Expert: Claes-Gustaf Nordquist, M.D. - 11/6/2009

Question
QUESTION: I am an electronics engineer; my mother has been treated with mastectomy few days ago

Her Mammography (both breasts) results were:
1)   There is an evidence of ill defined increased opacity with speculated margins measures approx 23*25mm is seen in left inferior quadrant with few small lesion are also noted s/o? Malignant lesion.
2)   There is evidence of well defined increased opacity measures approx 12*14mm seen in right breast at 9’o clock position s/o? Benign lesion.
There is a benign calcification speck right breast.

FNAC – Left breast – Duct carcinoma Cells are seen in hemorrhagic background.

My first question – Do you think she was over treated by Mastectomy (left breast)? This is what I feel. As we were told that only the tumor will be removed and Mastectomy was done without any information and is there any complication with right breast also?

Today I got a Histopathology report which I discussed it with the doctor but got nothing to know about the stage, grade, and lymph node involvement etc of cancer as the doctor didn’t tell anything about it except for one thing that she needs a chemo treatment.

My second question – Please see the Histopathology report mentioned below and tell me what is going on exactly? What type of cancer it is? Is there something very serious and to be worried? Chances of its reoccurrence? And survival rate

Histopathology Report- Multiple sections from the breast show a tumor composed of clear cells arranged in nests.
The tumor has pushing margins with lymphocytic response at the advancing edges. In situ component notes with comedo necrosis and micro calcification.
PAS stain for glycogen is negative.
Histology consistent with clear cell carcinoma-left breast
The nipple, areola and deep resected margins are free of tumor. The adjacent breast shows feature of fibroadenomatoid hyperplasia.
Reactive hyperplasia – Regional lymph nodes (12)

The tumor measures 3*2. 5*2 cms

Report for ER, PGR, HER 2 are awaited.

I look forward to your response.


ANSWER: Thanks for the rest of her report! So my estimate of the size of her tumor was essentially correct. We have to wait for those other test results since they can influence her future treatment. How old is your mother?


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

QUESTION: Thank you for your response.
My MOM is 55 years old.
So if it is a stage 2 cancer, is this something very serious.?
will my MOM be fine after the treatment? what are the chances of reocurence of the cancer and what all precautions can be taken like exercising, managing diet or something to prevent its reoccurence.

Is there anything to be done for the right breast which shows benign lesion.?

Answer
It is too early to evaluate her prognosis. We have to wait for her remaining test results. ALL cancers are serious! I do not think anything needs to be done with her right breast. Except of course regular check ups. We will have to discuss the rest when all results are available.