Cancer Update-Pathology Report Results

Amy's husband Todd here.  It was important to Amy that we get an update posted tonight despite it being so late.

We received a combination of good news and bad news from the doc tonight.  

First the good news.  There was some response to the chemo done prior to surgery.  The major tumor measured only .8 centimeters at the time of surgery which represents shrinkage of roughly 75%.  Doc is not very worried about this tumor at this point. 

Unfortunately, there is also bad news.

First on the bad news front they did find cancer in a lymph node.  They only found cancer in one lymph node, but doc believes there was likely cancer in additional lymph nodes originally that got zapped by chemo.  

Also on the bad news front the margins were all clear, but the deep margin (the one closest to the chest wall) was clear by only .1 centimeter.  As far as they can tell the cancer has not moved into the chest wall, but they did find cancer .1 centimeter from the chest wall.  Because this margin is so small there is concern about microsopic cancer cells moving to the chest wall.

Finally on the bad news front they found a second type of cancer.  The tumor that was originally biopsied was labeled invasive ductal carcinoma.  But the pathology report has now found a second type of cancer called invasive lobular carcinoma.  This cancer did not respond nearly as well to the chemo treatments done prior to surgery.     

What does all of this mean?  It means additional treatment.  

Radiation is a certainty due to the margin issue.  It will be done as a precaution to kill any microscopic remaining cancer cells. 

Radiation will be followed by five years of taking the drug Tamoxifen. Tamoxifen is a hormonal therapy drug which has proven extremely effective in killing estrogen positive lobular cancer.   

The only unknown at this point is whether Amy will need additional chemo treatments.  Doc will be running a test called Oncotype DX test. This test will give a numeric score to the chance of recurrence.  If Amy is at low risk for recurrence then they will forgo additional chemo.  If Amy is at high risk for recurrence then additional chemo will be added to the treatment docket.

Continue to pray for Amy as she settles into the reality that we are in an ongoing fight against this stubborn disease.  It’s been a rough night as we were all hoping for better news.  But we also recognize the news could have been worse.  There is still reason for hope and belief that we can beat this.  It is just going to take longer than we would like. Despite the disappointment and tears tonight she is ready to move forward and fight. 

Thank you all of your prayers and support.