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Dr. Love, One more thing. They didn't do pathology on my

Dr. Love,One more thing. They didn't do pathology on my lymph nodes. But do you know if ER+ cancer usually has ER+ nodes?

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Dr. Love, I have suddenly gotten worried that all my

Dr. Love,I have suddenly gotten worried that all my perinodal involvement was cancer stem cells. This is because I know that regular cancer cells don't like to live outside the cancer, but stem cells do.That study said that only 5% of lobular cancers had stem cells. But I know this isn't true. All cancers have stem cells--they just must have gotten slices for testing on the lobular that didn't have stem cells. Which, I guess, is good, because it means the stem cells aren't as prevalent in lobular cancer. BUT, somehow between these lymph nodes I think all the cells are stem cells, because they couldn't survive otherwise. What do you think?The pathologist doesn't test ANY of the nodes or surrounding tissue because they just assume it is the same as the cancer. So no clue there.

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Love ONLY, I just thought of something. The big calculator

For Dr. Love ONLY,I just thought of something. The big calculator things don't have inputs for DTC's, tumor markers, or estrogen positivity. All of which have significance concerning outcomes from breast cancer. So I think that the perinodal soft tissue involvement could still be really bad but not show up there.

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Dr. Love, I am really really upset. According to the

Dr. Love,I am really really upset. According to the University of Michigan website, breast cancer stem cells are resistant to both chemo and radiation.I had EXTENSIVE perinodal involvement with my lymph nodes--which meant there were cancer cells in the tissue between the lymph nodes. Everyone passed it off as no big deal. But now, I think it is significantly bad.I am especially worried that a few stem cells got in there, the doctor missed them in surgery, now they are dormant, and that they will come alive at any time. This is probably why perinodal involvement is so serious.From that last paper we read about stem cells--only 5% of the lobular samples had stem cells. But I would assume that every cancer has them. And since these were just slices, that makes it even easier to miss them. Other kinds of cancer definitely had more, though.Help. I need to feel safe again, and I can't.

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Dr. Love, Is this good for me? "The correlations between CSC

Dr. Love,Is this good for me?"The correlations between CSC markers were stronger in ER- than ER+ disease (Additional file 2). In ER+ disease, ITGA6 was the only marker significantly correlated with all other CSC markers; it was most strongly correlated with ALDH1A3 with a Spearman's rho of 0.16, P < 0.0001. CD44+CD24-/low was significantly correlated with ITGA6 only (Spearman's rho = 0.09, P = 0.0006). ALDH1A1 and ALDH1A3 were only weakly correlated in ER+ disease (Spearman's rho = 0.07, P = 0.0035). By contrast, in ER- disease all CSC markers were significantly positively correlated. The correlations between markers were also generally stronger in ER- cases. ITGA6 and CD44+CD24-/low were the most strongly correlated markers (Spearman's rho = 0.29, P < 0.0001) while the weakest correlations were between ALDH1A1 and CD44+CD24-/low (Spearmans's rho = 0.11, P = 0.0141) and between ALDH1A1 and ITGA6 (Spearmans's rho = 0.11, P = 0.0176)."

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Dr. Love, This article is bad for me, right?

Dr. Love,This article is bad for me, right?http://www.medscape.com/medline/abstract/21680574

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Dr., I noticed on my pathology report that it says extensive

Dr. David,I noticed on my pathology report that it says extensive perinodal involvement with the lymph nodes. I think that is the cancer cells that they told me were in between the nodes.Does this worsen the prognosis? How do they get there? Do they spread faster or farther than just plain lymph nodes?

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Dr. David

Radiation Oncology Attending Director

Post-Doctoral Degree

49,592 satisfied customers
Dr. Love, I've just realized that I misinterpreted that last

Dr. Love,I've just realized that I misinterpreted that last comment you made about the DTC's not causing me to be in the 13%. What I really want to know is that the tendency to shed cells which my tumor obviously has (evidenced by all the DTC's) is not automatically leading to stem cells being shed. And I hope the article indicates that.

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Dr. D. Love

Doctoral Degree

15,308 satisfied customers
Dr., (Please look at table 2 in particular)--everyone in

Dr. David,http://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-13-480(Please look at table 2 in particular)--everyone in this study had DTC's and the results don't look too bad.Here's the thing: I have 2 concerns:1. That because I have DTC's and they obviously shed from the original tumor, stem cells also shed and they are deadly. This table doesn't look "bad" enough for that.2. I have a new concern that my DTC's left the bone marrow and became dormant elsewhere BEFORE I could start the zometa to kill them. There are people who say that DTC's are really putative stem cells--deadly. I guess this article would probably look worse if that were typical, too.The main problem with this is that 88 months was the median--so half the data came from people between 88 and 108 months, and half was below 88 months. We don't really know if the people in the study (or I) could hold the cells dormant for 5, 10, 15 or 20 years. But here's the big question--don't you think there would be enough coming out of dormancy in both cases (1) and (2) that the stats in this study would reflect that?Hoping this study can make my worries go away, but I wanted to put it past you first.

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Dr. David

Radiation Oncology Attending Director

Post-Doctoral Degree

49,592 satisfied customers
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