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Medical Forum / Diseases and Disorders / Breast Cancer / April 2007lymph node involvement
can't find a reference to this for anything but DCIS....seems that spread to sentinel is fairly rare with that...but what about with IDC, if it is very early (nuclear 1/3) and not aggressive (neg for p63)....wood it be more, or less common for sentinel to be invaded? All I can find are references to LCIS and DCIS...thanks for any help. > can't find a reference to this for anything but DCIS....seems that spread > to sentinel is fairly rare with that...but what about with IDC, if it is > very early (nuclear 1/3) and not aggressive (neg for p63)....wood it be > more, or less common for sentinel to be invaded? All I can find are > references to LCIS and DCIS...thanks for any help. Earlier & less aggressive probably makes it less likely that nodes are involved, but there's no magic formula. Once the cancer cells pack their tiny suitcases and start moving around (invasive) rather than staying home (in situ), I think you kinda gotta go through the sentinel node procedure and see whether they moved into the nodes. I had five tumors in one breast (largest 3.1 cm), 1 in the other, and only had one positive node. Oh, yeah, and the palpably enlarged node was how I discovered I had BC in the first place. (I think the technical term for this nodal outcome in my circumstances is "damn lucky" . . . . <g>). Ann T. Remove 'dontsendspam' from address to reply by email I've had swollen nodes on and off my whole life, CFS.....but yeah, no question of doing the sentinel, was just trying to diagram the process, due diligence....it baffles me that DCIS can have node involvement.... >> can't find a reference to this for anything but DCIS....seems that spread >> to sentinel is fairly rare with that...but what about with IDC, if it is [quoted text clipped - 15 lines] > Ann T. > Remove 'dontsendspam' from address to reply by email > I've had swollen nodes on and off my whole life, CFS.....but yeah, no > question of doing the sentinel, was just trying to diagram the process, due > diligence....it baffles me that DCIS can have node involvement... Hiya, pumpkin - As Tim mentioned in another thread in the strictest terms DCIS cannot have node involvement. If nodes are involved it's IDC, not DCIS. I think perhaps you're getting a bit hung up on terms - there's no such thing as a breast cancer diagnosis without a biopsy and what may appear to be DCIS at first can turn out to be IDC after lymph node dissection. Hang in there - it only gets more interesting ;-) allan >> I've had swollen nodes on and off my whole life, CFS.....but yeah, no >> question of doing the sentinel, was just trying to diagram the process, [quoted text clipped - 5 lines] > As Tim mentioned in another thread in the strictest terms DCIS cannot > have node involvement. If nodes are involved it's IDC, not DCIS. I know. But we all know that with DCIS they always do sentinel nodes.....and I was referring to the statistics about those.... > I think perhaps you're getting a bit hung up on terms - there's no > such thing as a breast cancer diagnosis without a biopsy I've had the biopsy, that's why I'm getting the mastectomy. and what may > appear to be DCIS at first can turn out to be IDC after lymph node > dissection. agreed...there will be further tissue analysis then, obviously, and my harmless little ICD will become....god knows what.... > Hang in there - it only gets more interesting ;-) one way to put it. thanks. I like it. > allan > I've had the biopsy, that's why I'm getting the mastectomy. I think I oversimplified things a bit, pumpkin - my apologies. Cancer staging cannot be done from a simple tumor biopsy - so although you've had a biopsy and know that you have cancer the particulars of the disease won't be apparent until at least the sentinel node has been biopsied. The whole TNM score (and thus cancer staging) can't be done without both tumor and lymph node dissesction. ... > I had five tumors in one breast (largest 3.1 cm), 1 in the other, and only > had one positive node. Oh, yeah, and the palpably enlarged node was how I > discovered I had BC in the first place. (I think the technical term for > this nodal outcome in my circumstances is "damn lucky" . . . . <g>). I like that kind of technical term :-) Mary I saw something that said it commonly spreads to lymph nodes...the PA at my surgeon's office said she felt the chances of positive nodes were "microscopic" but when I tried to clarify she said of course sometimes they are surprised and it happens even with a small, unaggressive tumor (which of course might not be that small when excised, we know)....when I talked to her today I threw out the figure of 10% chance and she didn't argue...she just said we never know...I'm to the point now where I figure if it's not in the lymph it's probably everywhere else....uterus, cervix, colon, pancreas.....liver....it's one of those PESSIMISTIC doomsday feeling nights.....good prognosis feels like doom sentence when things shift.....they have a grade for the tumor but not a STAGE of course.....she told me that something estimated at 8 mm could turn out to be 4 cm....good grief....how could they be THAT wrong....anyway, the cells could be everywhere..... >> can't find a reference to this for anything but DCIS....seems that spread >> to sentinel is fairly rare with that...but what about with IDC, if it is [quoted text clipped - 15 lines] > Ann T. > Remove 'dontsendspam' from address to reply by email > I saw something that said it commonly spreads to lymph nodes...the PA at my > surgeon's office said she felt the chances of positive nodes were [quoted text clipped - 10 lines] > grief....how could they be THAT wrong....anyway, the cells could be > everywhere... pumpkin, you've gotta listen to what your oncologist *says*, not what she *doesn't* say. Breathe. We've all had those kinda nights. Sometimes we still do ;-) The reason they do sentinel node biopsies is that it's pretty easy to figure out where cancer cells may have migrated by injecting dye close to the tumor and seeing which lymph node lights up - and the chances of things migrating to other parts of your body without invading your lymphatic system is exceedingly small - I don't even know if it's possible. Well, I guess it's possible but I've never heard of it. That doesn't make me an expert, it just means in almost eight years of almost daily research I've never seen it ;-) One thing about breast cancer - it's breast cancer no matter where in your body it is. Cancer is a catch-all term for more than 100 diseases that display similar characteristics - for example, first line treatment for pancreatic cancer is not nearly as effective for breast cancer and is usually an oncologists' fourth or fifth choice when selecting treatments. Other treatments proven effective for other tumors are only used once *everything* else has failed. Your uterus is most likely safe unless you also have cervical or uterine cancer - breast cancer normally spreads to bone, brain, lungs or liver. I've run across one person with skin mets and one with eye mets since I started this journey. But - in the long run it doesn't matter. My spousal unit and I have been battling Stager IV breast cancer for what'll be eight years come this August. Except for a short period of remission she's been on chemotherapy constantly since diagnosis. The nasties growing in her lungs aren't much bigger now than they were back in 1999 when we started this journey. Breast cancer isn't a medical emergency until it reaches end stage - and for most of the people who get breast cancer it never does. Most of them die of something else ;-) This is a good place to vent. Bring your worries here and we'll fix you up ;-) hugs - allan I had been gonna reply on this thread, but Allan said it all. Deeeeeeeep breeeeeaaath! The odds that your BC has spread (to lymph nodes or elsewhere) seem to be pretty small, but all you have is statistics and probabilities, until you get through the surgery and see the pathology reports. Then you'll have resolution about things like the size of the tumor and the nodal status, but still have only probabilities about prognosis. As far as the size of the tumor: All they know now is what the lump feels like, and what the density looks like on mammograms (or other imaging they've done). They need to get the suspicious tissue out and examine it microscopically, and see which cells are cancerous (vs. just dense or funny-looking on images) in order to know the tumor size. While unusual cases are possible, they're (d'oh!) unusual. If they think you have a 8mm, it's *probably* reasonably close to that. At this point, your medical team *will* waffle and estimate, because they don't have enough information to do otherwise. They're knowledgeable professionals, but they're human & there are limits to human knowledge (however much we wish they had a magic crystal ball!). Depending which doctor I listened to, I had maybe a 40% chance that I wouldn't be standing here today. Guess what? Well, OK, I'm sitting here, not standing here, but you know what I mean! Deep breath! Ann T. Remove 'dontsendspam' from address to reply by email >> I saw something that said it commonly spreads to lymph nodes...the PA at >> my [quoted text clipped - 64 lines] > > allan >I had been gonna reply on this thread, but Allan said it all. Deeeeeeeep >breeeeeaaath! [quoted text clipped - 23 lines] > > Deep breath! So it's only a 60% dailure rate. Or was in your time, probably much less now - your being so old ... <duck> :-))))))))))) Mary > The odds that your BC has spread (to lymph nodes or elsewhere) seem to be > pretty small, but all you have is statistics and probabilities, yep, kinda like life. until you > get through the surgery and see the pathology reports. Then you'll have > resolution about things like the size of the tumor and the nodal status, > but still have only probabilities about prognosis. gawd. tonight I went on a safari into every imaginable complication, worst-case scenario, side effect.....talk about three-ring circus...no, FOUR rings, and no ringmaster.....even the simplest aspect of this whole thing seems...well, uh, what's that technical term? Oh, I know...SUCKY! not really..... > As far as the size of the tumor: All they know now is what the lump feels > like, and what the density looks like on mammograms (or other imaging > they've done). ultrasound. I questioned the accuracy and she said they are usually close but I have suspicions because it FEELS a lot bigger than that! at the time it was found (palpable) during the ultrasound, the MD of radiology said "Feel that? The tip of my finger" (which is more like half an inch or hell, I don't know, I'm losing my mind)..... They need to get the suspicious tissue out and examine it > microscopically, and see which cells are cancerous (vs. just dense or > funny-looking on images) in order to know the tumor size. the tissue is out, graded in the biopsy....grade I....very well differentiated. but they don' tknow the margins, obviously > At this point, your medical team *will* waffle and estimate, because they > don't have enough information to do otherwise. it was the PA who told me this stuff, not the surgeon....the surgeon seemed confident too but isn't it their job to reassure people...no wait, not THIS surgeon, I just remembered how much she scared me five years ago...but then, ....oh hell, They're knowledgeable > professionals, but they're human & there are limits to human knowledge > (however much we wish they had a magic crystal ball!). > > Depending which doctor I listened to, right, but we know we have to listen to our doctors. Today I am trying to figure out which plastics doc to use....insisted on seeing two but jeez, do you decide based on the color of the carpet, the receptionist's hairstyle? Both are very very highly recommended.....if both are likable, then what? one is older, both same distance to home (roughly), both favored by my breast surgeon and will work in concert with her....the woman who does all the tattooing for these two states recommended the one I saw today but I am not sure WHY; the PA at my surgeon's office recommended the other, partly personality..oh hell, I don't think it matters, can you spell OBSESSING!!!???? Waa waa, she said, stomping her little foot in its little Mary Jane....why is this support group so poorly "supported"? So many other groups on less prevalent issues have 500 posts a day...this one seems anemic by comparison...not that I'm insulting anyone, I'm just surprised because BC is more common than many other maladies that seem to be well "discussed" in these forums (or should that be "fora," no, it should not)... > Today I am trying to > figure out which plastics doc to use.... > ..oh hell, I don't think it matters, can you spell > OBSESSING!!!???? Waa waa, she said, stomping her little foot in its little > Mary Jane What you need is the "guillotine" procedure. This is where you have a choice to make but not enough information to tip the balance, and don't want to be like the donkey stuck midway between two piles of hay. Consider what the costs or risks of making the wrong choice would be, and compare that to the expected costs of further research to refine the choice to a point where a decision becomes clear. When the expected research costs exceed the expected benefit, toss a coin. At that point making *any* decision becomes more important than making the "right" decision. > ....why is this support group so poorly "supported"? So many other > groups on less prevalent issues have 500 posts a day...this one seems anemic > by comparison...not that I'm insulting anyone, I'm just surprised because BC > is more common than many other maladies that seem to be well "discussed" in > these forums One explanation is that compared to many other maladies there is a *lot* of information "out there", exactly because it is such a widespread disease. So there is less need for individual discussion: new developments are headline news in the media, there are hundreds of websites describing treatment options, risks etc. Consequently our discussions tend to centre around exceptional situations, less researched peripheral conditions like lymphedema and minor drug side effects, and adjusting the misconceptions that sometimes creep into mass-media reporting. Another reason is the quality of the posts here. When you read other Usenet groups you find an awful lot of trolling, flaming, etc, which actually accounts for a lot of the volume of posts. Thankfully such things are very rare in this group: posters are mostly very sensible and don't rise easily to provocation. Tim Jackson > ....why is this support group so poorly "supported"? The regulars are very supportive of newcomers - and old timers - when they have emotional problems and even (to some extent) knowledge of our condition. But we are NOT doctors and we can't give accurate diagnoses or solutions especially when bc is so complicated and different in every person. There's also the problem that many people come in and don't stay if they don't get a quick fix. We've all had a lot of experience but none will be exactly the same as yours. We are also very different people emotionally, our approach to our diagnoses and treatments take us in diverse ways. What do you want from the group? If you ask a question and it isn't answered according to your hopes or googling or whatever you might be disappointed but you shouldn't be, we're only giving our opinion based on our experience, we can do no more. Your clinical team is the best to advise on your case, we can't even suggest how you should decide between e.g. surgeons, we can only say how we did it. If we DID do it - in Britain we rarely do, we are usually happy with the one we're assigned to. BC is confusing in every aspect but it's not the end of the world for most of us. Act as though you were a survivor and the odds are that you will be - and enjoy life more. Stick around! Mary I guess what I want from the group, apart from occasional information, would be encouragement.....hope....slept almost none, nightmares, fears, shock, horror, the usual.....have been through worse things than this in my life but still can't imagine ever being "past" this....still not past things that happened years ago....feel ill equipped....terrified.....trying all manner of things....feel I cannot do even 1/10 of the things I must do, physically and psychologically....physically. fighting, always, the worries...staying busy, doing volunteer work (help someone ELSE, you idiot girl), playing with my son, because he is oblivious. struggling mightily. I counsel others: great coach but lousy player. I put 1/3 of an Ativan under my tongue and even THAT amount made me sick, LOL!!!! warm diluted milk, lots of journal writing, standing under the stars.....and another day has dawned. Mastectomy is 9 days away...I want it to be an adventure.....a revelation.....but panic sometimes encroaches. and the stupidity is thinking well, even if I get through this it's only for the privilege of getting to the NEXT THING! LOL....the next horrible thing >> ....why is this support group so poorly "supported"? > [quoted text clipped - 28 lines] > > Mary I don't know much about your diagnosis, but from what little I do know, it seems that it could be so much worse, so give thanks for that. The operation itself is not particularly difficult - at least it wasn't for me - virtually no pain. The greatest difficulty was getting used to the prosthesis and now after four years, it's something I accept and give little thought to. Try very hard to calm yourself and take it one step at a time. From your posts I get the impression you are trying make a lot of decisions best left for the future, or at least for the weeks and months following the operation when you will be better informed about your condition. You might try this link to a discussion that appears to be related to your particular diagnosis : http://community.breastcancer.org/ubbthreads/showflat.php?Cat=0&Number=488788&an =0&page=0 This is only one thread; I'm sure there are others. But the group seems informative and supportive. I know how panicked you must feel, I've been there. We all have. But the fact is most of us are here years after the fact living normal lives and dealing effectively with out individual situations. Wishing you the best of luck. MH > I guess what I want from the group, apart from occasional information, would > be encouragement.....hope....slept almost none, nightmares, fears, shock, [quoted text clipped - 12 lines] > through this it's only for the privilege of getting to the NEXT THING! > LOL....the next horrible thing > You might try this link to a discussion that appears to be related to > your particular diagnosis : > > http://community.breastcancer.org/ubbthreads/showflat.php?Cat=0&Number=488788&an =0&page=0 no, this thread isn't pertinent to my situation at the moment, I know almost nothing about chemo and it wasn't brought up at an appointment; I've been on that board often, and posted, but I can never find my posts later, no matter what search modality I use. I really like that group. > This is only one thread; I'm sure there are others. But the group > seems informative and supportive. > > I know how panicked you must feel, I've been there. We all have. But > the fact is most of us are here years after the fact living normal > lives and dealing effectively with out individual situations. I wasn't doing that BEFORE this diagnosis so I think I'm screwed, LOL! Or maybe this will be the gift that sets me free..... > Wishing you the best of luck. > [quoted text clipped - 24 lines] >> through this it's only for the privilege of getting to the NEXT THING! >> LOL....the next horrible thing >I guess what I want from the group, apart from occasional information, >would be encouragement..... Well, in my experience of being here there's lots of encouragement. Just read any of Ann Thorsen's posts, nobody could be a great encouragement. > hope Oh, we all have hope. I guess those without bc have hope too ... Pumpkin, there IS hope, if you hope for survival that is. > ....slept almost none, nightmares, fears, shock, horror, the > usual.....have been through worse things than this in my life but still > can't imagine ever being "past" this I'm not a counsellor but it occurs to me that if you've been through worse things this can't be the worst. You will get past it, you have no option. Afterwards you might look back and wonder why you were so upset, when you realise how easy it's been - the actual surgery. > ....still not past things that happened years ago Pumpkin, they're in the past, better leave them there and concentrate on this moment. It's all we can be sure of, any of us. Live for today, you can't change the past and can't foretell the future. > ....feel ill equipped....terrified.....trying all manner of things.... You don't need to be equipped, your medical team will be equipped and you're in their expert hands. > feel I cannot do even 1/10 of the things I must do, physically and > psychologically....physically. fighting, always, the worries... Stop fighting, accept that you're going to have healing surgery and you'll be telling us all about it afterwards. > staying busy, doing volunteer work (help someone ELSE, you idiot girl), Oh yes, I've been there. Working with disadvantaged children and not realising that by my neglect MY children were disadvantaged :-) It's good to help others but you must also help yourself. > playing with my son, That's good. That's very good. > because he is oblivious. So is that. > struggling mightily. I counsel others: great coach but lousy player. LOL! Yes, we've probably all been there :-) > I put 1/3 of an Ativan No idea what that is, medications are known by different names, often, in Britain. > under my tongue and even THAT amount made me sick, LOL!!!! warm diluted > milk, lots of journal writing, standing under the stars Oh that's good! >.....and another day has dawned. Mastectomy is 9 days away...I want it to >be an adventure.....a revelation..... So is that. The trouble is, you won't be aware of what's going on. When I had brain surgery I was told what was going to happen but I wanted to watch, they wouldn't allow it, wouldn't even give me a video :-( Not that I had a machine to play a video ... It would have been a Great Adventure. As it was I just had to ask questions, lots of them, and be satisfied with the answers. And be satisfied that it healed me - as your mastectomy will. > but panic sometimes encroaches. and the stupidity is thinking well, even > if I get through this it's only for the privilege of getting to the NEXT > THING! Oh, Pumpkin! Nobody ever added a minute to her life by worrying about what MIGHT happen! I'm sure you know that really, you're not daft! > LOL....the next horrible thing I hate to say it but why not concentrate on the good things you have, your son, your diagnosis - which means that action is to be taken instead of it being neglected. I can't remember if you've said how you were diagnosed. My bc was found as the result of an annual mammogram. That was in April 1998, in May I had surgery - or was it June ... ? Funny, that, I can't remember ... it's been overtaken by other events both good and bad. Most important is that I'm still here after nine years, with no ill effects. Even those like Allan's Deborah, who had a much more serious diagnosis, are still here and enjoying life. The diagnosis has given us something to live for ... Keep talking to us. Others will have very different answers to your worries and I'm not known for diplomacy, it comes with being a Tyke - someone born in Yorkshire. We don't tarradiddle, we say what we think. And we appreciate it when others do - so don't hold back :-) Big, gentle hugs, Mary thanks, Mary.... I realized that my challenge is not cancer but panic/fear (duh)....so....well, yeah, I'm a hot babe and it's weird having body altered, but it's happened before, in more minor ways, and we're all getting older, and change is vibrant and inevitable.....and yes, I've been through worse. I have to "allow for the possibility of a positive outcome." it's what I tell my clients.....the North Wind made the Vikings. >>I guess what I want from the group, apart from occasional information, >>would be encouragement..... [quoted text clipped - 103 lines] > > Mary > thanks, Mary.... > [quoted text clipped - 4 lines] > through worse. I have to "allow for the possibility of a positive > outcome." it's what I tell my clients.....the North Wind made the Vikings. Are you a viking then? Mary >Are you a viking then? >Mary Do we allow "Vikings" to post here? I think she needs to find "alt.support.vikings" for the type of support she is looking for. Then again, I am not sure there "is" a group like that so I vote we let Pumpkin continue to vent here with the rest of us who have her same fears and concerns. Knowing you are not alone with your fears can be a great part of coping, in my opinion. Bea 'NO FORWARDS OR SPAM, PLEASE" >>Are you a viking then? > >Do we allow "Vikings" to post here? I'm alleged to have Viking ancestry, and I've been posting for 18 months. >I think she needs to find "alt.support.vikings" for the type of support >she is looking for. Then again, I am not sure there "is" a group like that >so I vote we let Pumpkin continue to vent here with the rest of us who have >her same fears and concerns. I think of myself as an Amazon, seeing as I only have one breast. Perhaps that would be helpful. >Knowing you are not alone with your fears can be a great part of coping, >in my opinion. I really agree. This group and http://www.breastcancercare.org.uk/content.php have helped me through the worst of times. Breast Cancer Care UK has lots of resources for women in the UK who have breast cancer and apart from obvious differences in health provision, their online information is very good and they have helpful publications, free of charge. They will also provide newly-diagnosed women with telephone partners who can talk to them about their cancer and their own experiences. I found it really helpful when I didn't want to talk to my family about things. Sadly I don't know of a similar resource in the USA, but I'm suure there must be.  SignatureIt's easier to get forgiveness than permission. - Banksy oh, gracious, yes, there are such resources here! I have a 24/7 phone number, and there are dozens and dozens of on-line and phone support and face/face groups! The main one in my city here in the U.S. has a name I find distasteful but... anyway, we Yanks have lots of resources...after all, Susan G. Komen was born/lived here. >>>Are you a viking then? >> [quoted text clipped - 31 lines] > Sadly I don't know of a similar resource in the USA, but I'm suure there > must be. > oh, gracious, yes, there are such resources here! I have a 24/7 phone > number, and there are dozens and dozens of on-line and phone support and [quoted text clipped - 5 lines] > anyway, we Yanks have lots of resources...after all, Susan G. Komen was > born/lived here. Who? Mary > http://www.breastcancercare.org.uk/content.php > [quoted text clipped - 9 lines] > Sadly I don't know of a similar resource in the USA, but I'm suure there > must be. American Cancer Society's Reach to Recovery program, but it's not available in all areas. http://www.cancer.org/docroot/ESN/content/ESN_3_1x_Reach_to_Recovery_5.asp Ann T. Remove 'dontsendspam' from address to reply by email >>>Are you a viking then? >> >>Do we allow "Vikings" to post here? > > I'm alleged to have Viking ancestry, and I've been posting for 18 > months. Well, we all have if we can trace it far enough back. We're such a mixture ... >>Knowing you are not alone with your fears can be a great part of coping, >>in my opinion. [quoted text clipped - 11 lines] > can talk to them about their cancer and their own experiences. I found > it really helpful when I didn't want to talk to my family about things. I didn't know about that, it could be useful when talking to others with problems. I'' have a look, thanks, Mary I said the North Wind made the Vikings; I don't know that I want to be one. I went to Iceland summer before last; seems I don't have a Viking palate. it was a metaphor. I have a million of 'em...platitudes, axioms, and maxims. "we must burn our pain and use it as fuel for our journey." I do know that much of life is auditions...and theatre. AND I tell my clients "Sometimes you have to build your wings on the way down." Hmmm...maybe wings would be better than implants....thank you Bea for accepting my vent. "vent" is in the middle of "adVENTure," after all. > >Are you a viking then? > [quoted text clipped - 11 lines] > > 'NO FORWARDS OR SPAM, PLEASE" >I said the North Wind made the Vikings; I don't know that I want to be one. >I went to Iceland summer before last; seems I don't have a Viking palate. We've been to Iceland twice (as a viking) and apart from the shark we loved ALL the foods. I wish we could get them here, especially skir ... Mary I did eat the skir. >>I said the North Wind made the Vikings; I don't know that I want to be >>one. I went to Iceland summer before last; seems I don't have a Viking [quoted text clipped - 4 lines] > > Mary > >Are you a viking then? > >>Mary > > Do we allow "Vikings" to post here? I'm sometimes a viking :-) no-one's suggested that I shouldn't post here ... > I think she needs to find > "alt.support.vikings" for the type of support she is looking for. Then [quoted text clipped - 3 lines] > Knowing you are not alone with your fears can be a great part of coping, > in my opinion. OIndeed, I was interested from another point of view, not criticising :-) Mary > Bea > > 'NO FORWARDS OR SPAM, PLEASE" > I realized that my challenge is not cancer but panic/fear Bingo. Knowing that, the best way to combat fear is with information. But - it's important to maintain some balance. I've been with this group for almost eight years and they see me go off the deep end once or twice a year. You know what? I'm entitled to do that. It's okay for me to be afraid sometimes. It's okay for me to be overwhelmed occasionally and the people who've interacted with me for the past eight years know that if you let me rant for a little bit I'll be all better. Sometimes it gets to be too much and since the spousal unit is already carrying a full load I choose to throw my little hissy fits here. If I remember correctly the last time I pitched a fit was a few months back when I asked the people in the group to tell me everything was gonna be okay. Well, at the end of this journey it's liable to *not* be okay, as those who have been following Deborah's progress know we're kinda scraping the bottom of the barrel treatmentwise and that after this course of treatment there ain't a whole lot left to try. Yet. ;-) But - this course of treatment might buy her a couple years. Maybe more. Maybe it'll put her in permanent remission but that's not likely. As I said the other day cancer is not a medical emergency and there's still a whole lot of fight left in both of us. When it's time to worry I will, but right now the way I keep from being scared witless all the time is by learning as much about the process as I can - and since Deborah just started her sixth course of chemo on Saturday I've got a fair bit of experience to fall back on. You see, every treatment she's taken has beaten back the disease for awhile. Average time to disease progression for the treatment she just started is 10 months and she's beaten the odds every damn time, so in my mind we've got at least two years, and most likely a lot more than that - and a lot can happen in two years. New treatments are coming out all the time. So for now, we do what's in front of us to do and we don't spend time pondering what might (and most likely will) happen. No sense ruining today by worrying about tomorrow. We work when we have to and rest when we can. When it's time to get busy again we will, but that time isn't now. > I want it to be an adventure.....a revelation.....but panic > sometimes encroaches. and the stupidity is thinking well, even if I get > through this it's only for the privilege of getting to the NEXT THING! I had to grin a little at this ;-) pumpkin, at best it's gonna be a major pain in the a.s. I'm grateful for the insight this disease has brought and for the people that have been placed in my path to help me, but as far as actually being grateful for the disease? Nah. ;-) (I think the technical term for > this nodal outcome in my circumstances is "damn lucky" . . . . <g>). That's exactly what my GP said a few weeks ago after I gave him the fully orchestrated version of my life over the past year, especially the part about discovering the Adrenal Cortical Carcinoma during pre-chemo scans. I prefer "blessed" but will accept his "damn lucky"! ;-) > can't find a reference to this for anything but DCIS....seems that spread to > sentinel is fairly rare with that...but what about with IDC, if it is very > early (nuclear 1/3) and not aggressive (neg for p63)....wood it be more, or > less common for sentinel to be invaded? All I can find are references to > LCIS and DCIS...thanks for any help. Strictly speaking spread to nodes is impossible with DCIS, if a diagnosis of DCIS was made and later found that there is spread to the nodes, then that means the diagnosis was wrong. Of course no diagnosis is 100% accurate, so it happens, but as you say, fairly rarely. Without going and looking up statistics (and I'm not sure where I could find that particular analysis) I'd guess that node invasion would occur in something like 10% of low-grade small tumours. Generally tumour size (rather than grade) is the best indicator of risk of spread. For a starter on risk statistics, have you looked at the Imaginis website? www.imaginis.com Tim Jackson > Strictly speaking spread to nodes is impossible with DCIS, Oops. Looks like he mentioned it in the same thread ;-) |
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