Question

PMoore

My mind is full of questions tonight and so I thought I would try here for some answers.  I was diagnosed 10-27 with grade 2 IDC, er/pr+, HER-.  I had a MRI yesterday, should get results Monday.  I am scheduled for a lumpectomy and sentinal biopsy on 11-18.  I was told that I would need radiation treatments and maybe chemo.  They said that the decision about chemo would come later. What decides that exactly?  The day that I had the meeting with the doctor I was kinda numb and didn't really know what to ask.  It was difficult enough to absorb what they were saying, much less ask anything.  I am terrified of what is to come.  I am 44 with 4 kids, the oldest is 20 and the baby is 4.  I just started a new job this year-finally got my teaching degree and I am teaching 5th grade.  I am a mess now adjusting to this, what is really ahead of me?  Any advice would be appreciated!

lexislove

Hi there!

I think what your docs might be waiting for is news if you had positive lymph nodes or not AND the Her2 gene. When they remove the tumor they will check the lymph nodes under the arm pit to see if the cancer had spread there.  If yes? Chemo.

the Her2 gene is an overexpression of the gene on tumor cells making them act wild and aggressive. there is Herceptin given for this but the Herceptin is used together with chemo.

Sorry you had to come here...but the woman are fabulous!

CoolBreeze

If you don't have any cancer cells in your sentinal nodes, than you probably won't need chemo.  If they find cancer cells in your nodes, than it has moved beyond the breast and they will want to systemically treat any cells that have escaped.

Everybody who has lumpectomy gets radiation.  Did they mention hormonal treatment to you?

I work in a school too, and have a 12 year old. and a 23 year old.   I will need chemo as I'm HER2+ with multi-focal IDC, also DCIS with lobular invasion - all Grade 3 - but I had no lymph involvement.   Hopefully, you won't either!  Good luck to you!

hollyann

Hi PMoore...So sorry you had to join this club......I would think they will decide chemo later after an Oncotype DX test is done if you are node negative.....This test will show if you will benefit from chemo or not.....My score was 11 so no chemo for me.....I had DCIS grade 2 AND IDC grade 1.....It also depends on the STAGE you are in......The more advanced the stage the more likely you will have chemo....Also if you are HER2 Positive you will proba by do chemo also plus Herceptin..There are numerous variables when deciding chemo or not as you can see...I wish you well and much luck on your surgery and pathology......I wish you low stage and no node involvement........I was 43 when I was diagnosed and am now almost 46...It has been a long road for me but it was doable....I also had a bilat mast with immediate TRAM recons........Good luck..........

CoolBreeze

I think in her original post she said HER-?  So, it will likely depend on lymph status for her.  I forgot about the oncotype test  - they didn't bother with me since I wasn't getting out of chemo anyway.

PMoore

Thank you so much for the information.  I guess the hardest part is all the unknown.  The surgery doesn't scare me really, I survived 3 c sections, so I figure I can survive this.  It is everything that will come after that terrifies me.  Will I have to have chemo, will it make me sick, will the radiation be horrible, will I be able to work, will I be able to continue to do everything that my kids need-especially the 4 year old?  My mind is consumed by all of these fears.

CoolBreeze

The time between diagnosis and treatment is the worst!  But, you'll get through it.  Read around - we are all in the process of doing just that!  It's not easy but it's not as hard as you imagine either.  You'll be fine. 

Gillkath

Hi there,

My own tumor was 1.7 cm, with no lymph node involvement, and I did chemo.  For some reason, my doctor never suggested that I have the oncotype DX test, which I first read about here on these boards.  I was 46 at diagnosis and pre-menopausal.  I wish that my doctor had offered me the Oncotype test.  My onc told me that any tumor over 1 cm requires chemo. 

I was diagnosed in June and had my mastectomy in August, and I have to say that the worst part was the "waiting." 

Good luck to you.

jacee

It is very overwhelming and you get so much info at once, when you are really not in a position to make decisions. I was already scheduled for a total hyst & oopherectomy when I got my bc diagnosis. Then, having to decide on lump or mast, recon or wait., what is chemo going to do, rads, work, sick time, money, hair, wig, bras...AAAAAGGGHHH! What I did was alot of reading on this board, but I finally had to just study each topic as I was faced with it. Then, when that was over, I'd deal with the next thing. And I had to admit that there was just no way I could know EVERYTHING. I HAD to trust those who God had placed in my path to care for me. That wasn't easy for me, as I like to be all knowing and don't easily trust the medical professionals. But there was much relief when I admitted my dependence on others, yet still researched all I could. My faith carried me during those early days and continues as I am now in chemo, and facing rads and reconstruction in the future. Best wishes as you begin this journey. You will be amazed at your strength and you WILL make it through these days.

one-L

PMoore, you are getting some great information here.  Right now there are so many variables regarding bc and we are all  so different.  Take one day at a time, don't try to get too far ahead of the game. 

Best of luck to you on your journey and my thoughts are with you.

Juannelle

bluedasher

Another thing that won't be known for sure until after the lumpectomy is the tumors size. They have an estimate now from the mammogram and MRI, but until the pathologist examines it they don't know the size for sure. For example, we knew that my lump was about 3 cm long from the mammogram and ultrasound, but it turned out that part of it was a non-cancerous cyst, part was DCIS (non-invasive cancer because it was still in the duct where it started) and the part that was IDC (invasive cancer) was less than 1 cm. Sometimes it goes the other way with some of the tumor not showing up on the scans.

The size of your tumor, lymph node status and, if you are lymph node negative, Oncotype all go into the decision on whether to do chemo or not.

gfbaker

Hi PMoore,

 When I was diagnosed back in 2008, I had a 10 month old and a 2 1/2 year old. I was terrified that I would not be able to take care of them, but with help I did, and I am sure that you will be able to also. I think the trickiest part is going to be explaining what is happening to your youngest. You can PM me if you want to talk about how I handled some different things during treatment.

Good luck and please let us know how your surgery goes.

Gayle

Regawhatever

You've gotten a lot of good info here already. They'll probably run your tumor through the oncotype test if your nodes are clear. For some of us, hormonals are our big guns, not chemo.

I just wanted to throw in my two cents about working (specifically teaching) through all this. I'm a teacher and they scheduled my radiation treatments around the school day. You can almost certainly work through that, I would think, unless there's something unusual about your circumstances. As for working after a lumpectomy/SNB, it only took me (other people are, of course, different) a few days to feel remarkably better. It's still (6 months out) very tender, but I had my surgery Friday at 6 p.m. and I was hosting my daughter's birthday party Saturday at noon. Not the ideal recovery and certainly not recommended, but physically possible.

Hope that helps. Post often and ask lots of questions. You're in the worst part now. It does get better and easier, but the only way around it is through. Hang in there. 

-Tricia