Diagnosed IDC large tumor remove or reduce?

Calirose

Hi I started out in "no answers from dr." and have had a biopsy resulting in a diagnosis of invasive ductal carcinoma. When the doctor called me she said it was unclear whether another mass close by was lymph node or start of another tumor. The large mass is 9cm. I called back again today to see if I should be checking in to a hospital or something since it seems so fast growing and my appointment with a breast specialist isnt until next week.  At one point the radiologist mentioned possibility of reducing tumor which is why markers were placed. The referring doctor said that it was just important to "get it out right away" but I could call the radiologist's office to ask more questions. This all seems rather backward? I don't know what kind of time I have to make several appointments or just try to check in to a cancer center. The one in Phx. does not take my ins. though. Any words of experience for me please. I'm so very scared as it seems like this thing grows fast.

Anonymous

Hi Cali,

I'm so sorry for your breast cancer diagnosis. My tumor was 4.9cm and was an aggressive Grade 3. My medical oncologist recommended chemo before surgery to reduce the size of the tumor, so I could possibly have a lumpectomy instead of mastectomy. The other reason was to kill any cancer straggler cells as soon as possible, which may have traveled to other areas, rather than delay chemo by having surgery first. Although my tumor didn't shrink a whole lot, other people have a much better response, and some people see the tumor disappear entirely from chemo. The radiologist probably mentioned shrinking the tumor for these reasons. I know it's a really scary time and every day seems like a week, while you're waiting for answers. My medical group has someone called a Nurse Navigator that I could call to ask if I could get an earlier appointment with providers who couldn't see me in a reasonable amount of time. Maybe your medical group has the same? I hope you find your answers soon.

ruthbru

Is the breast specialist an oncologist? If not, that is who you need to see before you do anything else. I'm thinking you will probably want to do chemo first, and get the tumor shrunk down as much as possible before any type of surgery.

Anonymous

Cali:  I'm not sure how radiologist can determine "size" accurately.  And by that I mean that from my experience, both a PET & MRI showed two tumors, both less than 2 cm. and nothing lit up to indicate lymph nodes were positive.  After mast surgery, the tumor size was over 6 cm and 4 nodes positive for cancer, much to everyone's shock, incuding surgeon & onc.  I did surgery first and I know many that do even with a large tumor but there are probably just as many women that do the chemo before any surgery or rads.  Pick an oncologist with whom you feel most comfortable and who are most willing to answer any and all of your questions. 

Hugzzzzz 

sarahjane7374

Sounds like you need someone who is running the show, so to speak.  I mean it shouldn't be you that has to decide which direction to go right now, a medical professional should be coordinating things.  Is the specialist you are seeing next week a breast surgeon?

Calirose

Thank you everyone, I agree that someone should be helping me run the show so to speak, the breast specialist has been recommended and I believe is part of a group that has an oncologist- I think I started in the wrong direction. I have high blood pressure due to alot of stress the last couple years and was just getting a med check and asked about the lesion, so it's just been the referring doctor that has been directing things. I will feel better after I see a specialist I suppose on Tues then and ask about an oncologist. otherwise if I don't feel comfortable I may just switch directions with someone else, it seems by what you all are suggesting. Thank you again, right now I don't have a lot of family to go through this with me unfortunately.  Hugs back.       

Calirose

Hi again, I picked up my pathology report myself again just like I did my first mamo. Can anyone tell me what a Invasive ductal Carccinoma, Nottingham grade 3 means?  I also have  different grades for other apsects including mitotic rate, nuclear pleomorism and tuble formation which were all 3.  Is my total score the Nottingham grad 3 as it says or the combination of all of the three other things?  I asked the Dr to go over as much as was indicated on report as possible and she did not mention these things . Frustrated, of course I know the specialist will give me the best answer but am scared of a combo score of 9?? or is it a grade 3, still not good.....:(   

Kalonis52

Calirose, Hi honey, I am real sorry. I hate to be blunt, but, being a 9 cm lump, you need to have that removed fast. Invasive means fast growing. It spreads. Being a Grade 3 your Cancer is moving beyond the markers.. I had a Grade 3. I caught it right in time. You do need to see a Breast Cancer Surgeon first.Then your treatment of Chemotherapy or Radiation thereafter. I do not mean to frighten you, but, you really need to have it removed fast. I will check in on you soon honey. Good Luck.

Kaloni 

rozem

calirose speak to your BS in consultation with your MO - they will instruct you on what they think the course of treatment should be. To answer your question Grade 3 tumors are the fastest growing BUT respond well to chemotherapy.  The logic behind doing chemo first is not so much to shrink the tumor but to start attacking any stray cells right away - if you do surgery and then chemo it will be at least 4-6 wks recoup before you can start chemo. 

Kalonis45 - not sure what you mean by "I caught it right in time"  -unless you catch it at DCIS stage then we never know if we caught it before it had a chance to spread which is why we do adjuvant treatment.  Yes you normally see a breast surgeon first but now that chemo before surgery is being done more, often the surgeon works in conjunction with the MO to determine the best course of treatment.