Already confused/Treatment options

Mykidsmom65

My IDC dx was on 6/16/17. I feels like things are progressing at a snails pace. I never realized until now how involved just figuring out how involved your cancer is. I got the call yesterday that I have lymph node involvement. This is where I'm feeling confused. So I've had a mammogram, ultrasound, breast biopsy, MRI, and now two days ago a needle biopsy of ONE lymph node. Which did contain cancer. And here is where my confusion begins. Why only needle biopsy one? So is it in more nodes or just that one? They don't know. I still have no idea what stage my cancer is and my original mammogram was in May. I feel like in 2 months time they should know. But, maybe this is just how this process moves along? So now I know it IDC, i know its hormone positive, grade 2, 2.7 cm but who knows how many lymph nodes? No one. Is it normal to just needle biopsy the biggest node? I am having my first appointment with an oncologist next week. How does an oncologist decide treatment with only one node result?

Also, does anyone on the forum have experience with Cancer treatment centers of America? I have one within 2 hours of me. Would it be worth meeting with them as well as the oncologist i have an appointment with? I am really overwhelmed right now. I never realized how many different approached there are to treating breast cancer. I just really want the best shot at living, and hopefully living well. I have an eight year old I adopted as a baby. She has already lost her bioparents and now I fear she will lose me too. I just want to stay well as long as I can.

ElaineTherese

Hi!

Are you scheduled for surgery? Often, you don't know your exact stage until surgery and you receive your pathology report (unless you're doing chemo first, but that's another issue).

Knowing that one node is positive may lead to the removal of others. I had all 20 of my levels 1 and 2 lymph nodes removed because a fine needle biopsy showed that one node was cancerous. Make sure that your doctors keep track of the location of the compromised node so you can avoid having multiple, healthy nodes removed. At most, your surgeon should take out the compromised node and a few of its neighboring nodes. That will reduce your chances of lymphadema.

Re: your oncologist and chemo.... Chemo is most likely to be recommended if you are triple negative (ER-/PR-/HER2-) or if you are HER2+. If you have the most common form of breast cancer, (ER+/PR+/HER2-), whether or not you have chemo may depend on the results of the Oncotype Test.

I have no opinion about the Cancer Centers of America. There is one 2.5 hours away from me, but I stayed local. However, many women do ask for second opinions and find them helpful.

Best wishes!

Mykidsmom65

Thanks so much for your reply. No I'm not scheduled for surgery. I've been seeing the surgeon for the initial biopsy, lymph node biopsy, and mri. He had laid out 3 treatment options to me. treatment first then surgery, surgery first then treatment, B/L mastectomy although cancer is only in one. I am hormone receptor +, H Er (?) negative. These options were discussed prior to the needle biopsy of node. So now I have an appt. with the medical onc. next week so I have no idea what the plan is now.

What is an oncotype test?

MinusTwo

MyKidsMom - it would be helpful if you continued posting & asking your questions on your previous thread & stick to one. That way we can all see the back story and review the answers posted to date with out having to jump back & forth or research your previous questions.

Meet with the MO and see what you think. Ask him about the oncotype test.

Mykidsmom65

sorry. new here. i'll stick to my old post and delete this one.

MinusTwo

No need to delete. Just pick one and keep updating there.

ChiSandy

OncotypeDX is a 21-gene assay of a sample of your tumor. It is ordered by your MO when your path report says your tumor is in a “gray area,” i.e., has one or more factors that make it impossible to say chemo vs. no chemo without doing further testing. It is available only for Stage I grade 1 or 2 tumors that are ER+/PR+/ER2- with 0-3 positive nodes. Tumor size between 1-2 mm. is an example of that “gray area.” Results are given recurrence scores: 0-17 is “low-risk,” 18-25 “intermediate-risk” and >26 “high risk.” (Sometimes if ODX comes up “intermediate,” a MammaPrint or Prosigna test is done to further refine the prediction: those tests have either “high” or “low” risk results). 2.7cm. (regardless of nodal status) almost certainly takes you out of the “gray area” into chemo territory—either neoadjuvant (pre-surgery) to see which drugs will work and shrink the tumor enough to possibly have breast-conserving surgery, or post-surgery.

carmstr835

I am going to CTCA. I believe they are my best place for my cancer. Message me privately if you need any information. I have been going there since March 22. They did my surgery and now my chemo and in september, my radiation. I had 2 second opinions to be sure and decided to go with CTCA.

Susug

Minis Two you need to stop telling the new people that are posting in different topics to stick to one. They will get the hang of it soon. I'm sorry but it's sound insensitive and rude. They are in a whirlwind and are just trying to test the waters on this forum and they get blasted and start apologizing. I'm sure your not trying to make them feel this way on purpose. When I was first diognosed and found this site it took me awhile to post I was just reading many many post before I felt comfortable posting. I'm sure I probably wouldn't have continued if you posted that to me in my early diognos It's to

TWills

Well said Susug:) 👍

Optimist52

Mykidsmom65, just to add to this, your MO would order the Oncotype DX test after surgery, which measures the activity of a group of cancer-related genes in your tumour tissue. It is available up to Stage IIIA. My tumour was 4cm and I was eligible for it, score 22, no chemo. The intermediate range goes from 18-30, high range is 31+.

I agree with you that your medical assessment is moving very slowly. Can you contact your BS directly to push for surgery sooner? It's not until you have sentinel node dissection or axillary node dissection that you will know exactly how many nodes are affected which will help direct your treatment plan.

Wishing you the best as you get through this stressful time.

Brightness456

mykidsmom, I'm new too. I don't even know where your old post is or how to find it (I was told to stick to one thread too and felt embarrassed about it), but I've been wondering how you're doing. I hope you're getting the answers you need.

If you're still reading this thread, know that you're in my thoughts.

kira1234

Brightness I've been here for 7 years now. I find there are many very interesting threads and I tend to become active on many of them. It's how we learn