A little confused on the information I received

ayr1016

As of now (even though I know it can not be officially diagnosed till after surgery), I have been told "invasive ductal, no lymphatic vascular permeation, stage 2, grade 1, aprox. 2.7cm. I wish I remembered more during our conversation, but as you can imagine, I was a bit stunned and numb. During the biopsy, she did not biopsy any lymph nodes. She did ultrasound and saw nothing and felt nothing. I am assuming there is still a chance for something to be there and find during surgery? Do they always do something with the lymph nodes during surgery (either removal or biopsy)? I do not have my pathology report yet. I was given this info on Christmas Eve (so thankful she was kind enough to call me on that day when a lot of places are closed, etc.). Can they tell from the biopsy if my lymph nodes are affected? I'm trying really hard to be hopeful and distract myself till Monday morning when I hit the ground running with making a ton of phone calls to gather medical records and set up appointments.

Also, I feel like I've been in good hands as far as knowledgeable doctors (primary doctor and breast imaging center radiologist). However, even though my primary doctor has referred me to good doctors as well....how beneficial is it to get a 2nd opinion and do you let all parties involved know you are getting a 2nd opinion? For example, I set up an appointment with the surgeon suggested by my primary - Should I tell that doctor I intend to get a 2nd opinion and then when I call to set up an appointment with another surgeon tell them I'm looking for a 2nd opinion? Did YOU get a 2nd opinion? and Why?

So many things to do and think about. I am also thinking I should go back on my anxiety medication. I have not been on it since after my father died about 3 years ago. I suffer through my daily anxiety, but I think it is time I surrender to it and allow yet another medication to help me through this. I am sure many medications are in my future with my recent diagnosis.

mustlovepoodles

I'm sorry you find yourself here, but breastcancer.org is truly the best place to find information about BC.

To get to your questions:

They usually do not biopsy the lymph nodes until you have the actual lumpectomy. They look at the sentinel lymph nodes. We have a lot of lymph nodes in and around our breasts. The sentinels are the ones that are closest to the tumor. Sentinels are basically the watchmen--any cancer cells that try to leave the main tumor have to get past the sentinels first. Your surgeon will send 1 or 2 sentinels to pathology for a quick look during surgery. This will tell him/her whether they need to get a few more or if it's okay to close up. The pathologist will also do an in-depth examination of the sentinels to make sure there aren't any small cells lurking--that report comes back in a week or so.

Sometimes, the breast surgeon doesn't get clean margins the first go-round. When this happens they have to go back in later to get more tissue. This is what happened to me. Thankfully, they got it all on the second pass.

As for second opinions, that all depends on your comfort level. For me, I was able to research my cancer without scaring myself to death so I felt very confident in what my breast surgeon had planned. After the lumpectomy, she sent me to an oncologist. We didn't click at the first appt, but I wanted to give him a second shot--it was clear to both my DH and myself that this guy was NOT going to work for me; he was flippant and silly. He gave me a prescription for a hormone suppressant and told me to see him in 6 months! He all but patted me on the head during the visit! Ugh.

I got a second opinion 4 days later. The second oncologist took a thorough family history, looked at all my labs and pathology and immediately determined that I needed chemo. Like I said, I had done a lot of research and everything that I had read lead me to believe that I would need chemo.

The waiting is the worst part of this breast cancer experience, IMO. I found that once I had a real plan in place I was much calmer. Still, I found that I needed some anti-anxiety medication for a bit. I have an anxiety disorder so all this stuff has really made things ugly for me. My oncologist gave me a prescription for Ativan that I usually take during the week of chemo (the chemo and steroids they give me make it hard to sleep, so I take it then.) There is no shame in taking a medication that benefits you. It's not like it's heroin, after all.

Best of luck to you.

Skittlegirl

Since I am doing chemo before surgery, I ended up having a biopsy on a lymph node since it was enlarged on the MRI and also showed up on the PET scan.

My friend was pushing me to get a second opinion for surgery. I asked a couple local people who had gone through breast cancer and other breast issues who they used and the same name came up. I had used the surgeon years ago for a different surgery and everything had gone well and meeting with him again reassured me that he knew what he was doing and would take good care of me. He referred me to my MO and my MO referred me to my RO. They are all on the tumor board at the cancer center , so they work together a lot.

ayr1016

mustlovepoodles thank you for that information and explanation. It helped a lot!