Stages of Cancer ... just found out ... what does this really mean?

viking1
viking1 Member Posts: 288
I suddenly feel like I have just been newly diagnosed again.  Since original diagnosis in June I was told I had 'early cancer' - ER neg, PR neg and HER2 pos, grade three.  Had the lumpectomy and all lymph nodes in right arm removed. I was under the misapprehension that I didn't have a stage, just a grade as this was 'early cancer'. They said the success for prevention was 90 plus per cent. Then I got asked by someone what stage I was, so asked chemo onc thinking he would confirm my ideas. He was a registrar and I don't know if everyone does this but googled some stats from my file and said Stage 2. I was in shock. Does this mean things are a lot worse than I thought? I couldn't help crying on the drive home as it felt like I'd just found out things aren't as good as I thought. ☹

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Comments

  • Unicornkisses
    Unicornkisses Member Posts: 402
    There is a graph somewhere on the Internet showing the stages of breast cancer. And a very good section explaining it on the main US website www.breastcancer.org 
    I am early breast cancer stage 2B
    Early breast cancer includes stages 1+2,  I understand, then you go onto locally advanced and then metastatic. 
    So you are still early breast cancer.

    I was multi focal ( many tiny cancer foci in the tissues surrounding the tumours) and multi centric (2 main tumours, 2.2 and 3.2 cm in size and 1 DCIS)
    I also had one sentinel node positive but all 21 other nodes removed were clear.
    This makes me stage 2B

    The grade is just the degree of change in the cells and the rate at which they are growing
    Everyone with breast cancer has a stage, even a stage 0.

    Stage 2 is highly treatable, with very good statistics.
    Knowing your stage hasn't changed anything, just keep going the way you were.






  • Afraser
    Afraser Member Posts: 4,352
    My diagnosis was similar to you, stage 2, but the tumour was larger and required a mastectomy. 17 nodes removed, one positive, chemo and herceptin. I hope my oncologist will sign me off as 5 years no evidence of disease next month. So take heart, the words are not quite what you thought but the prognosis hadn't changed! 
  • KatyJoy
    KatyJoy Member Posts: 181
    I haven’t been told what stage I was, and I don’t think they could ever know. I had core biopsies which showed grade 2 invasive ductal carcinoma, er+ pr+ her2-.  It didn’t show up well on mammogram or ultrasound so I had an MRI which showed the tumour was 9cm, left breast. I was then given chemotherapy before surgery and had my bilateral mastectomy after the chemo. My pathology report after surgery showed the tumour at 2.5cm, but micro metastasis in 2/20 lymph nodes on the left, nothing on the right. Grade was the same. Due to very dense breast tissue I never felt a lump, and it was very difficult to find which is part of the reason I decided to have a double mastectomy. If you are treated with chemo first before surgery, does that mean you will never know the stage? Would my stage be determined by my results pre chemo and surgery, or the post surgery after I received chemo treatment?
  • primek
    primek Member Posts: 5,392
    @KatyJoy Good questions but I have no answers for you. I'd be speaking with your oncologist if you really want to know. 

    I often wanted to know my prognosis or chance of recurrence. I only asked that question much later. I didn't want to have doubts during treatment. The reality is people have grim looking beginnings and never have recurrence, others can have stage 0 cancer and go on to on to have recurrence. The trouble with stats is you don't know on which side your cancer will sit. So I now choose to believe I am 1 of the 90%. 
  • Unicornkisses
    Unicornkisses Member Posts: 402
    KatyJoy, I had a lumpectomy then chemo, then mastectomy.
    There were still foci in the breast tissue after the lumpectomy and pre chemo.
    I asked the Oncologist if the chemo would remove the evidence of cancer or would it just die and we could see the dead cells there?
    He said usually they would see dead cells, and that if there was a lump, chemo would rarely reduce it to nothing, so we would be able to see something.
    In my pathology post chemo and mastectomy, I did still have tiny lumps in the tissue, but the Ki67 had dropped from 17% to 5% -and the pathology report said no evidence of treatment in the lymph nodes that were removed, so they were classed as clear.
    It wasn't enough for anyone to consider a change in stage but was enough to send me for radiation.

    Unless you find evidence of cancer in the lymph nodes, I doubt the stage will change, and though the lump could shrink, the Oncologist and surgeon will also take into consideration pre chemo pathology in deciding a stage.
    As Primek says though, the stage doesn't absolutely determine the outcome, in my case my chance of recurrence is at 21% which means 79% against recurrence.
    I have no idea which side of the graph I sit on so I will believe I am in the 79% that will be fine and go ahead with my life on that premise.

  • viking1
    viking1 Member Posts: 288
    Thank you everyone, you have helped a lot. @primek I think you should go into consulting or at least counselling as you have so much knowledge and experience and a calm and logical way of talking this hysteric off the ledge!
  • primek
    primek Member Posts: 5,392
    Glad you are feeling better today @viking1
  • melclarity
    melclarity Member Posts: 3,502
    Hey @viking1 I can only imagine how you felt to hear this. All diagnosis come with both Stage and Grade even if the Stage is 0. My 1st diagnosis was DCIS in 2011, my recurrence same spot was Stage 2 Grade 3 (he said was aggressive) which left me with no choice of chemo but not radiation as I had that in 2011 whoa! hmmm a year after treatment I had a single mastectomy with immediate diep flap earlier this year. In terms of stats, I don't even look at it after what I went through...because according to the stats I should never of had a recurrence. So now I just look at the treatment, what I have done to help prevent and keep on moving. I have found as long as I do all the things that make me feel good in terms of recovery and prevention, there isn't anything more. I did all the right things and still?? so I believe you're in a good position and you have a really good team and certainly wouldnt be worrying at all. Hugs Melinda xo
  • poodlejules
    poodlejules Member Posts: 393
    Thanks Kath @primek, you made more sense than any doc I've seen !
  • viking1
    viking1 Member Posts: 288
    @melclarity thank you, what you say makes sense. Am still a bit ambivalent about  my 'team' ... just seeing a different person unfamiliar with your file is worrying. The surgery side was better as they had a team meeting on Fridays and discussed all their patients. If the surgeon wasn't avail. someone who knew my case was. The chemo side of things seems to be a bit messy. i think i may need to be a bit more assertive and if need be ask to speak to a Dr if not happy with reg. ?
  • primek
    primek Member Posts: 5,392
    @viking1 Just so you know. A Registrar is a fully qualified Doctor. They are just doing additional mentoring training in the specific field. You will need to ask for the Consultant...ie head honcho Dr.
  • MKitty68
    MKitty68 Member Posts: 261
    edited November 2017
    On this chart - it mentions stages and Categories, not grades... are they the same?
    https://breast-cancer.canceraustralia.gov.au/diagnosis/stages-breast-cancer

    My bc was discovered as i felt something was not right, as well as physical changes to my breast, not routine mammogram. I had 2 x 2.5cm mixed ductal & lobular invasive carcinomas and all 17 nodes were positive. (ER+, PR+, HER2-) When I was first diagnosed, when they did the biopsies, i had 3 spots, 2 of which they tested. 25mm,15mm & 10mm - when they did my mastectomy, they found 2, both of which were 25mm. 
    going on that chart, I am at stage 3C due to the amount of nodes. 

    At my first visit, my surgeon told me that it was not early bc, (it's locally advanced). Overhearing him discussing with the registrar saying it's in line with metastasis' prior to my mastectomy, I believe that they thought it was going to be metastatic. Thankfully it's not. So basically it wasn't as bad as they thought, but worse than i thought. 
  • primek
    primek Member Posts: 5,392
    @MKitty68 Grade is how different the cells look compared to how they should look. Stage is size and nodes etc. 
  • viking1
    viking1 Member Posts: 288
    Ta, I had some idea that they were a bit like clinical psychologists accreditation wise and just had to do some field work before being let lose on the public ☺ But that helps with the lingo ... I might need to see the consultant...if I'm lucky.