My Dr. Oz Story Continues / Pathology Report

(Note: If this is your first time visiting my page, thank you for your concern and support.  You may want to read the pages to the left first, then read from below.  My latest blog entries will feed to the top automatically.   The most recent blog entries are also listed as links on the bottom left.)

So I sent Dr. Oz an email yesterday telling him the good news about my pathology results.  I also wanted to tell him about my recent learnings: how my surgery was exactly 5 months to the day from his show on medical mistakes and how my good pathology results came back exactly 5 months to the day from my original mammogram.  I think all the dates and numbers have been really fascinating – how I kept looking at the clock at 9:11 before I was diagnosed, how I found out I was pregnant on Friday the 13th, how I started chemo on April Fools Day, etc.  God works in mysterious ways, just like the sign my mom received yesterday when those songs came on the radio (see prior post).  Anyway, Dr. Oz sent me a response last night, said he was proud of me and asked me to be on his new TV show!  Woo hooooo!!  I’m so excited.  I don’t know all the details yet but I’ll keep everyone posted.  I also hope my radiation schedule won’t interfere.  Here’s a link to his new show: www.doctoroz.com

Also, I had my follow up appointment today with Dr. Turk, my oncology surgeon.  I didn’t get the drain out but I won’t go into gory details about that.  He said I’m doing great and mentioned that he was going to present my case at the next CMC oncology convention meeting.  He also said he was so impressed that I had such a good response (near complete) to the chemo because I had “so much” cancer before and now it’s all gone.  He never told me this before – that I had “a lot” of cancer, probably to avoid scaring us too much but today it was ok to hear since we know where we are now.  He mentioned again how there were 9 lymph nodes removed and that the rest were completelty destroyed by the chemo.  I originally had 2 lymph nodes that were biopsied, which we learned had cancer in them.  They didn’t test any others in the beginning but I was 1 lymph node away from being stage III (see info below).  We asked if the other lymph nodes were destroyed because they probably had cancer in them as well.  He said that’s probably what that meant.  Otherwise, all my lymph nodes would have been destroyed but only the ones that contained cancer would be destroyed.  So basically, this means I had more lymph nodes that had cancer in them than we thought – causing my original staging to actually be higher – stage III.  But now, I’m stage I so we’re all good.  🙂  Here are some more informational tid bits about my pathology reports:

Pathology Report Indicator Clinical Stage – determined by what the doctor learns from the physical exam and tests. (the one I got in the beginning from my biopsies) Pathologic Stage – includes the findings of the pathologist after surgery. (the one I just found out about after surgery)
T Category: Tumor Size

Tis: Tis is used only for carcinoma in situ, or non-invasive breast cancer, such as ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS)

T1: The cancer is 2cm in diameter (about ¾ inch) or smaller.

T2: The cancer is more than 2cm but not more than 5cm in diameter.

T3: The cancer is more than 5 cm in diameter.

T4: The cancer is any size and has spread to the chest wall or the skin.

T2 – 3rd best out of 5 options T1 – 2nd best out of 5 opions

(the remaining IDC was only 1/20 inch in diameter)

N Category: Node Involvement

N0 Clinical: The cancer has not spread to lymph nodes, based on clinical exam.

N0 Pathological: The cancer has not spread to lymph nodes, based on examining them under a microscope.

N1 Clinical: The cancer has spread to lymph nodes under the arm on the same side as the breast cancer.  Lymph nodes are not attached to one another or to surrounding tissue.

N1 Pathological: The cancer is found in 1 to 3 lymph nodes under the arm.

N2 Clinical: The cancer has spread to lymph nodes under the arm on the same side of the breast cancer and the lymph nodes are attached to one another or to surrounding tissue.

N2 Pathological: The cancer has spread to 4 to 9 lymph nodes under the arm.

N3 Clinical: The cancer has spread to lymph nodes above or just below the collar bone on the same side as the cancer.

N3 Pathological: The cancer has spread to 10 or more lymph nodes under the arm or also involves lymph nodes in other areas around the breast.

 

N1 Pathological – 3rd best out of 8 N0 Pathological – 1st best out of 8
M Category: Metastasis

M0: No distant cancer spread.

M1: Cancer has spread to distant organs.

M0 – 1st best out of 2 M0 – 1st best out of 2
Tumor grade: How much the tumor looks like normal breast tissue.  The higher the number, the more likely the risk for spread.

1 – Low (best)

2 – Moderate

3 – High (worst)

3 – High Nuclear Grade – Poorly Differentiated (worst) 3 – High Nuclear Grade – Poorly Differentiated (worst)

 

(doesn’t change; based on initial biopsy)

HER2/neu status: About 15-20% of breast cancers have too much of a growth-promoting protein called HER2 and too many copies (more than 2)  of the gene that instructs the cells to produce this protein.  Tumors with increased levels of HER2 are referred to as “HER2-positive”.  HER2-positive breast cancer tumors tend to grow and spread more rapidly than other breast cancers.

 

HER2-positive (bad, except for the fact that Herceptin is so good)

 

This is why I’m taking Herceptin.

HER2-positive (bad, except for the fact that Herceptin is so good)

 

(doesn’t change; based on initial biopsy)

 

This is why I’m taking Herceptin.

Hormone Receptors: Two hormones in women – estrogen and progesterone – stimulate the growth of normal breast cells and play a role in many breast cancers.  Cancer cells respond to these hormones through the estrogen receptors (ER) and progesterone receptors (PR).  ER and PR are each cell’s “welcome mat” for these hormones circulating in the blood.  If a cancer does not have these receptors, it is referred to as hormone receptor-negative.  If the cancer has these receptors, it is referred to as hormone receptor-positive.  ER+

PR-

 

This is why I’ll be taking Tamoxifen.

ER+

PR-

 

(doesn’t change, based on initial biopsy)

 

This is why I’ll be taking Tamoxifen.

Findings “Findings are highly concerning for multifocal invasive ductal carcinoma with involved lymph nodes.  Highly suggestive of malignancy” – Gosh, that brings back scary memories.  Near complete response to chemo. 
Staging: see below Stage IIB: T2, N1, M0 Stage I: T1, N0, M0

 Staging Table:

Overall Stage T Category N Category M Category
Stage 0 Tis N0 M0
Stage I T1 N0 M0
Stage IIA T0

T1

T2

N1

N1

N0

 

M0

M0

M0

Stage IIB T2

T3

N1

N0

M0

M0

Stage IIIA T0

T1

T2

T3

T3

N2

N2

N2

N1

N2

M0

M0

M0

M0

M0

Stage IIIB T4 Any N M0
Stage IIIC Any T N3 M0
Stage IV Any T Any N M1
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3 Responses to “My Dr. Oz Story Continues / Pathology Report”

  1. Shelley Says:

    Go Danielle!!! So happy for you and proud of you!!!

    Shelley

  2. Becky Says:

    Wow, that is amazing. You are a walking miracle! I’m so happy for you! 🙂

  3. lori kragnes Says:

    Hey girlie,
    well, i m sooo happy for you and glad this part is behind you, only good things now are goin to happen, love you and if you need anything, i’m here….p.s. I’m so glad to see an excel spreadsheet, i knew you wouldn’t let me down(lol)


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