Surgical Pathology Report

After I left the office of Dr. Carr, I kept thinking back to his comment he made on the phone to the oncologist. He referred to me as a T2. Doesn't that mean stage 2? But he told me I was a stage 1. What's going on? I looked it up, and sure enough, T2 means stage 2. How could this be? What happened to make me go from a stage 1 to a stage 2? I couldn't get ahold of him on Friday, since he was in surgery. I even was at the hospital that day for a bone scan, but wasn't able to leave a message for him. I called my family doctor but she wasn't in either. I asked for someone in the office to call me back, but there was only one doctor and she was swamped. At least I could see the pathology report for myself. 

After driving to Ladysmith in the snow to pick up Norm, we made it back to the doctor's to pick up the report. Here is the diagnostic summary: 

• Ductal adenocarcinoma
• Tumor grade: 3/3 (8/9). 
• A. Tubule formation - 3/3
  
• B. Nuclear grade - 3/3
  
• C. Mitoses score - 2/3. 
  
• Tumor measures 1.8 cm in greatest dimension.
• DCIS associated microcalcifications present. 
• Surgical margins are negative for invasive tumor.
• Two lymph nodes are negative for tumor. 
• pT1, N0, MX

I focus on the last item - this is a rating based on the TNM staging system. The T refers to the tumor stage (1 being less than 2 cm, which I am, at 1.8 cm) N0 means there is no lymph node involvement, and MX means that the presence of distant spread (metastasis) cannot be assessed. I see a stage 1, not stage 2. I will now have to wait until Monday to find out for sure. 

The two main reasons for the recommendation of a mastectomy is the tumor grade (8/9 means a pretty fast growing little devil) and the macrocalcifications.