Help Understanding Mom’s Biopsy Results

My (27f) mom (57f) recently found out she has breast cancer again. She was first diagnosed in 2014 with invasive ductal carcinoma in her LEFT breast and had a double (partial?) mastectomy where all of her breast tissue was removed and refilled with abdominal fat and she was able to keep the skin and nipples. Recently she went to the doctor, because she had pain in her RIGHT breast. They did a mammogram which came back normal, but they decided to do an ultrasound which showed a mass in her LEFT breast. She then got a biopsy which came back positive for invasive ductal carcinoma. She sent me the pathology report and I’ve been looking online to try to understand it, but I thought I’d ask here. I’m attaching her results. Does this mean the tumor is 12cm? Isn’t that considered very large? Also, why does the M score say 2? She’s also concerned about the pain in her RIGHT breast. She says she can feel a swollen lymph node there, but the mammogram and ultrasound didn’t find anything there. I also want to add that she has Crohn’s disease and is actively being treated for that.

BIOPSY RESULTS

Specimen: 1. Left Breast 10:00 N+ 11cm

FINAL PATHOLOGICAL DIAGNOSIS:

Left breast, 10:00, biopsy: Invasive ductal carcinoma, Grade 2 (T=3, N=2, M=2) The invasive carcinoma is present in multiple cores and measures 12cm in greatest linear dimension within the core biopsy.

Breast Biomarkers: ER: Positive (95%, strong) PR: Positive (12%, moderate) HER2: Negative (score 1) Ki67: 25%

Comment: The patient’s history of left breast cancer status post bilateral mastectomy in 2014 is noted.

I’m feeling a bit helpless and want to be informed so I can help her as best I can. I’d love to hear any advice or words of wisdom on the results or how I can help and support her moving forward. Thanks in advance for any insight.