biopsy came back positive and waiting to see Breast Surgeon

timetobebrave70

November 2017, My Gyno found the lump on my left breast during a routine pap smear. When I had mamogram done January 2017, it was fine. So I got ultrasound biopsy done and it came back positive...I am waiting to see a breast surgeon on the 11th. Would she be running more tests or would she be going over treatments with me? I am so confused and scared......

Luckynumber47

Your surgeon might run more tests but most likely this will be a "teaching" appointment and sign permissions for surgery. Your surgeon will tell you your hormone status, whether your are Her2 positive or negative, the grade of the tumor (how aggressive it is) and what course of treatment they recommend you follow. They might indicate the size of the tumor and a guess at the stage. They might also have info on whether they suspect the lymph nodes are of a concern.

This forum has lots of useful articles for anyone newly diagnosed and I recommend you read as many of them as possible between now and your appointment. The more you know the better you will understand what the dr is recommending and what choices are right for you.

Take someone with you to your appointment to write down what you dr says because you likely will be overwhelmed. Some dr's will let you record the visit.

When I first met my surgeon I was a nervous wreck (who wouldn't be). She walked through the door and told me I would be fine. That this was just a bump in the road, a minor inconvience. Before she left she repeated: " you will be fine". Start saying that to yourself because you will be fine. I know this is a scary place to be but once you meet your surgeon and have a plan things will get much easier.

In the mean time, find things to do to keep your mind off the diagnosis. Deep clean your house, finish some projects you started, etc. Anything to keep you from worrying.

Let's us know what the dr has to say and how we can help.

Lucky

timetobebrave70

Thank you. Your advice is very helpful. I will stay busy and positive. Thank you again.

smwusaf

I remember going to that visit and it is scary and overwhelming. Don't google too much. Stick to legit sites with valid info. There are a lot of good articles here on this site.

I took my husband and grown kids with me to that surgical appointment. My daughter was my scribe and she took copious notes. write down questions you have ahead of time because it's easy to forget to ask. If you don't have family that can go you might even ask a friend.

Good luck and hugs

Sarah

moth

timetobebrave - you may want to get a copy of your biopsy pathology results ahead of time so you have a bit more info. I started a binder right away & I had copies of the diagnostic mammograms, the radiology reports and the biopsy documents. I had a good idea of the size and type of tumor, and thus the probable course of action the surgeon would recommend before we went in for the appointment. Of course it was good to hear his explanation as well but mostly he was just confirming stuff I already knew, and I felt confident deciding on the next step as I'd already spent time thinking about the possibilities.

In my appointment with the surgeon he examined my breast, my lymph nodes and palpated the liver, went over the preliminary diagnosis & staging (final diagnosis and staging would be done after surgery), talked about surgical options and what he recommended and why, talked about the probable treatments after (these will be decided on by the oncology team after surgery). Then I signed permission forms for the surgery & got a requisition for bloodwork. I had surgery a week later.

Your surgeon might do things differently because of your age or your case or specific circumstances regarding your tumor. Hang in there. The waiting part sucks the most. Be careful googling or you might end up scaring yourself.

I tried to focus on concrete things I could do right now - plan for the healthiest possible me for recovery and prevention of recurrence. I looked at http://foodforbreastcancer.com/ and have been making meal plans which incorporate these guidelines. I also read that single biggest lifestyle change which reduces recurrence is exercise; even though I already exercise, I made specific plans about incorporating more exercise in my life and told everyone in my life that the best thing they can do for me is be active with me. http://www.cmaj.ca/content/189/7/E268.full?sid=0be...

Maybe these might help you too. I just found having something I could try to control - like the diet & exercise - has been important for my mental health....

timetobebrave70

I just picked up my ultrasound biopsy that was done on December 20th. I won’t see my breast surgeon until the 11th. Can someone help me interpret some of it? It’s hard for me to understand and it’s driving me crazy.

It says: invasive ductal carcinoma

Nottingham histologic grade: 2 of 3, moderately differentiated

Tubule score-2, nuclear score -2, mitotic svore -2

Size of invasive carcinoma in submitted cores: 1.0 cm

DCIS: cribriform, intermediate nuclear grade

LCIS: not identified

Lymphovascular invasion: suspicious

Micro calcification: present

Luckynumber47

Another part of the puzzle that is missing is whether the tumor is ER/PR positive or negative and whether it is Her2 positive or negative. Knowing that part will give you info about systemictreatments they will recommend after surgery.

It looks like the tumor is small (most likely stage 1), intermediate grade (grade 2) so not fast growing or aggressive. I would think your surgeon will offer you a lumpectomy plus radiation or you could chose a mastectomy and probably skip radiation.

I had focal lymphovascular invasion. It didn't change my treatment. It's good to know but not something they do anything about. Also, the DCIS doesn't affect your treatment because whatever they do for the IDC takes care of that.

It's a bummer to get a BC diagnosis but from what you've told us so far yours seems to be the most common and easiest to treat.

OCDAmy

I had IDC and DCIS in the same Breast but they were in different areas and my BS said he couldn't successfully do two lumpectomies so I had mastectomy.

Best of luck to you. The waiting is the hardest part

Georgia1

Just chiming in to agree with Lucky. A BC diagnosis is always a shock but looks like yours was caught early. ER status is a missing piece of data that is important, and of course trusting your surgeon is huge. Expect lots of waiting around and possibly more testing, which is a pain, so this is a good time to book an appointment with a second opinion surgeon or oncologist if that is an option where you live. Best wishes.

timetobebrave70

Thank you All

lrwells50

I can’t stress enough to take someone with you to your appointments. I missed a lot of stuff at my first appointment with the BS. My husband took it all in, but I’d take notes, or even record it if the doctor has no objection. In fact, if he objects, I think I’d look for another surgeon. At the first appointment the BS laid out all of my choices, all of which had the same survival rate. Then his office made me an appointment with a plastic surgeon, so I had all of the info I needed to make an informed decision.

timetobebrave70

thank you.

smwusaf

This looks a lot like my initial diagnosis, which is good. Small, not too aggressive. They will probably want to do a sentinel node biopsy along with the lumpectomy just to make sure nothing has moved into the lymphnodes.

At the surgeons visit he/she will have more information for you. I remember thinking why aren't we going in sooner to get this thing out? No one seemed like they felt the urgency I did.

Good luck. The waiting is hard, I know.

timetobebrave70

Hi everyone. I went to see my breast surgeon few days ago. I like the doctor because she seemed really caring and informative. She drew me pictures. Lol. So even though my diagnosis wasn’t so great, I decided I will not be seeking a second opinion and just go with her.

I am ER+PR +Her2+

She says surgery. Chemo. Radiation.

For now, she’s sending me for a MRI, PET scan. And genetic testing and referring me to an oncologist. I will see her in two weeks after all tests are done.

She says my cancer is not the least aggressive like we would like but it’s not the most aggressive. I am in the middle and since the size is small and caught it early, it’s mostlikely not have spread although won’t be sure until the surgery. So more waiting for me. But now I have more answers.

I went with my husband for second set of ears and recorded my visit like I was advised by my pink sisters. I made a list of questions to ask and my doctor was impressed that I was already knowledgeable. Thank you everyone for your support! God bless you all and stay strong!💕💕

Jt3

Sorry you are here and waiting for results. I am awaiting a Monday visit to go over mine and it is an anxious time for me. Hugs to you! Did she tell you what type or stage? Or waiting for all the results

Georgia1

Good morning! That is all good news. The size is small and it sounds like spread is unlikely, but MRI and PET scan will give you the answer you need. If that comes back clean, then it's possible you will not need chemo. So as much as you like the surgeon, you will need a medical oncologist to help you there and you will also want to discuss getting an Oncotype DX test done. Keep us posted but also try to enjoy a nice optimistic weekend! You can do this.

timetobebrave70

jt3, no stage knownyet. Waiting to do more tests. But when I tried to make MRI appointment, they told me I have to call back on the first day of my period. They said the test has to be done within 5-10 days of my menstual period. Which will be another 3 weeks! Is this right???

Georgia1

Hi TimeToBeBrave. Yep, being on your period can confuse the MRI machine so they usually do make pre-menopausal women wait. So sorry! This initial testing phase is so annoying and stressful.

timetobebrave70

thank you so much Georgia1.

Jt3

Timetobebrave, I know waiting is really tough. I have surgery on 2/21 and have alot to think about before then and be anxious. I hope you are staying busy.

timetobebrave70

thank you Jt3. I am getting the MRI today. I have a question friends. I got a genetic test last week at a lab. I get a phone call from a genetic counselor to make an appointment for a genetic counseling over the phone. They said my insurance company does not pay for the test until I have the counseling. So I have the counseling. They ask me my family health history going all the way back to my great grand parents of both sides. Make long story short, she said I had the criteria to test 3 genes rather than 34 that my doctor requested. There’s 20,000 genes to test. Her Question is do I really want to know if test comes back positive for other cancers and chances might only be like 7 to 15 %... I said yes, I want to go ahead with what the doctor ordered. I feel like this whole process was to talk me out of all the tests and save insurance money. Am i wroung

Veeder14

Hi timetobebrave70,

Due to family history it was suggested that I get tested for the BRAC gene. The hospital clinic required that I go in for counseling before the blood test was even ordered. I was sort of frustrated waiting because I live far away and just wanted to give blood and get the test results. One of the reasons that they want to do counseling first is to get your complete history. The hospital I go to said that they only test for the BRAC gene (1 or 2) which a family member is positive for. They don't just test for "everything." The questionaire and interview determined that BRAC 2 was positive in my family and that's what was tested for. I didn't realize how many genes there are that can be tested.

Sorry about the bold print, I don't know how to get it back to regular.I don't know about the insurance part. I definitely want to know if the tests come back positive for other cancers even at low percentages and assume most patients would.