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Initially diagnosed June 4, 2009 Invasive Ductal Carcinoma Stage II,Grade II tumor size: 2-3 cm node positive ER/PR postive HER2 Neu - negative Current Diagnosis: Metastatic Invasive Ductal Carcinoma Grade 3 Mets: Scalp/skin, Liver, Spine, Bone ER/PR + HER2/NEU -

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Wednesday, October 23, 2013

Sometimes it's good to be wrong

Ok, I made a call to the American Cancer Society to verify some of the conclusions I had drawn.  Even though I did find some information regarding pan cytokeratin (aka pankeratin) and basal cell subtype, this might not necessarily indicate the subtype on this preliminary report, but rather have been used to confirm the adenocarcinoma.  When you get into this level of pathology the unknowns throw you sometimes.  I definitely am hoping to have drawn the wrong conclusion and will know for sure after talking with the Breast Oncologist at MD Anderson on Monday. 

So at this point, let's just stick to what appears to be the known facts that have been proven via biopsy:

  • Fine Needle Aspiration (FNA) confirmed breast tumor on same breast, opposite side, ductal type carcinoma
  • Fine Needle Aspiration (FNA) confirmed scalp tumor, adenocarcinoma (no confirmation on type)
  • Both biopsies are Grade 3 (agressive) and poorly differentiated

Grey areas:

  • Assuming the unknown adenocarcinoma on the scalp is most likely metastasis from the breast tumor.
  • Assuming this is a recurrence of the original invasive ductal carcinoma I had in 2009.
  • Assuming the ER/PR status is the same on both tumors, but until I see the report, no way to confirm.  Nurse at MD Anderson confirms ER/PR status is positive, but for one or both, she was not sure.
  • Local oncologist says it is a recurrence in the breast with scalp metastasis and possible spine (neck area) and liver metastasis (both unconfirmed by show on films)

Guesses from reading pubmed articles, research studies, and other scholarly resource articles, that may or may not factor into the equation:

  • Basal like cell carcinomas tend to be positive for pan cytokeratin 
  • Basal like cell carincoma subtype may cancel out ER/PR positive benefit
  • Spine and liver metastasis indicate poorer prognosis
There... I like being wrong when it's in my favor!  Still not a great prognosis, but definitely looking better than the one I was suspecting.  I did this more for my benefit than for any other reason.  I needed to sort all this out into neat little groups to get it straight my own head. 

The information contained here gets pretty deep into some of the pathology crap I've taken the time to educate myself on in order to better understand what the information from the tests is telling me. Please don't feel bad if you are lost by the jargon.  When I have the information confirmed I'll post it and explain in regular terms what it means.


  1. I get the having to dig deep into it and find anything and everything you can, and really it's a good thing. It may sometimes lead you into some worry needlessly, but I would rather go into consultations and hearing results already having some idea what the various stuff means, and what the implications are for you, instead of just being at the mercy of what they tell you or don't.

    Not to say that internet research can't lead you down the wrong path sometimes -- it can -- but overall I'd rather be over-informed and let a doctor correct a misunderstanding than under-informed and not the best advocate for myself and my own health as I can be.

    And I feel better when I feel informed, even when the information is worrisome, that seems more palatable than all the unknowns. So I'm certain I'd be doing the same things you are right now.

    In any case, yeah -- I got a little lost in the jargon so I'm merely going to hope it comes out the way you are most hopeful for -- and let you worry about and untangle the alphabet soup a little later when you know more.

    Fingers crossed, prayers still going up, hugs and good thoughts headed your way always.


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