Infiltrating duct carcinoma, stage III, age 55. Need help with understanding the case and cure

[vinipathak]

Hi, My Mother, age 55 has been detected with Duct Carcinoma on 10th Oct'19, had undergone surgery - Lt Side Quadractomy with axillary lymph nodes. The biopsy report states - Infiltrating Duct Carcinoma grade III. Size of tumor 1*0.6cm, Left AXLN-0.8,*0.6 cm, 4*2.8 cm necrotic lymph nodes in left axillary tail. With 15 out of 31 axillary lymph nodes showing metastasis. FISH HER report yet to come. ER-positive (30% tumor nuclei shows moderate intensity.) PR - negative.

PET CT Scan shows - Few tiny lung nodes on the left upper lobe and along bilateral fissures seen with no significant uptake.

Reactive tiny-subcm left level II and IV neck nodes.

Doctors have prescribed Granisetron 1mg, Dexamethasone 12 mg, Cyclophosphamide 900mg, Epirubric 140 mg, Dexamethasone 4mg

As this is the first breast cancer case in our family. I wanted to understand a few questions:

1) What does ER, PR and HER mean - and what does it mean with positive and negative

2) With regard to the nodes in the neck and lungs (PER Report)- doctors have said that the chemo will take care of these as well. However, after the chemo how do we ensure that the nodes are not malignant?

3) Also, I want to understand what does "Infiltrating Duct Carcinoma stage III mean. What are the chances of recurrence? How should we take care of it?

[sumeet_shah Administrator]

ER Is Estrogen Receptor

PR is Progesterone receptor

Positive or negative means whether these receptors were there in the tumour.

As for nodes, cannot be commented here, as it needs seeing report in detail and understanding it. Your Oncologist will guide you.

Chances of recurrence, your doc will guide. Again, it needs detailed assessment of report and understanding of the patient’s situation, which only your Oncologist will know.

[vinipathak in reply to sumeet_shah]

Thanks, a lot for the detaile reply Sumit. I just have one more question, post chemo and radiation whom should we consult for regular follow-ups - MD Onchology or Surgical Onchologoist?

[sumeet_shah Administrator in reply to vinipathak]

Ideally the Surgical Oncologist. However, most teams usually split follow ups between them. So one follow up you can do with your surgeon, the other with your Med Onc. That’s what me and my colleagues do. But many of my patients prefer to come to me and I call them once in six months or so.

[Pankyforhelp]

My mother was also diagnosed with almost same but quite severe .

I would suggest . It’s important to keep MRI doing for brain may be after every 6

Months just to make sure it’s not infecting brain .

We were not aware and it damaged her brain . Note - we were doing CT scan after every 4 months . But didn’t helped .

It will be tough time as soon as you start chemo .

Be strong !

[vinipathak in reply to Pankyforhelp]

hey! thanks a lot Pinky. But is it okay to perform MRI in every 6 months, I mean would it be clinically correct?

[Pip6 in reply to vinipathak]

You can take scan it is ok as there is no choice

[Pip6 in reply to vinipathak]

It is better to scan to make sure cancer doesn't spread

[UpperHand Administrator]

vinipathak , our doctors are here to help. As a respect to their time, the one request we have to all people like you is, before asking here and expecting a detailed reply, just once, just once, please ask the same questions to your treating Oncologist first. After you have discussed all basic cancer info with them, then if you have doubt, it makes sense asking here.

For example, your first question on ER PR. It tells us that either your doc hasn’t explained anything or you have not asked him; and it’s such a basic question, there are a million sites on web to understand that. But not putting any effort to read once and just asking here amounts to spoon feeding. An answer to that question will require writing as much as two Microsoft word pages, which will easily take an hour to just type and explain. And one answer from doctors here will lead to another few questions from you. Also, this question has been asked unpteen number of times. Just search for it and you will get many answers.

So please understand. Ask your doctors first. I am sure they will explain. If they dont, change your doctor.

Once you have some idea, and still confusion persists, definitely feel free to ask our docs here. They are kind enough to have been helping many over last seven years, giving their precious time.

[vinipathak in reply to UpperHand]

Hi! I do get your point, we did discuss it with multiple doctors but were not getting proper information, so asked in the forum. These elements are new for us as well, and we are doing our research.

However, I understand the doctors replying to the forum may have paucity of time, so will try to be specific

[sumeet_shah Administrator in reply to vinipathak]

I hope you don’t get him wrong. UpperHand (he refuses to disclose his name!) is one of the nicest person from pharma I have ever known and amount of help he does to patients for procuring drugs at cheapest rate, is unmatched.

I do agree with him, though, because, at times it’s the same question over and over and yet over again. So all we request is, if most users read a bit more before asking, it does help us explain better.

Don’t worry much and feel free to ask if you have anything in mind.

[MsLockYourPosts TeamBCI]

A reliable resource is breastcancer.org The site is US based, so not specific to what is available in other countries, but the basic medical information is universal. Just googling can yield lots of dated and incorrect information. Many doctors here (US) usually recommend staying away from the internet, with the exception of this site.