She’s 7 years out. We keep our fingers crossed every day. It was weird. Her annual mammogram picked it up. No one could feel it or see it with ultrasound, so they did a biopsy. It looked like low grade and stage, well differentiated, so they said lumpectomy and radiation, quick and done. During the surgery, her doc, as a routine practice, would always sample the “sentinel” lymph nodes for that breast. It turned out one of the lymph nodes came back positive with a metastatic tumor as large as the primary which had already eroded through the lymph node. Back in for a second surgery to remove 9 more lymph nodes, then chemotherapy, followed by radiation therapy and she’s still on hormone therapy. She hates it because of weight gain and joint pain and was hoping she could stop after 5 years. At the end of 5 years though, her medical oncologist told her they had recent evidence that further protection could be had by extending the duration to 10 years. I know she wants to stop but I sort of feel like it’s the water that keeps putting out her lit fuse. Ladies, get an annual mammogram. Screw that every 2 years BS.
Oh, so the metastasis was in the lymph nodes; that is still considered "local," and not technically MBC (metastatic breast cancer). Very slight but significant terminology since MBC is stage IV and terminal. (MBC means that cancer has spread outside of "local" to other organs, bones, brain, etc.) My inflammatory diagnosis was triple negative so I got all the bad news. However my labs after surgery were pCR so hopefully I'll be here a while longer. I hope your wife continues to be cancer free!
Well, there’s the doc’s jargon and the scientific definition. Technically, metastasis refers to a secondary tumor, sourced from the original, that occurs anywhere else in the body. It’s a bad sign, anywhere, because it shows that the primary tumor is one that is going to spread. The lymph nodes are just the most likely site to encounter such errant cells because that is one of their main functions, to scoop up scraps in our body. In any case, please do the annual mammograms. They were pushing every two years instead of annually when my wife was diagnosed. If she had delayed another year, the insurance company’s attempts to save some bucks would probably have killed her.
If a doctor's jargon differs from the scientific definition concerning cancer, then time to take that doctor's license. Metastatic breast cancer is also classified as Stage 4 breast cancer and indicates that cancer has spread to other parts of the body and has reached a stage that is fatal. Stage 3 breast cancer is more advanced than stage 2 but is not considered metastatic. With stage 3, cancer has not spread from the breast to organs or other distant sites in the body. Instead, cancer cells are constrained to nearby axillary (underarm) lymph nodes or those beneath your sternum (breastbone) or clavicle (collarbone).
This is a good explanation of staging and grading breast cancer. Metastasis, is any spread of the cancer cells beyond their site of origin. It isn’t necessarily where the cells end up, it is the simple fact that the primary tumor is metastasizing. The grade of my wife’s tumor is what kind of fooled every one. Even her surgeon was surprised. I might not have mentioned it recently so, just for good measure, I HATE cancer. https://pathology.jhu.edu/breast/staging-grade/
You are preaching to the choir; both Faye and I are cancer survivors. If a person claims they have "metastatic breast cancer," the assumption is that they are Stage 4 and terminal. I would never use that term even though I had a local (node) occurrence. (Stage III) And I hope I never have to use it.
You didn’t look at the link, did you? Metastatic does not mean stage 4. It means a secondary tumor, originating from cells of the first, is growing elsewhere, anywhere. There is no need to automatically associate metastasis with a death sentence. Cancer is bad enough.
It is a fallacy that cancer in the lymph nodes attached to an organ with cancer is metastasis of the original cancer, since the nodes are part of the organ (breast) where the cancer originated, the affected nodes are considered part of the original cancer, not a metastasis. Just like if a stage 1 cancer spreads to become a stage 2 or 3, it is not a metastasis just an increase in size. As Beth explained. metastasis is where it spreads to another organ like the brain. It isn't called brain cancer, but breast cancer stage 4, which has metastasized to the brain, an organ that is not part of the breast system.
The lymphatic system is its own organ, separate from all others. It moves lymph and other stuff throughout the body. It would be like saying that blood or blood vessels are part of another organ just because they are intimately associated with other organs. The scientific definition of metastasis is simply the spread of tumor cells from a primary tumor to a different site, doesn’t matter where. The lymphatic system is usually one of the first to be susceptible because of its function. However, a secondary tumor in the lymph node is metastatic. “Lymph node metastasis occurs in "metastatic" lymph nodes, lymph nodes that have been infected by cancer from elsewhere in the body.” https://www.webmd.com/cancer/what-to-know-lymph-nodes
What you are overlooking here is the lymphatic system is what spreads cancer to another organ system. The nodes nearest to the breast are the ones tested for cancer. These nodes are considered part of the breast system. If they show cancer and no other nodes in the lymphatic system show cancer, then they are removed thus possibly stopping the spread of cancer through the lymphatic system to other organs. Chemo is advised in these cases to make sure that if cancer has spread further than biopsy indicates in the lymphatic system, it can be stopped before it affects another organ. If the entire lymphatic system shows cancerous, then chances are another organ is affected already and would indicate perhaps another surgery and harsher chemo or gives the patient the choice to go into a hospice or perhaps choose to exercise their right to die with dignity. I think it is a very important discussion because metastasized breast cancer is stage 4 and indicates another organ has been affected via the lymphatic system and is considered terminal. Also, cancer can originate in the lymphatic system. This is called lymphoma.
Since cancer is almost a sure thing before we reach 100, if something else doesn't kill us sooner, I thought maybe a thread about how the lymphatic system can spread cancer is an important discussion. I found it interesting the complexity of the lymphatic system as it relates to women and why removing lymph nodes during surgery for breast and colon cancer is a very important procedure. Stage I: These breast cancers are still relatively small and either have not spread to the lymph nodes or have only a tiny area of cancer spread in the sentinel lymph node (the first lymph node to which cancer is likely to spread). Stage II: These breast cancers are larger than stage I cancers and/or have spread to a few nearby lymph nodes. Stage III: These tumors are larger or are growing into nearby tissues (the skin over the breast or the muscle underneath), or they have spread to many nearby lymph nodes. Stage IV breast cancer refers to cancer that’s spread beyond the breast tissue and local lymph nodes into other areas of the body. The lymphatic system consists of open-ended vessels, lymph nodes, and organs such as the tonsils, spleen, and thymus. Unlike the blood-vascular system, lymphatic circulation is not a closed loop. It creates a one-directional flow of lymph toward the heart. Lymph reenters the cardiovascular system at subclavian veins situated near the neck. The lymphatic system in the woman's breast is very complex and explains why even at stage 1, how the lymph nodes near the breast can be affected. There are some graphic and explanatory diagrams online but I can't post them here due to copyright.
Sadly, when a cancer patient has surgery to remove the cancer (and/or associated lymph nodes), the patient is often left with a compromised lymph system. This usually causes lymphedema, an uncomfortable swelling in the affected areas.
Even my colon cancer surgery left me with mild lymphedema in the lower abdomen. I am lucky so far to control it with compression garments.
Actually, I did look at the link and not sure what "staging" has to do with common terminology. Here's a link for you, from the same Johns Hopkins website. Please scroll down in the "Glossary of Breast Cancer Terms" to metastatic breast cancer. https://pathology.jhu.edu/breast/glossary I'll just leave this here... Metastatic breast cancer Breast cancer which is spread beyond the breast and is growing in a distant organ such as the bones, liver, lung or brain.