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About Claes-Gustaf Nordquist, M.D.
Expertise
I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.

Experience
I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.

I also answer questions about Oncology (General Cancer), General History, Military History, Brain Tumors, Colon Cancer

You are here: Experts > Health/Fitness > Women's Health > Breast Cancer > Need to understand Mastectomy and Pathology Report

Breast Cancer - Need to understand Mastectomy and Pathology Report

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

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 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)

I look forward to your response.

Answer
First of all. According to her mammography the tumor in her left breast was 23mmx25mm in size. So probably around 1 inch in all 3 dimensions. That is in my opinion (and obviously also in the opinion of her surgeon) too big for only a lumpectomy (surgical removal of just her tumor) followed by radiation therapy. So instead a mastectomy was done which in my opinion with this tumor size was the correct decision. Already her fine/thin needle aspiration biopsy (FNAC) showed that this was a cancer tumor so that was known before surgery. Also her mammography picture indicated that it was a cancer. The pathology report of her breast confirmed her cancer diagnosis. It also states that 12 regional lymph nodes were removed. As far as I can understand her pathology report no cancer has been found in those lymph nodes. So a preliminary staging of her cancer would probably be a stage 2. But it is a stage 2 with a rather big primary tumor (that is why a mastectomy was done). So I would probably at least consider chemotherapy here too if I was in charge of her treatment. Good luck!

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