayo Clinic or other reputable cancer center? I was able to send all of my imaging and scans to them without having to be seen and was still given recommendations. The more information you have besides reading scholarly articles might help you make a decision on which path you should take regarding treatment. Best of luck to you!

So have done a lot of research- I am a patent attorney and sometimes file biotech cases so no problem reading technical papers, I read technical literature all day long at work as part of my job. Right now mostly using Google Scholar and I can access full text of most articles through a subscription I have access to. It seems (in general) chemo is quite good on agressive tumors as it attacks cells that are dividing rapidly (like your hair!). But not much on very slow tumors like mine. Read some of the original studies on Femara and, seriously, in the population being studied the risk was reduced from 6% to 3% so not sure, at 59, that it's worth it for such a small reduction. Radiation seems more promising, but still not super optimistic about that either. And, yeah, so much for mammograms...the images I looked at from my last one (the fancy 3D kind, did in March) don't even go down that far- I mean, think about where your breast is positioned and, no, it's not looking at your sternum...the guy doing my biopsy kept saying "strange" and then the mammographer would answer, "very strange" guess they didn't know I can understand a lot of Chinese.

I am dragging all my files to a private pay doctor outside the national health system for a second opinion and there are some other places that will do second opinions. Have not yet met with the pharma oncologist, 100% he will recommond AI, strongly ER positive (over 90 percent). Everyone is on the fence about chemo (surgeon, radiologist) will see what he says (and what chemo drugs) then run and do research on my own. Typically after any appointment, I go down to medical records and get whatever latest report (pathology, MRI, CD with scans) so I can read it myself. They print it out for me in English, very kind.
In general, I don't get to speak to doctors very long- while the system gets you instant appointments and biospy results to surgery was exactly 2 weeks (did all the scans in that time), the doctor sees about 100 patients in a 4-hour window (the surgeon) and other doctors I have dealt with at least 50-70 patients in a 3-hour window. But, everyone gets seen, everyone gets treated, I can't really fault their system. Not to mention the incredibly low cost (I have maybe spent 200 dollars-US- so far).
Just not a lot of literature discussing pectoral muscle invasion with tumor cells still in the margin, I guess in more tumors it's not that deep and easier to get a "clean" margin. And the one I read not that optimistic (attached here) but only a couple of data points (Johns Hopkins studies).
Thank you so much for sharing your story, gives me a little bit more optimism.

Oh, also attaching a very poor MRI image (a photo of a low-quality printout, I didn't have a CD reading, coworker printed this out for me)- this is a cross-section, it is kind of hot-dog shaped I think, running down the sternum.

So have done a lot of research- I am a patent attorney and sometimes file biotech cases so no problem reading technical papers, I read technical literature all day long at work as part of my job. Right now mostly using Google Scholar and I can access full text of most articles through a subscription I have access to. It seems (in general) chemo is quite good on agressive tumors as it attacks cells that are dividing rapidly (like your hair!). But not much on very slow tumors like mine. Read some of the original studies on Femara and, seriously, in the population being studied the risk was reduced from 6% to 3% so not sure, at 59, that it's worth it for such a small reduction. Radiation seems more promising, but still not super optimistic about that either. And, yeah, so much for mammograms...the images I looked at from my last one (the fancy 3D kind, did in March) don't even go down that far- I mean, think about where your breast is positioned and, no, it's not looking at your sternum...the guy doing my biopsy kept saying "strange" and then the mammographer would answer, "very strange" guess they didn't know I can understand a lot of Chinese.

I am dragging all my files to a private pay doctor outside the national health system for a second opinion and there are some other places that will do second opinions. Have not yet met with the pharma oncologist, 100% he will recommond AI, strongly ER positive (over 90 percent). Everyone is on the fence about chemo (surgeon, radiologist) will see what he says (and what chemo drugs) then run and do research on my own. Typically after any appointment, I go down to medical records and get whatever latest report (pathology, MRI, CD with scans) so I can read it myself. They print it out for me in English, very kind.
In general, I don't get to speak to doctors very long- while the system gets you instant appointments and biospy results to surgery was exactly 2 weeks (did all the scans in that time), the doctor sees about 100 patients in a 4-hour window (the surgeon) and other doctors I have dealt with at least 50-70 patients in a 3-hour window. But, everyone gets seen, everyone gets treated, I can't really fault their system. Not to mention the incredibly low cost (I have maybe spent 200 dollars-US- so far).
Just not a lot of literature discussing pectoral muscle invasion with tumor cells still in the margin, I guess in more tumors it's not that deep and easier to get a "clean" margin. And the one I read not that optimistic (attached here) but only a couple of data points (Johns Hopkins studies).
Thank you so much for sharing your story, gives me a little bit more optimism.

Oh, also attaching a very poor MRI image (a photo of a low-quality printout, I didn't have a CD reading, coworker printed this out for me)- this is a cross-section, it is kind of hot-dog shaped I think, running down the sternum.

Check into proton radiation therapy vs. traditional radiation.

I am really glad to hear you are able to do research, that paper you posted pretty much mirrors what I found in 2004 for any tumor anchored to the chest wall.
I am also really, really happy to hear you are getting a second opinion. My knee jerk reaction, after losing a few family members to cancer was to say no to everything too. Boy am I glad for that surgeon and his encouragement. I know you said things move pretty quickly, do you have any idea when you will get a second opinion?

@margaretb have you considered asking for a second opinion at the Mayo Clinic or other reputable cancer center? I was able to send all of my imaging and scans to them without having to be seen and was still given recommendations. The more information you have besides reading scholarly articles might help you make a decision on which path you should take regarding treatment. Best of luck to you!