my wifes diagnosis?

There were different tumours found.  Multifocal means that several IDC tumors were found,  and the largest was 25mm in size. IDC tumours are ones which have spread beyond the milk ducts and the most usual sort found. They are grade 3, which means that the cells are faster growing. The is also a larger 42mm area of DCIS, which is contained but also grade 3. ER- means that it doesn't respond to oestrogen,  so your wife won't be given medication like Tamoxifen or Letrozole to lower her natural oestrogen when treatment is finished,  but some of the cancer found was HER2+, which is why she'll be given the Herceptin. Some of ther cancer is triple negative,  which is treated (like the HER2+) with chemotherapy. They checked 5 sentinel nodes nearest to the affected areas and they were all clear which is good,  but they did find signs of LVI, which means that it could spread directly through the vascular system (but might not have). MDT means multi disciplinary team (surgeon,  oncologist,  radiologist,  nurse etc.) Who are involved in your wife's care. 

thank you so much londonmumof2,

i can at least make sense of it now.

it doesn't say i know but im sure the surgeon said he removed 5 nodes, would that be right?

does the chemo treat the LVI?

its quite a relief just to read that and at least begin to be able to understand.

thank you,

Yes, it states lymph nodes 0/5, which means 0 lymph nodes were positive. Some hospitals do staging scans when LVI is present and others don't. The chemo is to mop up any tiny deposits of spread, helped by the Herceptin for the HER2 element.

thank you once again londonmumof2  X

Hi. I just wanted to add that you, or your wife, need to ask whether she will  be offered pertuzumab (aka Perjeta) as well as Herceptin. And if not, why not. The best available care is both plus chemo (a taxane in particular). 

Best 

hi Lynn, thank you for your input.

is there a reason they wouldn't want to give it and if i ask and they say no, what could there "why not" answer be.

also what would this be targetting or what benefit will it give us? 

XX

Unfortunately Pertuzumamb is not offered after surgery. It is only given if chemo is before surgery, for the last 4 cycles of chemo. Blasted NICE guidelines again!! There can be a bit of a postcode lottery with it also, with some areas giving it regardless, so it's definitely worth asking about. It targets the HER2 along with Herceptin.

xx

thank you karen x

i will ask about it anyway, from the little I've been reading, it is or can be given to those with a high risk of it returning,

where does that start, you would think if you've had it then your at high risk of it coming back.....that's me thinking again.

my wife is just 50 and we are under norfolk and norwich hospital.

x

My apologies, I didn't realise it wasn't generally given after surgery in the UK (cost-cutting?). It is here in Australia. 

I mentioned it as your wife (with a grade 3 tumour ie aggressive) would seem an ideal candidate.

I can't find too much about it being given post op but I did read, and I can't find where that it CAN be given post op if it's it's aggressive and potentially going to return, which would seem sensible, initially before the full and final diagnosis my wife was to have treatment then mastectomy, Notsure why it changed.