Expert: Claes-Gustaf Nordquist, M.D. - 4/5/2011

Question
I have been diagnosed with breast cancer. I have ductal carcinoma NST, Grade 3 (T3 P3 M2).  I had 3 tumours in total.  Lymphovascular invasion = present and prominent.  DCIS = high grade with luminal necrosis.  ER: +  p 3/5     i 2/3      TS= 5             PR:  weakly + p 1/5       i  2/3    TS= 3          HER-2 positive.    Lymph node metastasis 5/7.    Could you please explain this to me in particular T3 P3 M2.

Answer
You have as you know breast cancer with 3 separate tumors if I have understood your message correctly. Your cancer is considered to be of grade 3 which means that it is of high grade. High grade indicates that the cancer is quite malignant with a high risk of spreading. Further investigations show that your cancer is hormone receptor positive for estrogen and also but weakly for progesterone. It is also positive for HER2. Such cancers are called triple positive and are usually more aggressive than other cancers. But they also offer other treatment methods (hormonal due to the positive hormone receptors and with Herceptin together with other chemotherapy due to the positive HER2). T3P3M2 is a staging indication. Staging is a description of tumor behaviour at the time of treatment. T for example stands for tumor(s). We know you have 3. The other letters stands for how it has spread etc. That also indicates what kind of cancer that is at hand and how it has behaved and will behave. We know that it has spread rather extensively to lymph nodes probably in your arm pit on the affected side. That is not a good sign. So like the grade your stage here indicates a rather aggressive cancer. I would suggest mastectomy followed by radiation therapy, hormonal therapy and chemotherapy including Herceptin. Is anything known with regards to if your cancer has spread outside your lymph nodes?



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