Lumpectomy Lounge....let's talk!

ORknitter

mapagail, My incision took forever to completely close, then got infected. They only postponed radiation because of the infection, not because the incision was still open. You may be able to see your son, talk to the RO and see what they can schedule.

mapagail

MJS1266, what a cute doggie. My Prissy, a Shitz, has been by my side and has given me so much comfort!

Thanks, ORknitter, I will talk to my RO!

I hope everyone had an awesome Christmas. Prayers for health and strength for 2016!

leger

Hi lumpectomy ladies,

I thought I might chime in here. I am16 months post lumpectomy with sentinel node biopsy. I had accelerated radiation (savi) and I took tamoxifen for about 10 months (the side affects were just not worth it, hope it was the right decision).

I developed a seroma in the breast where the radiation catheter was placed (I still have a hard lump there) and I have numbness under my arm where the lymph nodes were taken out. My BS says that this is probably permanent. I will say that I am now use to the sensation. I have also had to have a biopsy since surgery (turned out to be fibrosis and scar tissue).

The lumpectomy breast is about 1/3 the size of the healthy breast but I'm ok with it. (I'm pretty small to begin with).

The other issue I had was a small area where the sentinel lymph nodes were removed took several months to heal and drained everyday. I also still hate wearing a bra. I am a nurse and wear scrubs to work so I frequently just undo my bra for a couple hours each day, lol. No one can tell.

May you all have a blessed and healthy New Year.

Hugs

PontiacPeggy

Leger, you had your lx a week after I did. I finally got most of my feeling back under my arm in August or September. I was quite surprised. And, of course, you do get used to it. Like you, I'm small. My bad girl looks about the same as the good one. I find I don't wear bras much anymore. I wear padded camis from Walmart at $6 each. They run small so if you're a medium you might want a large or even XL. But they are comfy and don't bother a thing. Come in pretty colors too. Are you taking no hormonals now? Are you post-menopausal (though it seems as if you aren't). It's so hard to decide what to do when you have SEs that are not tolerable. Don't second guess yourself. You've made the best decision for YOU and that's all anyone can do.

HUGS!

Brightsocks

I will be having my lumpectomy Jan 5th. I am not even sure what to ask for I am still learning all the different terms and acronyms. I don't have all of my results in that most people seem to have when they post. All I know at this point is the my tumour is .8cm, Grade 1, well differentiated, invasive ductal carcinoma and tubular carcinoma, ER + and PR + no lymph vascular carcinoma. I won't have any answer for two weeks after the lumpectomy. I would like to know if I will have chemo but that will come with the results? I am also doing Vitamin C iv to see if that will help in the healing process. How do you feel after the lumpectomy the next day?

PontiacPeggy

Brightsocks, Welcome! You've found the most warm, caring and supportive place to be. We'll be glad to answer your questions.

First, you DO know quite a bit and you can put it in your profile AND make it public - that helps us answer your questions, so please do that. There is so much to learn in a seemingly short period of time. It is hard. (You might also put your location in your profile, there may be BCO gals near you).

Most of us find out if we need chemo through an Oncotype Test (Oncotype link ). You can ask your breast surgeon (BS) if one is being done. I had my pathology report two days after surgery, others find it has taken longer. And yes, it is possible you will find out if you need chemo at that time.

I'm not familiar with receiving Vitamin C via IV for healing so cannot comment on it. You may feel good the day after your lumpectomy or not. It varies widely. However, you should plan on taking two weeks off work if at all possible. This is major surgery and your body will be very stressed and working hard to heal. I felt good almost immediately but needed to rest a lot. Some women who go back to work after a week wish they had stayed home longer.

Keep asking questions! We'll answer.

HUGS!

Peachy2

Hi Brightsocks! Everyone's surgery experience is a bit different. Mine was that I was sore in the surgery area and tired, though as I replied to someone who sent me an encouraging text the next day I felt not much worse than the day after a really hard workout at the gym. I was back at work in a week with a slight soreness and not working late, but also not very impaired. The medical oncologist will advise you of your options and whether or not chemo should be part of your treatment plan, based on the pathology report.

PontiacPeggy

BrightSocks, BTW, feeling good does not mean no discomfort. I found the SLNB site (sentinel lymph node biopsy) most annoying. Everything rubbed it. And it annoyed me for quite sometime. You may want to purchase front closure bras with no underwires (perhaps Genie bras) to wear for a couple of weeks post-surgery. You will also want to take whatever drugs are offered the day of surgery (I was given a Valium and a Dramamine [for anesthesia nausea]). Fill the prescription for pain pills and take them! Don't let pain get the upper hand. Perhaps you'll only need Tylenol for the discomfort but be prepared. And yes, ice is definitely your friend. I was told to not lift anything heavier than a gallon of milk with my surgery arm for 3 weeks. Most of all, do exactly as your BS recommends.

HUGS!

hatgal

I just had surgery for two lumpectomy's and a few lymph nodes on one side. The surgery was 3 and a half weeks ago and I am still in pain and can't do much. Is that normal? One lymph node had cancer and I am supposed to have radiation in three weeks. How can I get my arm pit to heal and stop hurting?

Brightsocks

Is it common for the pathology report from the lumpectomy to be different from the core biopsy results?

Peachy2

Brightsocks, others have noted that there is a larger sample to test with lumpectomy, so pathology results may be slightly different. My experience was that both surgeons with whom I consulted prior estimated 10-15% chance of lymph node involvement. As it turned out, there was cancer in the sentinel node that was tested. (I should play the lottery more often!) The medical oncologist recommended chemo, due to lymph node involvement and other factors specific to the pathology of my tumor. It was not required. Because of the reduction in rate of recurrence and other factors, I opted for chemo.

Moderators

hatgal, Take a look at this article, in case it is what is going on: Axillary Web Syndrome (Cording)

Bright socks, yes, exactly what Peachy2 said. You are given the pathology report after a biopsy AND either a lumpectomy or mastectomy. Did they check the lymph nodes as well?

PontiacPeggy

HatGal, from my own experience, the armpit seems to take longer to stop hurting. Make sure nothing is irritating it - even tight armholes in your blouses can do it. Make sure you are gently stretching that area and not lifting with that arm. And don't overdo it. You will likely be comfortable enough for radiation at nearly 7 weeks out. Will you be having chemo also? Also, it would be helpful if you would fill out your profile and make it public. Makes it easier to answer your questions.

BrightSocks, it is very possible that the path reports from the biopsy and the actual surgery will be different, as Peachy said. Mine were not. Again, please take a few minutes to fill out your profile and make each item public, if you would.

HUGS!!!

Brightsocks

All I have had is a mammogram then ultrasound then biopsy. I have talked to the surgeon who just went over the biopsy report. I am finding out more info on this board for not knowing anything at all is the hardest part. I don't know if I will have chemo? I am guessing I will have radiation for it seems most have that in their plans.

PontiacPeggy

BrightSocks, that IS the hardest part. When first being diagnosed, you know nothing. It's hard to ask questions when you don't know where to start. It would seem, from your Dx, that chemo wouldn't be indicated. However, your path report after your surgery will tell you more. A biopsy report, seems to me, is more of a first indication of what's happening without being definitive. With only a very small amount of tissue it doesn't give as much information as your post-surgery pathology report. Often nothing changes, but sometimes it does. I assume you will have a SLNB to make sure no lymph nodes are involved, that's the usual procedure. Are you in the US? How old are you? Radiation usually goes with a lumpectomy.

HUGS!!

Brightsocks

I am Canadian and they will be doing the sentinel biopsy as well.

PontiacPeggy

We have quite a few Canadian gals here. If you put your location in your profile and make it public, you might even find someone near you! We do find that Canada sometimes does things differently than here in the States so your Canadian sisters will be able to tell you what IS different.

HUGS!

ChiSandy

My diagnostic mammo & ultrasound report estimated my tumor size as 7mm, based on measuring the suspicious area on film. The core biopsy path report said it took samples 9mm long--and reported everything except actual size, lymph node status and margins (the latter three can only be ascertained after surgical removal of the tumor. The post-surgical path report agreed with the biopsy report as to tumor grade, ER/PR/HER2 status, and proliferation index, but the actual size turned out to have been 1.3cm, or nearly twice as large as the ultrasound indicated and 4mm longer than the core samples. It also found the sentinel nodes and margins were all negative. You won’t know for sure whether you’ll be advised to do chemo until the surgical path report indicates actual tumor size, lymph node status, and whether the surgeon got clear margins; in my case my MO surmised I wouldn’t need chemo but ordered the Oncotype DX test (which is done not on the core samples but rather on a bit of tissue from the tumor after surgery). Her guess was correct, as my score was within the “low" area.

But if your surgical path report agrees with the grade and hormone/HER2 status reported on your biopsy path report, I’d be very surprised if your tumor were larger than estimated, there was lymph node involvement or lymphovascular invasion, or if your surgeon didn’t get clean margins on the first try. For low-grade node-and-margin-negative tumors under 1cm with a hormone+/HER2- profile, OncotypeDX isn’t usually ordered because it’s almost automatic that the DX score will be very low and chemo unnecessary--because it's ineffective on slow-growing cells. Even for grade 2 tumors of the same size and hormone/HER2 profile, as long as nodes & margins are clean, the protocol is that a low Oncotype score is a foregone conclusion. Since mine was over 1cm, it was in a “gray area” for which the Oncotype test would be a valuable decision tool. (If there’s significant lymph node involvement, hormone-neg. or HER2+ status and grade 3, Oncotype isn’t usually ordered because the tumor cells are faster-dividing--and chemo is designed to destroy such cells; with its benefits outweighing its risks.

Sloan15

Brightsocks - Welcome. Good luck in your surgery. We'll be here for you. So, you said that you are ER+PR+ and no noticeable blood supply to the lymph nodes. So, the preliminary staging is Stage 1, and when they take out the tumor and the lymph nodes, that will be the actual staging. My biopsy was pretty much the same as my tumor pathology except I went from Grade 1 to Grade 2. I asked why, and the doc said that the grading is the professional opinion of the pathologist, and the tumor is a better sample than just a piece of the tumor.

You asked if you will need chemo... You did not mention the Her status of your tumor. If your tumor is Her+, then positive Her status is often a more aggressive tumor and doctors often want to be aggressive back and do chemo. There is a type of chemo that specifically targets Her+ tumors. The pathology report will determine the actual Stage and characteristics of the tumor. The reason so many of us are saying, "Get the Oncotest!" is that the Oncotest is a guide for doctors and patients on whether or not chemo is needed. You get the Oncotest on the tumor when it is removed. It takes about 3 weeks to get the results, and you will be healing from your lumpectomy during that time. Most people with very high ER+PR+ tumors (like 80% or 90%) respond very well to the medications, and if there is no cancer in the lymph nodes, they often don't do chemo. Sometimes even if there are micromets (stray cancer cells) in the lymph glands, and the ER/PR is + and very high, they still won't do chemo. Most people who have ductal cancer and high ER+, PR+ and are Her- often have low or Intermediate Oncotest scores. I don't know about tubular since I didn't have that. Sometimes people with Her+ or Triple Negative (TN cancer that is ER-PR- Her-) have high intermediate or high scores and their doctors sometimes don't order the Oncotest because they will have chemo anyway. You are ER+PR+, but you don't say your Her status. So, ask your Her status. (They had to send out my biopsy twice for Her testing, and finally in the tumor pathology report it came back Her-. These things take time, and that drives us crazy!) Then, ask if you should have the Oncotest. If you have to have chemo, it's do-able.

Good luck!

marijen

Sloan, my pathology report on my one positive axillary node says macromets. Do you have any idea what that means for BC?

mustlovepoodles

Brightsocks, my core biopsy said the tumor was ER+/PR+, but the lumpectomy revealed that it was actually ER+/PR-, a somewhat more aggressive cancer. Thankfully the tumor was relatively small and HER2-. The Oncotype DX was 23, plus I have 2 gene mutations that probably caused my cancer, so chemo was the order of the day. It hasn't been too bad. I've had a few complications and some "normal" side effects (hair loss, fatigue, taste changes.)

I wish you luck on your breast cancer journey.

Brightsocks

I have not been told of my HER status yet which I should have in a few weeks after the lumpectomy. Then if there is no spread I ask for the other test to see if I need chemo?

mustlovepoodles

They can send the tissue for Oncotype during your LX, if there is enough tissue. Ask your doctor

HappyHammer

PPeggy- You are right..that IS why we come here....support, encouragement and help from those going through (or who have gone down this crazy path)....Wow..those cookies look awesome and I LOVE that you took them to the staff at DH's place.

ALL- thank you for "hearing me"...the bumps are unexpected and hard but having you out there is very helpful and calming...I just thought it would go ok til at least after treatment but nope- not my path. You gals keep the lights on and I appreciate you all! Praying for healing for us all, too.

HappyHammer

Brightsocks...welcome but so sorry you have to be here.....I am Er and HER@ pos and did chemo BEFORE surgery...Carbo/taxotere/Herceptin and Perjeta....6 chemo sessions 3 weeks apart. When it was time for the LX it was determined I had a "complete response" to the chemo as there were no active cancer cells in the LX tissue and SN was clear. Doing radiation now as they did find DCIS in the LX tissue. Personally think it's imperative to get HER@ status prior to LX. Sending healing and calming energy your way.

Brightsocks

I have noticed some do chemo then lumpectomy? Is the treatment plan just different depending on ones HER status? Or size or a mix of different factors? I am sorry ladies for all these questions. I am just trying to learn as much as possible so I have knowledge to understand what I might be facing very soon.

marijen

The oncotype test costs about $4000 so they aren't testing everyone

PontiacPeggy

HH, this is the best place. And not just for BC. I've found support and comfort here for other ups and downs in my life. I was glad I took the cookies to the nursing home. The staff there was so caring and all loved DH. It is an old facility but the staff made up for any deficiencies.

HUGS!

PontiacPeggy

Marijen, Medicare paid for my Oncotype test with no quibbling. But I know a lot of insurance companies make you jump through hoops and beg.

HUGS!

marijen

Yes they pay for it but it's still expensive so from what I've read they have to be considering chemo in order to do the test