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What Does This Biopsy Report Indicate?

Posted on Mon, 22 Jun 2015

Question: My mother, aged 60 was recently diagnosed with IDC carcinoma (grade 3). She recently underwent mastectomy (left breast) along with the removal of 16 lymph nodes. Her biopsy report suggested the presence of two tumours, less than 2 cm in size and 1 cm apart which upon testing were found to be ER/PR negative and Her2 3+++. None of the lymph nodes were found to be positive for malignancy but the presence of angiolymphatic invasion was cited. The deep margins were found to be free of tumour deposits and were located 1cm away from the second tumour. The areolae, nipples and skin over the breast did not show any evidence either. I would thereby like to request you to please advice me on further treatment and also let me know the stage of her tumour based upon her biopsy findings.

Answered by Dr. Monish De (36 minutes later)

Brief Answer:
Stage 2 breast cancer

Detailed Answer:
Hi

Your mother is suffering from stage 2 breast cancer.

Though the lymph nodes are negative for malignancy as angiolymphatic invasion is present I would advise 6 months of chemotherapy for such cases. Discuss with her treating physician.

Let me know if you need any more information.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Monish De (23 minutes later)

Thank you, Doctor. Which drugs would you recommend? Do you think she would need radiation therapy as well?

Answered by Dr. Monish De (1 hour later)

Brief Answer:
3 cycles of FEC followed by 3 cycles of docetaxel

Detailed Answer:
Hi

I would advise 3 cycles of FEC regimen consisting of drugs flurouracil, epirubicin and cyclophosphamide followed by 3 cycles of docetaxel chemotherapy.

Radiation is not needed at this stage

If you have no more clarifications please rate the answer and close the thread.

Regards

DR DE

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Monish De (29 minutes later)

Her doctor suggested 6 cycles of TCH followed by transtuzumab treatment for a year. When we went for a second opinion the other doctor said that 4 cycles of the same regimen would be enough. What is your opinion regarding this treatment?

Answered by Dr. Monish De (2 hours later)

Brief Answer:
6 cyces of TCH followed by transtuzumab treatment for a year

Detailed Answer:
Hi

I would suggest you take 6 cycles of TCH followed by transtuzumab treatment for a year.

4 cycles are not enough to prevent recurrence

Regards

DR DE

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Above answer was peer-reviewed by : Dr. Vaishalee Punj