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Monday, December 9, 2013
Thank you in advance. I am a 61 year old female originally diagnosed with DCIS almost 2 months ago. Had removal of breast tissue 3 weeks ago and pathology came back indicating breast cancer. The surgeon said `1.5 mm`. I`m assuming he means invasion of 1.5 mm (IDC)- would this be right? I am scheduled for a lymph node biopsy in 1 week and am wondering the likelihood of positive nodes? and of avoiding chemo? I should mention there is a family history of breast Cancer ( 2 younger sisters).
I think you would need to check with your surgeon what was meant by "1.5 mm" and if there was invasive breast cancer. If, in fact, this is a 1.5 mm area of invasion, there is very little chance that any lymph nodes will be positive, but a sentinel lymph node procedure should be done, nonetheless. Questions to ask might be: Is a sentinel lymph node procedure what is planned? Were the margins of excision on the breast tissue removed clear? I do not believe chemotherapy will be recommended for such a small tumor unless lymph node(s) are found to be involved. You may, however, be a candidate for hormonal (pill-form) treatment with tamoxifen or a drug in the class called aromatase inhibitors. You should have radiation after the surgery (with clear margins) has been completed. Your family history will not affect treatment of this cancer, but you and/or your sisters should consider genetic counseling and possible genetic testing for the BRCA-1 or BRCA-2 genes.
Paula Silverman, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University