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Micropapillary breast cancer

MargaretAB
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I was recalled after a breast cancer screening where I was not expecting anything unusual. The biopsy diagnosis was solid papillary carcinoma and micropapillary DCIS. I have had three lumpectomies, which all showed a margin of less than 1mm, and a mastectomy and a sentinel node biopsy (all on the same breast). Still waiting for results of the mastectomy & the one lymph node removed. The scans (mammograms & ultrasound done at the initial biopsy) have underestimated the extent of what is there. Micropapillary cancer is very rare. Has anyone else come across this and, if so, what type of scans were given? Also was there another cancer involved (papillary in my case).

I am interested in whether it was only the solid papillary carcinoma that showed up on the initial screening mammogram & the mammograms taken at the recall, or whether they could also see the micropapillary bit (even if they did not know that it was micropapillary at that stage). I would like them to compare these scans to what the end result shows after the mastectomy, but it looks as if they will not be doing that. I am worried that if I have/get micropapillary cancer in the other breast that it will not show up on a mammogram. It looks as if they would not do a mastectomy on the other breast unless they were sure that there was cancer there.

  • Hi MargaretAB,

     

    My name is Keith and I’m one of the Cancer Information Nurse Specialist

    Welcome to the online community we hope you will find the support and information helpful.

    Every situation is different from person to person in how the individual’s body is affected to what mutation or mutations are diagnosed during the initial diagnostic testing, to the histology from tissue being removed during active surgical treatment.

    Clear margins are basically a risk assessment or way of measuring the amount cancerous cells being removed as much as practicably possible. The role of achieving clear margins is by removing health tissue around the affected area to achieving the preferable outcome of no cancerous cells being left after treatment as much as practicably possible.

    Nice guidelines states that for many people a margin of 1mm is likely to be preferable over a more cautious approach with a margin of 2mm.But the greater the margin the better but limits must be set from clinically sound evidence.

    Initial treatment would normally be surgery for localised disease. But in your case a lumpectomy (the least invasive of surgical intervention) did not achieve the desired outcome, hence the move to a more invasive surgery in having a mastectomy. From what you have explained would be the logical next step.  The mastectomy would normally be the next step in achieving the best outcome in this sort of situation, as it appears from your description multiple areas of risks /mutation where present. This approach would normally offer the greatest beneficial outcome.

     However, there is never a 100% guarantee in any treatment in situations like this.  

    Papillary breast cancer can be detected in a lot of cases with routine mammograms without any visible symptoms. Its also not uncommon to find other types of breast cancer alongside papillary. But regardless of the different types once removed no matter what types of cancer are involved, risks should be reduced in many cases.

    Regarding your concerns re the unaffected breast, we would always advise discussing this further with your consultant. Lots of factors (risk versus benefit) are considered when deciding initial treatment to risk reduction strategies to remove the possibility of cancer returning as much as possible. So further surgery without any evidence of disease may not be deemed necessary at this point. Your concerns are understandable but looking at this research may be helpful .

    In a situation its normal to worry. It may also help reduce your concerns in being involved in the planning the best way of reducing risk of recurrence as well as follow up.

    If you’d like further explanation or have any other questions, please feel free to recontact us. By giving us a give us a call or contact us via our web chat platform.

    take care.

    Keith, Cancer Information Nurse Specialist

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

    Ref KM/KE

     

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