Deb Crowe Schlosser Beats Cancer

What I know so far. More tests & decisions to come. Stay tuned.

1.  Left breast mass 2:00-3:00, core biopsy; Invasive carcinoma with lobular features. Tubule differentiation = 3, Nuclear pleomorphism=2, Mitotic rate =1, Total Nottingham score grade 2.

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📌 Diagnosis

Invasive carcinoma with lobular features
This refers to invasive lobular carcinoma (ILC) or potentially mixed invasive carcinoma (e.g., lobular and ductal), depending on further classification. It means cancer has spread beyond the lobules into the surrounding breast tissue.

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🧬 Nottingham Grading System

This grading system evaluates three components to assess how aggressive the cancer is:

1. Tubule Formation = 3
   • Score of 3 means few or no tubule formations, suggesting the tumor cells are not forming normal glandular structures.
2. Nuclear Pleomorphism = 2
   • Indicates moderate variation in the size and shape of the tumor cell nuclei.
3. Mitotic Rate = 1
   • Indicates low cell division activity, suggesting a slower-growing tumor.

Total Score = 6 (Grade 2)

• The tumor is classified as Grade 2, meaning it has intermediate differentiation and moderate aggressiveness.

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🩺 Clinical Implications

• Invasive lobular carcinoma often presents more subtly on imaging and can be more diffuse, sometimes making it harder to detect.
• Grade 2 tumors have an intermediate prognosis—not as aggressive as Grade 3, but more so than Grade 1.
• Additional factors such as hormone receptor status (ER/PR), HER2 status, and imaging results will guide treatment, which might include surgery, radiation, hormonal therapy, chemotherapy, or a combination.

• Left axillary lymph node, core biopsy: Positive for metastatic breast carcinoma

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🔍 What This Means Clinically:

• Metastasis to the axillary lymph node is a key factor in staging breast cancer.
• This finding typically upgrades the cancer to at least Stage II or III, depending on tumor size and the number of involved nodes.
• The presence of nodal metastasis suggests the cancer is more advanced and may require more aggressive treatment (such as chemotherapy in addition to surgery and radiation).