FAQ - Carcinoma, Papillary
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Can anyone please share their experience or advice regarding papillary carcinoma?


My mother, aged 69, had a 2 centimeter invasive papillary carcinoma removed in a lumpectomy recently. Thankfully, there was no evidence of any of the lymph nodes involved.

Of course, we are very concerned, and would like to know what are the experiences of those who have been diagnosed with papillary carcinoma. What treatments did you undergo? For how long? What were the side effects/possible contraindications and outcome of your treatments? How did you choose your oncologist?

Any advice or details you could give us would be sincerely appreciated.
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I don’t know how many responses you are going to get, as papillary carcinoma of the breast is fairly rare and the information you provide is a little vague. Breast cancer treatment depends on the stage of the disease, the grade and if the hormone receptors are negative or positive none of which you mention. From what you stated your mom is a stage I, right at the edge of a stage IIA.

She is very luck that it was caught this early as they grow more rapidly than others and when found the tumors are often larger than your mother’s. The lymph nodes are usually negative, but hopefully a sentinel node biopsy was done to be sure. This type of cancer tends to happen most often in black women. For some reason we do not yet understand cancer in general is more aggressive in black patients, so if your mother is black I would have this treated as aggressively as possible to be on the safe side.

I firmly believe when faced with a significant medical decision you should get at least 2 opinions. If your mom lives in a less populated area she may want to get an opinion from the closest teaching facility as they tend to be involved in the most unusual cases and the cutting edge treatment. It may be too far to travel for treatment, but they can create a treatment plan that can be followed locally. Hope this helps. Best wishes to you both.




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What is the treatment of choice for papillary carcinoma thyroid discovered in a hemi thyroidectomy specimen?


We operated on a patient whose FNAC was a colloid nodule.. She was a case of Solitary Thyroid nodule.. Hemithyroidectomy was the procedure done... The biopsy report came back as PAPILLARY CARCINOMA THYROID without extra thyroid spread.. What is the next step...To perform a completion Thyroidectomy or Radioablation?
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Small thyroid carcinomas (< or = 1.5 cm), including microcarcinomas (< or = 1.0 cm) (n = 39), were found in 53 patients (41%) with a papillary (n = 130) and in 4 cases (4%) with a follicular (n = 110) carcinoma. The tumour was clinically manifested by palpability or by the presence of nodal metastases in 1/3 of patients. Concomitant diagnoses were colloid goitre (n = 24), cellular adenoma (n = 11), Graves' disease (n = 6), and Hashimoto's thyroiditis (n = 4). Nodal involvement, multifocal tumour, and extrathyroidal extent (pT4) were present in 9%, 19%, and 8% of cases respectively. Small follicular carcinomas were minimally invasive in all instances. According to the age-related prognostic TNM-classification, 52 patients (91%) were in the low risk category. 18% of the patients underwent uni- or bilateral partial lobectomy, 35% hemithyroidectomy, and 47% total thyroidectomy, according to the extent and nature of the concomitant benign disease, whereas hemi- or total thyroidectomy was performed in the patients with known cancer. Four of 5 patients with stage pT4 cancer and all patients with nodal involvement underwent total thyroidectomy with radioiodine (n = 8 [14%]). Postoperative morbidity was 0%. During the follow-up period of 1-17 (x = 5.5) years no tumour-related death and no serious recurrence was noted. One node recurrence was removed 1 year following treatment of a stage III pT1aN1b papillary carcinoma; the patient died 4 years later accidentally without residual disease. These results confirm that cases with a potentially favourable course can be defined and treated selectively by less radical measures. Small carcinomas (< or = 1.5 cm) belong to these favourable tumours with a cancer mortality rate of virtually 0%, and the aim of treatment is to prevent curable recurrences: node positivity is an important risk factor, and therefore radioiodine is reserved for carcinomas with nodal involvement and also for the occasional small pT4-tumour.
Materials and Methods :-
Thyroid tumor tissue was obtained at surgery from patients undergoing thyroidectomy (including hemi, subtotal, and total thyroidectomy). A pathologist dissected the tissue, and a small tumor tissue block from the dominant or suspicious nodule was snap-frozen in liquid nitrogen and stored at –80 C. The size and location of tumor samples were recorded in detail. All tumor samples were obtained with permission of and in accordance with the guidelines of our institutional review board, and informed consent was obtained from all patients. Histological classification was confirmed, the diagnosis was obtained from the final pathology report, and this diagnosis was reviewed and confirmed by an endocrine pathologist.

RNA extraction, purification, labeling, and hybridization

The methods described by Barden et al. (20) were employed for RNA extraction, purification, labeling, and hybridization. In brief, frozen tumor tissue was homogenized by sonication in TRIzol reagent (Invitrogen, Carlsbad, CA), and total RNA was prepared according to the manufacturer’s specifications. A total of 42 samples were analyzed by gene chip array (GeneChip Hu95 array, Affymetrix, Inc., Santa Clara, CA). The carcinoma samples included seven PTC and seven FVPTC. The benign samples consisted of 14 FA and seven hyperplastic nodules. An additional seven unknown samples were processed (blinded to preparer). All samples were processed in the same manner following the Affymetrix protocol. cDNA was synthesized from 8 µg sample RNA using T7 (dT)24 primer (GENSET Corp., La Jolla, CA). Second strand cDNA was then produced and purified. Biotin-labeled cRNA was made and used for hybridization to the Affymetrix oligonucleotide arrays. A sample aliquot was first hybridized to an Affymetrix test chip to confirm that the cRNA quality was adequate. All samples were of good quality. After staining with streptavidin-phycoerythrin, the chips were scanned in an HP ChipScanner (Affymetrix, Inc.) to detect hybridization signals.

Data analysis

The data were analyzed using MicroArray Suite version 5.0 (Affymetrix, Inc.). The intensity of each probe set of the array was captured, and the average intensity was calculated. Quantitative expression levels were calculated using intrachip-positive controls. Normalization of data was performed to account for variability in hybridization among duplicate probe sets and other hybridization artifacts. Transcripts were designated reliably detected (present) or not detected (absent) using the above analysis.

Data analysis was performed to identify genes that were differentially expressed between the papillary carcinoma (PTC and FVPTC) and benign groups (FA and hyperplasia). Data from the 21 benign tumors and 14 carcinomas that comprised the training set were used. First, the data were screened to identify signals counted as present by the Affymetrix software. These results were exported to GeneSpring (Silicon Genetics, Redwood City, CA), then analyzed with a parametric t test and multiple testing correction (Benjamini and Hochberg False Discovery Rate, with the P value set at <0.05), producing a gene list of 1149 genes differentially expressed. This list of 1149 differentially expressed genes was then used for unsupervised hierarchical clustering and statistical analysis. Cluster analysis was used to group the tumors based upon their similarities measured across the expression of 1149 genes.

To determine whether FVPTC could be differentiated from benign thyroid nodules, a second analysis, comparing only FVPTC tumors to benign thyroid nodules, was performed to identify genes differentially expressed between these groups. The data were exported to GeneSpring (Silicon Genetics) and using a nonparametric t test with a P value set at less than 0.01, the data were screened to produce a gene list of 843 differentially expressed genes between FVPTC and benign lesions. Finally, a similar analysis was performed to compare PTC to benign lesions. A total of 483 genes were differentially expressed between PTC and benign lesions. As described above, these gene lists were used for unsupervised hierarchical clustering and statistical analysis.

Evaluation of unknown samples

Once the hierarchical cluster analysis was established using gene expression profiles of differentially expressed genes in 35 tumors, the same analysis was performed on seven thyroid tumors (one PTC, four FVPTC, and two hyperplastic nodules) with investigators blinded to the final diagnosis. Gene profiles of the seven unknown tumors were produced using the 1149 differentially expressed genes for comparison. The unknown sample profiles were then added to the original 35 samples to create a combined group of 42 samples, which then underwent an unsupervised hierarchical clustering analysis.

To confirm the validity of the subset analysis of FVPTC vs. benign tumors, the unknown samples’ individual gene profiles were analyzed (excluding the one classical PTC), using the 843 differentially expressed genes produced by the analysis of FVPTC vs. benign tumors. The gene profiles of unknown samples combined with the test set (FVPTC vs. benign) samples underwent an unsupervised hierarchical cluster analysis, producing a dendrogram for the 34 samples. This same technique was repeated to analyze the PTC vs. benign tumor gene list. Unknown samples’ gene expression profiles were analyzed (excluding the four FVPTC) using the gene profile for 438 genes differentially expressed in the PTC vs. benign analysis. Once again the unknown samples were combined with the PTC vs. benign samples, and an unsupervised hierarchical clustering was performed. A dendrogram of the 31 samples (PTC vs. benign plus unknowns) was produced.

Semiquantitative RT-PCR

To verify the results of the Affymetrix gene chip array, a total of five genes were chosen that had expression levels with more than 2-fold difference, were implicated in the molecular pathogenesis of cancer, and had readily available primers or were made from the known mRNA sequences using Primer3 (21). One microgram of sample RNA was reverse transcribed with oligo(dT) primer in a total volume of 50 µl. A 1-µl aliquot of cDNA was used for PCR, and the product was electrophoresed in a 2.0% agarose gel and visualized with ethidium bromide and UV light. The band intensity for each sample was calculated using EagleSight software (version 3.2, Stratagene, La Jolla, CA), and a ratio of the intensity of the gene of interest to that of the housekeeping gene was calculated for each sample. These normalized intensity levels were then analyzed using a t test. The genes and primers are listed in Table 1.  (+ info)

Does anybody here know more about papillary carcinoma?


I had a thyroidectomy a couple of weeks ago & the biopsy showed that it'a a papillary carcinoma.I'm so paranoid.What should i do? Any information regarding this type of cancer will be very much appreciated.
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Hi, I had that too! May '06 was my TT. I have two great sites for you....www.thyca.org is the national thyroid cancer site, and health.groups.yahoo.com/group/thyca is the "chat" room that I belong to where you can ask questions and get info and tons of support.
Always get copies of all your paperwork, including the surgeon's report. Get a good endocronologist. Your goal after RAI (radiation) will be to have a low TSH of .1 or lower...NOT "normal" (that is for people with thyroids, and many doctors do not know that) and if you are having RAI, you should go on the LID (low iodine diet) for two weeks before hand to help make your thyroid cancer cells hungry to eat up the radiation. Cancer is scary- and don't let you have anyone tell you "it's the good kind". it does have a very good long term prognosis....but you must be vigalant about it for the rest of you life. You will love these sites, and I look forward to seeing you in the thyca health group on line. good luck.  (+ info)

What are the treatment outcomes for papillary serous carcinoma endometrial?


Try to give information in lay terms, not for professionals.
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From what I have found. The 5 year survivability rates are 36% for all stages.
What staging means is that as the cancer grows it's cells change. This change can be seen through a microscope and this is where a pathologist gives it a stage. A stage tells you how are along the growth has taken place. It is a poor indicator of severity for treatment of medical condition. A TMN (Tumor, Malignancy, Lymph node) grading scale is better for virtually all kinds of cancer.
The information I have found states that there is a 36% chance you will live for another 5 years despite how far along the cancer cells have matured. This source is not a definitive or recognized medical text and should not be the main source of your information, but it's the best I could find.

A better source talks about adjuvant therapy: "however, a review of the literature indicates that radiotherapy results in a 55% survival rate of only 55%, with follow-up ranging from 3 to 9 months [21-26]." so little more than 1/4 succed.

Your doctor will be the best source of information. If you don’t trust his opinion I suggest finding another equally qualified doctor to get a second opinion. Hope this helps.  (+ info)

Can I get first pregnancy at about 46yo with history of papillary thyroid carcinoma?


I had surgery 7 years ago (2001). My condition is good now, but after 2 yrs of surgery i had to take supplement (thyradin 50/0.05mg) everyday. Now i am going to 44.5yo. I really want to have a baby. What should i do? Do i have chance? Thanks.
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I got pregnant quite easily after thyroid cancer but I was only 28 and 31 at the time. I wouldn't be too worried about the thyroid part. It's your age that's the concern. The risks go up when a woman reaches age 35 and continues to go up thereafter. I know women in their 40's who had babies with no problems but unfortunately, I also know women in their 40's who weren't so lucky.

Talk to your doctor and perhaps a reproductive endocrinologist. Like I said, the thyroid part isn't such a big deal but your age is significant.  (+ info)

Anyone being treated for papillary renal cell carcinoma or renal cell or know someone who has been treated?


I lost my 23 year old daughter, 13 months ago to this disease and there are things people should know about this disease that the doctors do not tell you especially your options. I am doing some research and need to know other peoples ups and downs with this disease.
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First of all, please let me offer my condolences to you on the loss of your daughter. That must have been a difficult ordeal, and you are still grieving her passing. I'm not sure what doctors don't tell patients about renal cell carcinoma, but we try to tell the patient as much as he or she wants to know. The cause of renal cell carcinoma is unknown. The tumors may grow for a long time before they are detected. The usual way one is detected is as a result of blood in the urine on repeated urinalyses. Sometimes there may be tumor cells in the urine. When the cause of blood in the urine is sought, an ultrasound examination or a CT scan usually shows the presence of the tumor. These tumors spread by growing through the capsule of the kidney and invading adjacent tissues and organs, and they tend to grow into the renal vein and up the vena cava toward the heart. I have several patients who have had renal cell carcinoma, and I believe most of them are doing well. One unfortunate patient of mine had a nephrectomy for a renal cell carcinoma, and several years later, developed a second renal cell carcinoma in the opposite kidney. He was treated with a partial nephrectomy on the second side, and has lately been doing well with no evidence of further tumor involvement. So whatever causes a renal cell carcinoma on one side may also affect the other side. Another name for these tumors is hypernephroma. There is extensive information about kidney tumors in medical textbooks. A rare type of renal tumor that affects children is a Wilm's tumor, and these can actually be cured with early detection and proper treatment. Wilm's tumors and renal cell carcinomas are different and should not be confused. I hope I have given you some of the information you need. If you have further questions, you are welcome to contact me.  (+ info)

What is a thyroid cancer or Papillary Carcinoma with microfollicular pattern?


I was diagnose with Papillary Carcinoma, on my smaller nodule and Nodular Hyperplasia, larger nodule what does that mean?
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Hi I am 30 and have had papillary thyroid cancer since 2002. Sounds like you have papillary with follicular variant. There is a free site you can join and ask the members questions about their tests I have a link on the hyperplasia that you might be interested in it is
http://www.uscap.org/newindex.htm?93rd/shorth41-1.htm
and the group I am talking about is listed below in the sources list  (+ info)

What is intraductal papillary carcinoma with oci suspection?


Ask an Expert: Intraductal papillary carcinoma

Q. I have recently been diagnosed with a very rare type of breast cancer called Intraductal Papillary Carcinoma. I am looking for any information you might have on this type of breast cancer and how it is treated.

Answer from the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center: Intraductal papillary carcinomas are indeed rare, accounting for less than 1 percent to 2 percent of breast cancers in women. However, this type of cancer is similar to ductal carcinoma in situ (DCIS) in some important ways. It is a non-invasive cancer that is confined to the ducts in the breast. It rarely spreads to the axillary lymph nodes or elsewhere in the body.

Standard treatment for intraductal papillary carcinoma is the same as treatment for DCIS; namely, either a combination of lumpectomy and radiation or a mastectomy, possibly followed by tamoxifen therapy. Less than 1 percent of patients treated for intraductal papillary carcinoma will have a recurrence.  (+ info)

does anyone know what kind of exposer has been related to papillary carcinoma?


my husband was a commercial painter for many yearss and im curious if this could be related?
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Papillary Cancer? Do you mean Thyroid Caner?

I have Papillary Cancer (thyroid cancer - papillary) and I just had the surgery to remove the entire thyroid. A couple months after that, I had radioiodine treatments.

I was told that the only well know cause of this type of cancer is radiation exposure. This is all I know about this type of cancer. I didn't know anything about this, no symptoms, nothing.

I was asked if I had any exposure to radiation, but I don't know. Did you husband do any painting in a known radioactive dump area? Maybe a super site? You might want to looking into any relationship between his occupation and this type of cancer.

Please feel free to email me if you have any more questions.  (+ info)

how much usually it cost when you undergo papillary carcinoma surgey?


coz i have that. and im aware of the cost so please answer me thanks
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The cost of the surgery will depend on what area of the body you are referring to, what procedure you are referring to, what kind of hospital you are having it done and what part of the country you live in.  (+ info)

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