Expert: Claes-Gustaf Nordquist, M.D. - 4/10/2007

Question
QUESTION: These are the results of my breast ultrasound:
A few nonspecific lymph nodes are noted in the right axilla. The 2.5 cm round mass in the right breast is consistent with carcinoma and is highly suggestive of malignancy. BI-RADS 5 Highly suggestive of malignancy.

My question is: Given this report, what are the chances that this mass is not cancer. I've had the core needle biopsy and am waiting for results.
ANSWER: I'm sorry to have to tell you that with this report those chances are very small, probably less than 10 %. I'm sorry I have nothing better to tell you!


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QUESTION: Thank you for your frank answer. Is there any significance to the nonspecific lymph nodes mentioned?
ANSWER: When you ask a straight question I'm obliged to give a straight answer even if I do not like to do it! Now your new question. Could be but the report can not say, I would suggest that if possible needle biopsies are done on them (not core, instead thin needle biopsies). If not possible there should be a surgical evacuation of them at the time of your breast surgery which unfortunately I regard as probably a necessity. Please do keep me posted!


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QUESTION: I got my pathology results back:
High grade carcinoma with necrosis; compatible with ductal carcinoma; nuclear and histologic grade 3;
Preoperative diagnosis: IDC, medullary carcinoma

How bad is this kind of cancer? How is it treated?

Answer
Well it is not very good. Considering the size of your tumor I would suggest atleast mastectomy and radiation therapy. Perhaps chemo therapy too (depends largely on the condition of your lymph nodes). Maybe anti hormonal therapy too (depends very much on if there are any hormonal receptors in your cancer cells). I'm sorry I can not suggest anything easier but I do not think you can afford that!