IHC staining
I am brand new to this discussion board, in fact, this is the only discussion board I've ever participated in. When I was first diagnosed with breast cancer I looked around at other sites and got so freaked out I have been afraid to read more. After reading hundreds of your questions and responses I feel safe here and want to thank you for your sensitivity to all who read here and for being so honest about your fears.
I will fill you in on my story:
58 years old
1/09 diagnosed with invasive cancer, .7cm tumor
2/09 right side mastectomy with implant replacement
3/09 started chemo, completed 2 out of 4 AC treatments, to be followed by Taxol...
I had 9 lymph nodes removed for the sentinel node biopsy. The pathology report said there was no cancer in lymph nodes. The pre-surgery plan had been to start on Erimidex if no lymph node involvement. When I met with oncologist 3 weeks after surgery, I got a big surprise. She had ordered further testing of my lymph nodes, specifically immunohistochemical staining (IHC). This test showed some single cells of cancer in one lymph node. My oncologist and surgeon said I needed to do chemo as this test showed that it is likely that the cancer had entered my bloodstream.
Question: Did anyone else have this test with the results triggering chemotherapy?
Thanks,
Janet
Comments
-
Welcome, Janet!
I've been "here" only a week - so, still feel somewhat new, also. My own journey = lumpectomy/chemotherapy/radiation. Completed this "invasive" phase of treatment 5 years ago last month. Joined this wonderfully amazing group to mark that anniversary. Because our circumstances differ, I cannot specifically address the information you're currently seeking. However, if there's anyone here who fits the bill, I'm sure they will eventually step forward & share their experiences.
Just like you did, Janet - I "surfed" many other internet BC-related networking sites before choosing this one. After only a week, I know my choice was perfect. Am so very glad to be here; and, I'm sure you soon will be, too.
Best wishes to you, and with...
Kind regards, Susan0 -
Thanks SusanChristmas Girl said:Welcome, Janet!
I've been "here" only a week - so, still feel somewhat new, also. My own journey = lumpectomy/chemotherapy/radiation. Completed this "invasive" phase of treatment 5 years ago last month. Joined this wonderfully amazing group to mark that anniversary. Because our circumstances differ, I cannot specifically address the information you're currently seeking. However, if there's anyone here who fits the bill, I'm sure they will eventually step forward & share their experiences.
Just like you did, Janet - I "surfed" many other internet BC-related networking sites before choosing this one. After only a week, I know my choice was perfect. Am so very glad to be here; and, I'm sure you soon will be, too.
Best wishes to you, and with...
Kind regards, Susan
Thanks for welcoming to the site. I wanted to tell you that it was your message about recurrance, which you called rambling, that prompted me to sign on. It moved me to tears that you and the others are willing to share your deepest darkest thoughts. The fact that you have made it 5 years with no evidence of disease was especially motivating.
Sincerely, Janet0 -
you are safe here
and i am glad you chose us. You won't regret it. I don't believe there is a more caring and supportive group anywhere. I don't know exactly how they stain the lymph nodes but i do know that they did it and found 6 positive when they did my mastectomy. I didn't know the results of the lymph nodes for about 3 weeks also as we had to wait for the pathology report to come in. The way it was described to me was even a single cell could have got loose even though they took 23 lymph nodes and the 6pos. ones. That single cell could go anywhere and multiply. Hence the chemo/Radiation/yr. of Herceptin infusions (mine was hormone pos.)/5 years of tamoxifen or another inhibiter. All in hopes of no reoccurance. This is just my story and your Dr. can fill in the blanks for you. I wish you all the best.
Jackie0 -
IHC staining
Hi Janet, and welcome!
After reading your post this morning, I called "my" pathologist, whom I have developed a rapport with (I contacted the path lab a few weeks after my biopsy results, to see if I could talk to the pathologist who had examined my samples. He was very nice, said I could come in, he'd show me the slides, explain anything I wanted to know, etc. I spent quite awhile there, and learned a lot.)
So today I called him and asked about the IHC staining. He told me that his lab (at the hospital in Kalispell, MT, where I will have my dbl. mastectomy on 5/6/09)routinely does this staining technique as part of the final pathology report.
When they take the sentinel lymph node biopsies to the lab, at the beginning of the surgery, they freeze the samples and take a look at slides made from these frozen sections to advise the surgeon on how to proceed with regard to lymph node dissection.
Later, when the rest of the breast tissue comes in to be analyzed from the surgery,these same nodes, along with any others that may have been removed, are IHC stained to look for any "occult" or hidden individual cancer cells that may not have been detected through other methods. So basically it's a technique that makes absolutely sure the cancer cells have not "escaped" from the breast tissue and started out into the lymph nodes. If they have, IHC staining finds them, as in your case.
And it seems, from talking to survivors I know and reading posts here, that once they find even a single cancerous cell in the lymph nodes, most oncologists consider chemotherapy to be the next step.
Hope that helps. I appreciated the opportunity to research something that helps me understand more about the whole process of detection and treatment decisions! Thanks.
Gentle hugs,
Debi0 -
Welcome
Welcome Janet,
I too found this site about a week ago. I cannot express how very much it has helped me already. I really haven't talked to anyone throughout my treatment so I just thought that I was insane. My sister went through it 3 years ago so I do ask her some of the things that I think make me crazy and she has confirmed to me that she had some of the same feelings and emotions but when there are so many crazy things I kinda quit asking her for fear that she would think I am nuts as well. So, it is a relief to read what others write and think 'wow, that could be me writing that'. I hope that you will be equally blessed by all of these wonderful women (and men). A very special bunch of people and I thank God for each of you.
My brief story. 11/07 at age 46, Left, multifocal invasive lobular cancer. 4 cm main tumor and several others 0.3-3.5cm. Modified radical mastectomy with tissue expander insertion at the same time. 25 lymph nodes removed 1 positive with a size of 1.2cm. Estrogen/progesterone positive, HER-2-NEU negative. 12/07 Chemo - adriamycin/cytoxin/taxotere - 6 treatments with all 3 drugs at the same time. 6/08 Surgery to swap out tissue expander with saline implant. 25 radiations due to cancer within 1mm of the margin. 7/08 Tamoxifen for 6 months then I needed antidepressants and they interfere with the effects of the tamoxifen so I was switched to Arimidex about a month ago. Right breast lift 2/09. Next step will be a DIEP flap on August 4, 2009.
I did not have this IHC test. I would actually have liked to know what mine would have been. I do not sit and worry that the cancer will come back but I did want to do everything possible to reduce my chances of metastasis. I know they wouldn't have done anything different but I am one that likes to know everything possible so that I can prepare myself. I don't ever want to be blindsided like I was with this diagnosis again! I guess I have lost some innocence now that I have seen my mortality face to face.
Anyway, welcome to the site and I look forward to hearing from/about you in the future.
I'll be praying you through the yucky chemo sessions. (I know that is what got me through it!)
Rita0 -
Wowbfbear said:IHC staining
Hi Janet, and welcome!
After reading your post this morning, I called "my" pathologist, whom I have developed a rapport with (I contacted the path lab a few weeks after my biopsy results, to see if I could talk to the pathologist who had examined my samples. He was very nice, said I could come in, he'd show me the slides, explain anything I wanted to know, etc. I spent quite awhile there, and learned a lot.)
So today I called him and asked about the IHC staining. He told me that his lab (at the hospital in Kalispell, MT, where I will have my dbl. mastectomy on 5/6/09)routinely does this staining technique as part of the final pathology report.
When they take the sentinel lymph node biopsies to the lab, at the beginning of the surgery, they freeze the samples and take a look at slides made from these frozen sections to advise the surgeon on how to proceed with regard to lymph node dissection.
Later, when the rest of the breast tissue comes in to be analyzed from the surgery,these same nodes, along with any others that may have been removed, are IHC stained to look for any "occult" or hidden individual cancer cells that may not have been detected through other methods. So basically it's a technique that makes absolutely sure the cancer cells have not "escaped" from the breast tissue and started out into the lymph nodes. If they have, IHC staining finds them, as in your case.
And it seems, from talking to survivors I know and reading posts here, that once they find even a single cancerous cell in the lymph nodes, most oncologists consider chemotherapy to be the next step.
Hope that helps. I appreciated the opportunity to research something that helps me understand more about the whole process of detection and treatment decisions! Thanks.
Gentle hugs,
Debi
Wow,thanks for making the call and researching IHC for me. I had read some info about it but you made it so much clearer. Janet0 -
Crazyritazimm said:Welcome
Welcome Janet,
I too found this site about a week ago. I cannot express how very much it has helped me already. I really haven't talked to anyone throughout my treatment so I just thought that I was insane. My sister went through it 3 years ago so I do ask her some of the things that I think make me crazy and she has confirmed to me that she had some of the same feelings and emotions but when there are so many crazy things I kinda quit asking her for fear that she would think I am nuts as well. So, it is a relief to read what others write and think 'wow, that could be me writing that'. I hope that you will be equally blessed by all of these wonderful women (and men). A very special bunch of people and I thank God for each of you.
My brief story. 11/07 at age 46, Left, multifocal invasive lobular cancer. 4 cm main tumor and several others 0.3-3.5cm. Modified radical mastectomy with tissue expander insertion at the same time. 25 lymph nodes removed 1 positive with a size of 1.2cm. Estrogen/progesterone positive, HER-2-NEU negative. 12/07 Chemo - adriamycin/cytoxin/taxotere - 6 treatments with all 3 drugs at the same time. 6/08 Surgery to swap out tissue expander with saline implant. 25 radiations due to cancer within 1mm of the margin. 7/08 Tamoxifen for 6 months then I needed antidepressants and they interfere with the effects of the tamoxifen so I was switched to Arimidex about a month ago. Right breast lift 2/09. Next step will be a DIEP flap on August 4, 2009.
I did not have this IHC test. I would actually have liked to know what mine would have been. I do not sit and worry that the cancer will come back but I did want to do everything possible to reduce my chances of metastasis. I know they wouldn't have done anything different but I am one that likes to know everything possible so that I can prepare myself. I don't ever want to be blindsided like I was with this diagnosis again! I guess I have lost some innocence now that I have seen my mortality face to face.
Anyway, welcome to the site and I look forward to hearing from/about you in the future.
I'll be praying you through the yucky chemo sessions. (I know that is what got me through it!)
Rita
It sounds like you had all of the same stuff I will be getting, so the IHC wouldn't have made a difference, like you said. Thanks for letting me know I am not the only one who feels like they are going insane. Every day/hour I think up something new to worry about- my port seems a little swollen, what is that lump in my armpit, why do I have another migraine... My husband, siblings, kids are great listeners but I don't want to burden them with all of my imagined or real problems (although I have been). So it's great to know that my thoughts are normal given the circumstances. I feel like I have fallen into a deep dark tunnel with no end. But here I can read about people who have made it out of the tunnel. I appreciate your support.
Janet0 -
Debibfbear said:IHC staining
Hi Janet, and welcome!
After reading your post this morning, I called "my" pathologist, whom I have developed a rapport with (I contacted the path lab a few weeks after my biopsy results, to see if I could talk to the pathologist who had examined my samples. He was very nice, said I could come in, he'd show me the slides, explain anything I wanted to know, etc. I spent quite awhile there, and learned a lot.)
So today I called him and asked about the IHC staining. He told me that his lab (at the hospital in Kalispell, MT, where I will have my dbl. mastectomy on 5/6/09)routinely does this staining technique as part of the final pathology report.
When they take the sentinel lymph node biopsies to the lab, at the beginning of the surgery, they freeze the samples and take a look at slides made from these frozen sections to advise the surgeon on how to proceed with regard to lymph node dissection.
Later, when the rest of the breast tissue comes in to be analyzed from the surgery,these same nodes, along with any others that may have been removed, are IHC stained to look for any "occult" or hidden individual cancer cells that may not have been detected through other methods. So basically it's a technique that makes absolutely sure the cancer cells have not "escaped" from the breast tissue and started out into the lymph nodes. If they have, IHC staining finds them, as in your case.
And it seems, from talking to survivors I know and reading posts here, that once they find even a single cancerous cell in the lymph nodes, most oncologists consider chemotherapy to be the next step.
Hope that helps. I appreciated the opportunity to research something that helps me understand more about the whole process of detection and treatment decisions! Thanks.
Gentle hugs,
Debi
I don't think anyone can be absolutely sure that one hasn't escaped or why do all the tx, and i do believe my onc. that you can only speculate that some ca particles could have escaped.no one can ever be sure. or there would be a cure. just stating reality not trying to burst your bubble. even chemo, rads etc. cannot give you certainty. I so wish it could but no false hopes here.
jackie0 -
You are very kind, Janet!pajamamama said:Thanks Susan
Thanks for welcoming to the site. I wanted to tell you that it was your message about recurrance, which you called rambling, that prompted me to sign on. It moved me to tears that you and the others are willing to share your deepest darkest thoughts. The fact that you have made it 5 years with no evidence of disease was especially motivating.
Sincerely, Janet
Thanks for your kind words, means an awful lot to me. Being here is like a warm, fuzzy "virtual" group hug - all the time!
Kind regards, Susan
P.S.: This test - the "staining" - was not yet available for me (5+ years ago); so, I know it's fairly new. I first learned of it via a neighbor who was diagnosed a couple of years after me. According to her, there was only one lab in the entire country at that time - in California somewhere, if I remember correctly - that was performing these tests. Her samples were sent there, which is way out-of-state from where we live. Therefore, I'm finding all of these posts - particularly Debi's, our resident "scientific expert"! - to be of particular interest.0 -
Hey, Debi - Unfair Advantage!!!bfbear said:IHC staining
Hi Janet, and welcome!
After reading your post this morning, I called "my" pathologist, whom I have developed a rapport with (I contacted the path lab a few weeks after my biopsy results, to see if I could talk to the pathologist who had examined my samples. He was very nice, said I could come in, he'd show me the slides, explain anything I wanted to know, etc. I spent quite awhile there, and learned a lot.)
So today I called him and asked about the IHC staining. He told me that his lab (at the hospital in Kalispell, MT, where I will have my dbl. mastectomy on 5/6/09)routinely does this staining technique as part of the final pathology report.
When they take the sentinel lymph node biopsies to the lab, at the beginning of the surgery, they freeze the samples and take a look at slides made from these frozen sections to advise the surgeon on how to proceed with regard to lymph node dissection.
Later, when the rest of the breast tissue comes in to be analyzed from the surgery,these same nodes, along with any others that may have been removed, are IHC stained to look for any "occult" or hidden individual cancer cells that may not have been detected through other methods. So basically it's a technique that makes absolutely sure the cancer cells have not "escaped" from the breast tissue and started out into the lymph nodes. If they have, IHC staining finds them, as in your case.
And it seems, from talking to survivors I know and reading posts here, that once they find even a single cancerous cell in the lymph nodes, most oncologists consider chemotherapy to be the next step.
Hope that helps. I appreciated the opportunity to research something that helps me understand more about the whole process of detection and treatment decisions! Thanks.
Gentle hugs,
Debi
Just kidding, dear! Please know that! You can see in my other new post here that I've now dubbed you our "resident scientist" - and, I sincerely mean that as an affectionate compliment. :-) Your knowledge & obvious "inside connections" provide all of us with valuable information. And you have a wonderful knack for putting the scientific mumbo-jumbo into layman's terms, for which we are all grateful, I'm sure.
Now, before I go any further here... I don't mean to side with Jackie in some sort of weird way of "ganging up" on you, but...
There is no such thing - yet - as "absolutely sure" (your words) when it comes to an actual determination of whether or not "rogue" cancer cells have escaped from the tumor before it's been discovered. ALL of our lymph nodes cannot be removed & tested; therefore, like Jackie states, this is exactly why there is not a real & true cure for breast cancer. Even with this most advanced pathology testing method, it's still possible - even if minutely - that one of those damned "rogue" cells may linger in a node NOT removed. Everything about treatment recommendations, every aspect of them, is based on statistics ("odds" for the gamblers out there).
No hard feelings here, OK?
Kind regards, Susan0 -
no false hopesbfbear said:IHC staining
Hi Janet, and welcome!
After reading your post this morning, I called "my" pathologist, whom I have developed a rapport with (I contacted the path lab a few weeks after my biopsy results, to see if I could talk to the pathologist who had examined my samples. He was very nice, said I could come in, he'd show me the slides, explain anything I wanted to know, etc. I spent quite awhile there, and learned a lot.)
So today I called him and asked about the IHC staining. He told me that his lab (at the hospital in Kalispell, MT, where I will have my dbl. mastectomy on 5/6/09)routinely does this staining technique as part of the final pathology report.
When they take the sentinel lymph node biopsies to the lab, at the beginning of the surgery, they freeze the samples and take a look at slides made from these frozen sections to advise the surgeon on how to proceed with regard to lymph node dissection.
Later, when the rest of the breast tissue comes in to be analyzed from the surgery,these same nodes, along with any others that may have been removed, are IHC stained to look for any "occult" or hidden individual cancer cells that may not have been detected through other methods. So basically it's a technique that makes absolutely sure the cancer cells have not "escaped" from the breast tissue and started out into the lymph nodes. If they have, IHC staining finds them, as in your case.
And it seems, from talking to survivors I know and reading posts here, that once they find even a single cancerous cell in the lymph nodes, most oncologists consider chemotherapy to be the next step.
Hope that helps. I appreciated the opportunity to research something that helps me understand more about the whole process of detection and treatment decisions! Thanks.
Gentle hugs,
Debi
Debi,
Don't worry, your message did not give me false hopes. I understood what you meant when you said that the technique "makes absolutely sure" that cancer had not escaped, it's just another way of gaining information. We all know that it is all an odds games we are playing. I appreciated your finding out more for me and I thought your answer was perfect. The comments following yours felt a little brutal- like a slap saying don't get your hopes up that you will live through this. I think I am still too sensitive to take part in any discussion group. I wish you well.
Janet0 -
Oops!!!pajamamama said:no false hopes
Debi,
Don't worry, your message did not give me false hopes. I understood what you meant when you said that the technique "makes absolutely sure" that cancer had not escaped, it's just another way of gaining information. We all know that it is all an odds games we are playing. I appreciated your finding out more for me and I thought your answer was perfect. The comments following yours felt a little brutal- like a slap saying don't get your hopes up that you will live through this. I think I am still too sensitive to take part in any discussion group. I wish you well.
Janet
Hi pajamamama & all others here,
I was wrong to use the phrase, "absolutely sure." I agree that the only "absolute certainty," when it comes to cancer, is that there is NO "absolute certainty!"
I apologize. Mea culpa! But apart from that mistake, you got all the main ideas about what IHC staining actually is. That, ultimately, was the most important part (thanks, christmas girl, for the new title...I am honored).
Thanks to all of you, for pointing out my error. I really do appreciate the feedback, and it will help me pay closer attention to my terminology for future "research projects!!"
I love you all,
Debi0 -
Oh, dear Debi...bfbear said:Oops!!!
Hi pajamamama & all others here,
I was wrong to use the phrase, "absolutely sure." I agree that the only "absolute certainty," when it comes to cancer, is that there is NO "absolute certainty!"
I apologize. Mea culpa! But apart from that mistake, you got all the main ideas about what IHC staining actually is. That, ultimately, was the most important part (thanks, christmas girl, for the new title...I am honored).
Thanks to all of you, for pointing out my error. I really do appreciate the feedback, and it will help me pay closer attention to my terminology for future "research projects!!"
I love you all,
Debi
Good to see you posting, dear! Oh, Debi - you weren't "wrong"... Nor do you need to apologize. You didn't make a "mistake"... Weren't in "error"... You are an absolute WEALTH of pertinent info, with a much appreciated talent for explaining complicated subjects in a way that makes it so easy for the rest of us to understand. And, you always do so with such an upbeat & uplifting manner & tone - also much appreciated. It was certainly NOT my intention to "correct" you. And although I don't like to speak for others, I don't believe it was Jackie's, either. Your excitement about the IHC staining was palpable in your post, which is absolutely understandable. Hey, ANYTHING that provides ANY of us here with more hope IS EXCITING!!! You just got a little, a tiny bit, carried away - that's all! No harm done. OK?
Kind regards, Susan
P.S.: Am so glad you LIKE your "unofficial" title - I truly did mean it as a heartfelt compliment! :-)0 -
Oh Dear!Christmas Girl said:Oh, dear Debi...
Good to see you posting, dear! Oh, Debi - you weren't "wrong"... Nor do you need to apologize. You didn't make a "mistake"... Weren't in "error"... You are an absolute WEALTH of pertinent info, with a much appreciated talent for explaining complicated subjects in a way that makes it so easy for the rest of us to understand. And, you always do so with such an upbeat & uplifting manner & tone - also much appreciated. It was certainly NOT my intention to "correct" you. And although I don't like to speak for others, I don't believe it was Jackie's, either. Your excitement about the IHC staining was palpable in your post, which is absolutely understandable. Hey, ANYTHING that provides ANY of us here with more hope IS EXCITING!!! You just got a little, a tiny bit, carried away - that's all! No harm done. OK?
Kind regards, Susan
P.S.: Am so glad you LIKE your "unofficial" title - I truly did mean it as a heartfelt compliment! :-)
Susan is right. I did not mean to offend or correct you. I apologize if i hurt your feelings. I wish with all my heart that they could be "absolutely sure"!! and now i know you didn't mean it that way. I was just stating what the Dr. told me. Sorry, I am not brutal nor would i like to slap anyone in the face with this. UNLESS it is the beast! that is the only one i want to fight!! I appreciate all your info Debbie, I just didn't want anyone to think that there was a way to tell for "certain" that it hasn't escaped. We all wish this to be and that there would be a cure for ca. I pray for this everyday. And for each and every one of my pink sisters here. I love you all very much. Sorry.
jackie0 -
No worries!!Christmas Girl said:Oh, dear Debi...
Good to see you posting, dear! Oh, Debi - you weren't "wrong"... Nor do you need to apologize. You didn't make a "mistake"... Weren't in "error"... You are an absolute WEALTH of pertinent info, with a much appreciated talent for explaining complicated subjects in a way that makes it so easy for the rest of us to understand. And, you always do so with such an upbeat & uplifting manner & tone - also much appreciated. It was certainly NOT my intention to "correct" you. And although I don't like to speak for others, I don't believe it was Jackie's, either. Your excitement about the IHC staining was palpable in your post, which is absolutely understandable. Hey, ANYTHING that provides ANY of us here with more hope IS EXCITING!!! You just got a little, a tiny bit, carried away - that's all! No harm done. OK?
Kind regards, Susan
P.S.: Am so glad you LIKE your "unofficial" title - I truly did mean it as a heartfelt compliment! :-)
Hey, you survivors!
My feelings were not hurt! I am not thin-skinned, so PLEASE do not waste anymore time worrying about offending me...ever! What I said was heartfelt and true, vis a vis trying to provide information without adding personal enthusiasm that might be misleading. So, I'll try to stay "upbeat and uplifting", like yourself I might add, but when it comes to the informative stuff, as opposed to my story, I'll stick to the facts ma'am, just the facts, LOL.
Love,
Debi, R.S. (resident scientist)0 -
Debi, dear...bfbear said:No worries!!
Hey, you survivors!
My feelings were not hurt! I am not thin-skinned, so PLEASE do not waste anymore time worrying about offending me...ever! What I said was heartfelt and true, vis a vis trying to provide information without adding personal enthusiasm that might be misleading. So, I'll try to stay "upbeat and uplifting", like yourself I might add, but when it comes to the informative stuff, as opposed to my story, I'll stick to the facts ma'am, just the facts, LOL.
Love,
Debi, R.S. (resident scientist)
I'll just echo what Jackie said, just to be clear & to "go on the record"...
Of course, no "slap in the face" - to ANYONE - was intended. Of course not. :-)
Kind regards, Susan0
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