Surgical Pathology Results: T1a, N0, Mx, Stage 1a

Earl brought me into Kaiser today for my post-op visit with a physician’s assistant in the surgery department.  The incision sites are healing very well and I might be able to have my JP drain removed by the end of this week.  Just 48 hours after its removal, I would be able to take my first real shower in almost 2 weeks!

The physician’s assistant shared my pathology report with us.  While it could have been better (i.e., if the final diagnosis had been all DCIS), it is much rosier than what I had braced myself for with the multitude of scenarios played out in my head over the past few weeks.  Earl and I are delighted and immensely relieved.

Here are the highlights from the report:

1)   Of the total of 8 (4 more than I knew about!) lymph nodes removed, none showed any signs of cancer.

2)   No angiolymphatic (blood vessel or lymph vessel) invasion.

3)   Invasive Ductal Carcinoma with microscopic focus, grade 3.  Total size of my single invasive tumor was just 0.3cm x 0.2cm, or about half the size of a pea.  Staging is based on the invasive component, not on the DCIS.  And, yes, it’s invasive, but this is a pretty small tumor.

4)   Extensive 5.5cm DCIS (this was as expected, landing right in the middle between the mammogram estimate of 5.0cm and MRI measurement of 6.1cm).  Don’t forget, the DCIS is noninvasive.

5)   All margins clear of invasive and in situ carcinoma.  However, at the skin, there were two areas with very thin DCIS margins measuring 1mm and 2mm.

6)   No carcinoma found in muscle.  There was a 2.0cm clear margin from the lesion to the cut edge of the excised muscle.  Whoohoo!

I think am now diagnosed with Invasive Ductal Carcinoma Stage 1a.  I am still waiting on test results regarding the invasive tumor’s hormone receptor status.

I have a feeling I’m not done yet though.  I will meet with my oncologist on Tuesday next week to discuss the appropriateness of chemotherapy.  Before that meeting, she will be conferring with my radiation oncologist about whether I also need to consider radiation therapy to address the thin margins at the skin if they cannot be resolved with more surgery.

I’ll try to explain in tomorrow’s post a bit more about these results.  For now, I think I’ll just go get a decent night’s rest, satisfied with the fact that we did manage to catch my cancer at a very early stage.  To all you women out there:  please get your mammograms done!

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