Sunday, November 8, 2009

Surgical Pathology Report

I've posted my other path reports, so I'll post this one too; what the heck. If you are a future employer, and don't hire me because of this, I'm suing you and you are a bad, bad person, and wrong too - because I will live a long time and I'm under my husband's insurance so I won't be costing you any money, and my real name isn't Ann Silberman anyway.

So there.

Okay, it's five pages so I'm not going to type it all. I'll skip the part where they described my poor separated breast, sitting in a metal bowl, nipple looking up at them for the final time, proudly. I felt a little sad thinking about my breast there in that bowl all alone and missing me, but the medical stuff got me so interested I forgot about it quickly.

Besides, it didn't take them long to chop it up. Murderers.

Here is the "Diagnosis" Section on page 4. If you don't like medical terminology - skip this post. It will give me a nice typing workout though. My comments are in bold, although since they are in English, I'm guessing you figured that out.

Invasive Ductal Carcinoma, 3.4 cm, Grade 3 (3+2+3), comprising main tumor at inferior aspect of breast (approximately 6:00), with focal histological changes consistent with prior biopsy. This is larger than they thought - sonograms are not accurate. The arithmetic problem above is how abnormal the cells were. Mine were just about as abnormal as it gets, which means they grow faster.

Multifocal invasive ductal Carcinoma, including two additional separate foci of Grade 3 invasive ductal carcinoma, including 0.2 cm focus at 4:00 biopsy site and including 0.1 cm focus at gritty area of lower inner quadrant between main tumor and 4:00 biopsy site, each associated with intraductal carcinoma. There is more than one invasive tumor. The big one had babies!

No Blood Vessel or lymphatic vessel invasion identified. Yay! It appears to have stayed in the breast. My cancer is a homebody, like me.

Associated intraductal carcinoma, Grade 2-3 solid, comedo carcinoma, and focal cribriform types with extension into lobules, comprising 30% of main tumor. That stuff was tunneling through my breasts like gophers

Separate biopsy site, lower inner quadrent (approximately 4:00, showing grade 2-3 intraductal carcinoma, solid, cribriform, and comodo carcinoma types with extension into lobules, 1.6 cm, and associated biopsy cavity Remember when I said I had cancer soup? These are the ingredients

Second separate biopsy site, showing lobular carcinoma in situ (approximately 3:00), with associated biopsy cavity More ingredients

Additional larger zone of grade 2-3 intraductal carcinoma, 4.5 cm, including solid and comedo carcinoma patterns, grossly indentified as gritty zone in lower inner quadrent connected to main tumor mass Oops, a big chuck of meat in the soup

No invasive carcinoma is noted at soft tissue margins (within 3mm of closet, anterior margin) Excellent, that means no radiation

No intraductal carcinoma indentified at margins, although intraductal carcinoma is noted very close to deep margin (within 0.5 cm, and somewhat close to anterior soft tissue margin (within 1 mm) Oh damn, that probably means radiation

Random section from lower inner quadrent shows 0.4 cm focus of solid grade 2 intraductal carcinoma and 1.3 cm focus of lobular carcinoma in situ. Damn, this cancer sprouted like mushrooms in my breast

Nipple shows atypical ductal hyperplasia of subareolar ducts Bad cells even in the nipple?

Benign overlying skin. All that tanning paid off

Tumor Staging: T2, pNO(-1), MX
Main tumor under 5 cms, no node involvement, can't tell if there is metastatic involvement

That likely means I'm Stage II. I'll probably be alive in five years.

Sorry to those who are disappointed by that. (Not really)



  1. Woo Hoo! Whatever the hell you said! Well, I might not be able to celebrate 25 years with a husband, but with a best friend is even better! Things are looking up now - still got that other stuff to do, but you know it's gonna be okay!

  2. The more details we learn, the better I feel (for you) that you went the mastectomy route, though I can understand that it must have been such a difficult decision. I still say they need to add in the "Ann" factor at the end of their calculations, because I have no doubt you will be here 5 years from now, and probably many more. Hope you are feeling a bit better (physically) today.

  3. My oncologist today said, "It's a good thing you didn't try for lumpectomy because it wouldn't have worked."

    He also said I was "at minimum" stage II. But, they way I read the path report, it's stage II. I'll see what the surgeon says Wednesday. I guess there is confusion whether they include all the tumors in staging or not. Latest research seems to say not, just the largest invasive one.

    I got super lucky! I do feel better, every day I get stronger. As long as I don't lift anything, it's all good. :)

  4. Wow! Yeah, after removing all the lumps you'd be like swiss cheese! I'm so glad you caught this when you did, and you fought for the surgery to be sooner!


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