The Details

The Diagnosis:

Invasive Ductal Carcinoma with In Situ Component

The tumor is ER (+) PR (+) and Her2 (weak +) (but this could change to negative with confirmatory testing.  

We don't know the actual stage at this point because more advanced imaging needs to be done to determine the exact size of the tumor.  It does not appear at this point to have affected the lymph nodes (this is a good thing).

The invasive portion is Grade 2, the In Situ portion is Grade 1.


So what  does all this mean?  For the non breast cancer survivors (who probably already know what all these acronyms mean even better than I do, I will explain what this means in layman's terms.

Let's start at the top:  "Invasive" means the tumor has invaded breast tissue outside of the mammary duct.  "In Situ" means the tumor is confined within the mammary duct itself.  My understanding of having both terms in my diagnosis is that while my tumor has invaded the surrounding the breast tissue around the duct, there is a high concentration of cells (denser area on the mammogram) that is still contained within the duct.

ER , PR, and Her2 are molecular receptors on the tumor cells themselves.  ER and PR refer to estrogen and progesterone respectively.  This means that estrogen and progesterone can "fuel' the tumor cells - causing them to divide.  Her2 is another receptor.  While Her2 (+) cancers are slightly more aggressive, they can be specifically targeted with drugs designed to attack the cells with this particular receptor (which is only the tumor cells).  This form of therapy is very effective, making the prognosis for tumors of this type very good.  If the tumor is Her2 negative, you can't use the special targeted therapies specific to Her2, but the tumors tend to be less aggressive - another good prognosis.

As I mentioned above, I don't have the "Stage" of tumor because they need to know the size to make this determination.  We know that the tumor is at least 2 cm and could be as large as 6 cm.  The reason for not being able to determine the exact size is that there are areas on the imaging that appear to be calcification and these cover an elongated spider web like area.  While some of these could be cancerous, some may be secondary to the cancer m ay or may not be cancerous so they cannot determine the exact size without more imaging.  I will be having a breast MRI later this month that will hopefully shed more light on the stage of tumor.

The final statement about the "Grade" refers to how advanced the tumor cells are.  Basically how different are they from normal cells.  The grade is assessed on a scale of 1 to 3.  The higher the number, the more advanced the cells are.  So the cells that have already invaded the tissue outside the duct are a little more different than a normal cell, but the cells still in the duct are similar to normal cells.

This is about the extent of what I know about the tumor at this point in time.