
What Do My Lab Test Reports Indicate?



Not spread too much and Its with Good Prognosis
Detailed Answer:
Brief Ans-Not Spread too Much and Its with Good Prognosis
Its ?Stage II/B with axillary Single Node -Good Prognosis with Surgery
Hi Dear !! Thanks for the query to HCM.
Read and Reviewed your query in context to the health concerns about your wife.
Reviewed your breast USG and Mammography reports.
Reports suggest that the right breast has a ? malignant lesion of 2 cm around and is spread to local Single lymph node.
This suggests good outcome after surgery.
FNAC biopsy in addition would have been more helpful in deciding the prognosis.
As Surgery is planned in few days time, So just don't worry and things would be right post- surgery.So co-operate with your attending Breast Surgeon.
Do Contact for any further query in this regard by a direct question to ME, at following HCM link-
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229
Dear, If you have no further query,Do close this query with your praising /excellent feedback comments to rate this reply, to boost the morale of My visiting patients like You, at HCM Virtual forum.
Keep Me updated soon.
Good Day!!
Wishing Good Healthy Life in time to come!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS


Thanks for your response.
Some more facts, i want to put before further queries. She does not have anyone with breast cancer in her entire family. Her other tests required for surgery have been normal. She is healthy and does not carry any other illness.
In view of above facts, would have two queries below please.
- Doctor has said in 10% cases, breast removal may be required. Since you have seen the report is the breast removal in her case a possibility.
- Will only surgery do or she may have to undergo Chemotherapy and Radiotherapy as well.
Thanks.
You have good chances with Surgery and may not need total removal
Detailed Answer:
Brief Ans-You have good chances with Surgery and may not need total removal
Hi, Dear !! Thanks for your updates and update query.
Read and reviewed your updates and update health concerns.
Dear, there are so many variables upon which these things of future need, really depend.A hypothetical discussion should be curtailed, as it would only add to your needless anxiety.
Still to satisfy you, In My opinion Following are the replies -
Q-1- Doctor has said in 10% cases, breast removal may be required. The breast removal in her case is just a possibility.
Ans-Just neglect the statistical and technical data.
As your wife has no family history of breast cancer, chances of good recovery are high.
Q-2- Will only surgery do or she may have to undergo Chemotherapy and Radiotherapy as well.
Ans- This question has so many technical facets and angles. Radio and chemo or hormonal treatments depend on following factors:-
Histochemistry and histopath reports after surgery, which give a clearer picture of further treatment modalities.
But in view of the USG and mammography reports, Your wife has a good chance with Surgery, as still it is localised spread within a single node. The intra-operative findings may add to more findings to these investigations and could change the line of treatment.
So just don't worry and leave these to God and to your expert Doctors, and co-operate with them.
Keep Me updated for any progress and any further query in this regard.
Do Contact for any further query in this regard by a direct question to ME, at following HCM link-
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229
Dear, If you have no further query, do close this query with your excellent feedback comments to rate this reply, to boost the morale of My visiting patients like You, at HCM Virtual forum.
Keep Me updated soon, if needed.
Good Day!!
Wishing Good Healthy Life for your wife in time to come!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS


As previous email communications exchanged between us are self explanatory. At that point in time, my wife was diagnosed with breast cancer and was to be operated in XXXXXXX by Dr. XXXXXXX Pradhan.
Now she has undergone the said surgery. Post surgery biopsy, which actually contains the conclusion, is attached herewith for your kind reference.
Now would like you to give your specific answers to each of my queries given below.
1. Please see the post surgery biopsy report and give your views. How spread was the cancer? And post surgery where it stands now? Please give extensive answer.
2. Dr. XXXXXXX Pradhan has recommended both Chemotherapy and Radiotherapy. Please see his prescription. Would like to know what kind of chemotherapy, she will be given and the number also?
3. After how many months, she should start tacking Chemotherapy?
4. Would like to know the total cost of chemo-therapies? And in XXXXXXX where (Hospital Name/Dr. Name) should she take the same?
5. I have heard that post chemotherapy, lots of weakness comes and hair also disappears. Would like to know your views please on this?
6. We have only one small daughter. Can she get pregnant post this surgery and chemotherapy?
Thanks & Regards...
Can I get the revert please.
Consider Consulting local Surgeon for further care!!
Detailed Answer:
Hi Dear,Thanks for your query updates after almost 15 days. I really lost the track of your case.
Dear, I Read and reviewed your query which shows your anxiety and eagerness to care your ailing wife.
But too many questions and replies on such a complex subject-would only confuse you to plan further care in your wife's case and hence I will keep it short to the point only.
My Impression-
Though the tumour mass is small the axillary lymph node involvment in your case with Gr III- tumour tissue with conserving Lumpectomy, makes your case to go for Chemo / Radio and Hormonal- after IHC(Immuno-Histo-Chemistry)Report(which awaited still) and is a complex process of planning and execution.
There are many ifs and buts -which need to be decided yet, which your expert doctors attending the case, would take in due course over a time.
Don't get affected by the following answers and leave it to Onco-Chemotherapist and Onco-Radiotherapist in your area/ city for further care.
Replies to your queries in short are as follows-
1. Please see the post surgery biopsy report and give your views. How spread was the cancer? And post surgery where it stands now? Please give extensive answer.
Ans-1-Spread is still local and the tumor excision done by your attending Surgeon seems to be very good.But as the breast conserving surgery is done, the multiple micro-metastasis in local breast tissue by invasion and by transmission along the breast milk ducts, need to be tackled by Chemo/ Radio and Hormonal treatments, which would be decided as per the existing conditions, during the course of the progress of treatment applied, in your case.
2. Dr. XXXXXXX Pradhan has recommended both Chemotherapy and Radiotherapy. Please see his prescription. Would like to know what kind of chemotherapy, she will be given and the number also?
Ans-2-As explained above, the reason for chemo and radiotherapy needs to be understood by you.Due to cosmetic breast conserving surgery, the part of the cancer which remains needs to be treated with Local Radio-therapy to breast and axilla-if need be /and or by Chemotherapy-which takes care of micro-metastasis of the cancer spread via blood and lymph vessels.
The kind of chemo and no of sessions usually take 5-6 mths time once started and drugs would be decided by Onco-Chemotherapist,after due consideration of its merrits.
3. After how many months, she should start tacking Chemotherapy?
Ans-3-Chemo-treatments and radiotherapy would be planned as per the need and convenience of the attending doctor and his assessment of your case and general condition of the patient.
4. Would like to know the total cost of chemo-therapies? And in XXXXXXX where (Hospital Name/Dr. Name) should she take the same?
Ans-4-I would Suggest to Consult Local Surgeon-who would attend to the wound care and would help you in getting further information as asked by you and would be the right person to opine in the matter.
5. I have heard that post chemotherapy, lots of weakness comes and hair also disappears. Would like to know your views please on this?
Ans-5-Dear if general condition and health is kept good by good diet and medicines with the help of your attending doctor, this problem could be curtailed to a great extent and treated as well.So don't worry about it.
6. We have only one small daughter. Can she get pregnant post this surgery and chemotherapy?
Ans-6-I would ask you to consult your obstetric doctor and the attending Radio and Chemo therapist doctors, to discuss this subject in details.
But in general if things go well, you should be able to plan- it after 2-3 yrs only and not before that.But as suggested discuss this issue with your attending chemo and radio therapist doctors, for more details.
Hope with this information, You should get more strength to deal with the planning of further treatment of your wife's case in time to come.
Welcome for any further query in this regard.
Keep Me updated for any progress and any further query in this regard.
Dear, If you are satisfied with this reply and have no further query, do close this query with your excellent feedback comments to rate this reply, to boost the morale of My visiting patients like You, at HCM Virtual forum.
Do Contact for any further query in this regard by a direct question to ME, at following HCM link-
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229
Keep Me updated soon, if needed.
Good Day!!
Wishing Good Healthy Life for your wife in time to come!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS


Thanks for your detailed response. I just want to know that post surgery & Chemotherapy/Radiotherapy, WILL SHE BE COMPLETELY OUT OF DANGER OR NOT. I need your CLEAR independent view here please. Thanks.
And also let me know what is "Infiltrating Duct Carcinoma Grade III".
Is Grade III an advanced stage....Thanks.
Chances of recovery are high in your wife's case!!
Detailed Answer:
Brief Ans-Chances of recovery are high in your wife's case!!
Hi,Dear !!Thanks for the update query.
My Impression-
Dear, the Grade describes the prognostic (Histological/ or microscopic Variable) severity of a cancer in a given case.
Gr-III indicates the change from Normal Cell to Caner Cell- which is almost total change from Normal Cell to Cancer Cell-meaning the behavior of Cancer Cells in your tumor is aggressive and rate of cancer re-production is very fast.
Due to high re-production of Cancer Cells, chances of micro-metastasis-by lymphatic vessels and blood vessels to local and near by areas, are very high. Hence thereby in such cases, chance of Recurrence after Surgical Removal is Very high.
Hence therefore for complete cure in your wife's case, killing of local micro-metastatic Cancer growth-Radiotherapy treatment is planned which is targeted to Cancer areas in breast.
and to-kill distant spread to nearby areas out of the organ and to kill very distant spread from the site of origin of Cancer, Chemotherapy is used.
After physical checkup- the staging (Macro-scopic spread)was decided about your cancer, which was stage-II/b-meaning-Tumor was regionally spread to local lymph nodes-ie -axillary single node in your case. and hence was not of advanced stage. So your worry is wrong,as the tumor of your wife is not of very advanced stage.
On Biopsy(Frozen Section)-histological-microscopic severity-was found to be Gr III in your case-meaning-Cells were totally changed from cells of tissue of organ and Cells reproductivity is at very high rate.
-Also the infiltration rate is very high-meaning thereby, that the fast reproducing cancers cells-invade the margins of the local site of growth of the cancer and cross in to lymph and Blood Vessels, thereby making it more aggressive and of more serious type,as the Chance of Recurrence increases greatly in such cases.
My Comments on Status of Tumor and Prognosis-of recovery-
In brief -though the tumor in your Wife's Case was of very aggressive cell type, the tumor was locally spread out by physical examination and hence chances of recurrence are very less, provided chemo and radiotherapy and if need be hormonal treatment is given in your case.
Comments-In more details-are as follows-
In your case-Cut Margins of the Breast tissue removed are free of Cancer Cells, meaning thereby that the aimed Surgical Excision is totally Successful in your case.
But to Curtail the recurrence from hidden/ unseen micro-metastatic multi-centric growth in that breast, Radiotherapy needs to be planned to kill the locally infiltrating Cancer growth/Cells and Chemotherapy needs to be planned to kill the hidden, distantly spread Cancer Cells/growth- from the micro-spread out of the Cancer growth.
Prognosis in Your Case-
Thus in My opinion, everything available on the Earth being planned in your case, for your wife's cure.Hence chances of her coming out of this Cancer are Very Very High.
Thus though Gr III type tumor in your wife's case-is of highly aggressive type of the Cancer Cells, the cancer in your wife's breast- was removed in totality-as confirmed from Frozen Section -report- of -Cut Margins free of Cancer- with EIC(Extended Intra-ductal Component of Cancer Cell Spread) negative.
This means that the Tumor was excised at the right time and earliest time-one can do, as done in your case, with that available technology available for your type of Cancer breast.
Comments on Stage of Your wife's Breast Cancer-
Thus the Cancer of breast of Your wife- was not at advanced stage,as its only regionally spread to single axillary node.But to take care of the hidden spreadouts to more lymph nodes- more(11 more ) lymph nodes in axilla were removed to remove out the spread out Cancer in toatlity
Besides this still, to take care of Recurrence-of the hidden spread outs in distant and local areas, Radiotherapy and Chemotherapy is being planned in your case.
Hope with this information in the comprehensive discussion above,should give more strength to deal with further treatment of your wife's case in time to come.
Welcome for any further query in this regard.
Keep Me updated for any progress and any further query in this regard.
Dear, I hope that You will be more than satisfied with this reply and have no further query.
So do close this query with your excellent feedback comments to rate this reply, to boost the morale of My visiting Emergency patients like You, at HCM Virtual forum.
Do Contact for any further query in this regard by a direct question to ME, at following HCM link-
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229
Keep Me updated soon, if needed.
Good Day!!
Wishing Good Healthy Life for your wife in time to come!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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