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Picked up my operative and pathology reports from my surgery today. Can anyone help put in laymans terms?

Posts: 14
Joined: Dec 2010

Well, I dont know if perhaps I should have left this paperwork alone but I really wanted to see if there were things I was not being told. I was told that I had papillary carcinoma and that it had not spread anyhwere. Turns out that I have follicular varient of papillary carcinoma and if I understand what I am reading it had extended through the capsule into the thyroid tissue but not into any lymphnodes. Here is the exact wording:

Focal extension through fibrous capsule is identified. Negative for vascular invasion. Peripheral margins are negative.

Can any one put that in laymans terms for me? I am scheduled to meet with my radiation oncologist on January 5th and I just want to know what I am facing so I know what questions to ask. Thanks!


Posts: 582
Joined: Oct 2010

Hi Cathy,

I am not a doctor as I have said, however I am in the Medical field and have somewhat of an extended medical vocabulary. Don't hold me responsible if I am wrong but I am going to give it my best shot.

The interpreting pathologist (looking at your tumor in the lab) can visually see that fibrous tissue was coming out of the tumor. I.e. The tumor was not encapsulated. It did not invade any blood vessels therefore it probably did not spread to your bloodstream. Peripheral margins; I believe means that there is no evidence of cancer extending past the area that they removed (clear margins). I.e. they got all the cancer without leaving any cancerous edges inside you which could cause recurrence. There doesn't seem to be mention of Lymph node metastasis from what you have said, so I am guessing they didn't remove lymph's because they didn't look suspicious.

I hope this helps.


HeartofSoul's picture
Posts: 730
Joined: Dec 2009

I have question for SunnyAz. I hear surgeons mention they got it all (cancer/tumors) and margins are clear but i personally regard those conclusions with some skepticism. We know that microscopic cancer cells could very well exist outside the area the surgeon operated on and depending on the type of cancer, stage incl 0) and grade, subsequent treatment of radiation or and chemo can be the protocol.

Both my surgeon and my mom's surgeon told us they (Dr.) got it all and margins were clear. At the time of my surgery, both pet and cat were clean and tumor markers normal and same with my mom. Because my mom had triple negative Bresst cancer (stage 0), no hesitation from Dr on starting chemo and rads. I subsequently had 4 rds of chemo (24 treatments) for testicular cancer.

I found getting 2 to 3 opinions from medical oncologists especially for my specific cancer as well as my moms is very valuable.

Posts: 582
Joined: Oct 2010

Hi HeartofSoul!

I think you and I were on chat a few months ago. It's great to see you posting.

Yes, there can be and usually are microscopic cells left after removal of tumors even with clear margins. The goal of cancer is to survive just like any living cell. They will also mutate in order to stay alive in their host. (I hate being a host!) This is why they use Radiation and Chemotherapy (depending on the type of cancer) to kill any existing cells that can't be seen with the naked eye, to help prevent recurrence. If a doctor does not recommend follow up treatment as such, I would get a second, third opinion also.

The mistake made with my Thyroid removal was that my Endo did not recommend RAI, and I had recurrence, metastasis to the Lymph nodes. Had I known about this site and known what I know now, I might have avoided two additional surgeries and a second RAI coming up in February at double the dose of the first. I should have insisted on RAI after my Thyroidectomy.

There is a big myth about RAI. That is that the RAI only goes to the Thyroid tissue. This is a huge lie. Here is a list of the places in the body that will also uptake Iodine: Salivary Glands, Breasts, Lungs, Adrenals, Eyes, Prostate, Gastrointestinal Tract, Kidney, Ovaries, Thymus and Uterus. It's very important that we give our bodies the nutrition it needs after RAI to keep these other body parts healthy. Iodine is still needed after a Thyroidectomy so that other body parts don't suffer. We aren't feeding the cancer when we eat iodine, we are starving the body parts that still need it. Better to avoid sugar, this is what feeds cancer of all types.

Hope you are enjoying a happy and healthy new year.


Posts: 41
Joined: Jan 2010

Be sure to ask what stage your cancer is and what your thyroglobulin levels are. Your endocrinologist should be checking that every visit. You want it to be zero. The website thyca.com was really helpful to understand the staging aspect of my cancer. I think your report sounds good but I have found the more questions you ask the more you will understand what is going on. I wish you well.

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