Expert: Claes-Gustaf Nordquist, M.D. - 1/26/2009

Question
QUESTION: Bird 4 Radiology report: I wrote to you on Jan 16th. I had my core biopsy on Monday. They took 6 samples from 12 o'clock and also 5 from the 8 o'clock as you suggested. I am just waiting for results. My question: Is 11 samples a lot to take or is this standard?

ANSWER: I think they did a lot of tests to be on the safe side! We just have to wait for the results. One lesion may indeed be a cancer, we will see.


---------- FOLLOW-UP ----------

QUESTION: Will the size of the lesion be the factor that determines the stage. It was approximately 1.1 x 1.3 x1.8. Radiologist said this was approximate because they can't see clear margins. How long does it take to get results back.
I appreciate how quickly you respond. I have been on other sites and never get an answer back.

ANSWER: No the size though important in itself is not a factor in staging. That depends on local conditions which I'm not familiar with. But one week to 10 days may probably be a reasonably expected time in such a case.



---------- FOLLOW-UP ----------

QUESTION: I received my biopsy report and as suspected it has been confirmed as invasive ductal carcinmom in both area that they biopsied.modified bloom richardson grade 1/111  score 5/9.
DCIS present focal, Nuclear grade 1/111, architecture solid, LCIA absent.
Invasive tumour necrosis absent. Microcalcification absendt E/r P/R ordered. focally the tumour inflitrates as single cell or files of cells and those areas are negative e-cadherin, suggestive of lobular differentiation. What does all of this mean. I am seeing a surgeon today. I sthere anything specific I shouls ask regarding these results?
Thank you

Answer
All of that are technicalities leading to the conclusion that you have 2 different invasive and maybe lobular cancers rather widely apart in your breast. This complicates matters. Had it been only one lesion a lumpectomy followed by radiation and maybe hormonal treatment (if there are any hormonal receptors present which we do not know yet) probably would have been enough. However with this situation a mastectomy must at least be considered. If done it can probably be done together with breast reconstruction. Also your other breast must be checked carefully in the future. Good luck!