My Mom's second diagnosis

downandunderit

My Mom was just diagnosed with breast cancer after being 11 years cancer free. This time it's in the other breast. Her surgeon told her it's a good prognosis but she's worried because they want to check a lymph node during surgery. I figured this was just standard procedure for any breast cancer diagnosis, but the last thing I want to do is start rambling facts to her that I clearly don't know. Is this standard procedure? I'm frustrated and scared to death that she has to go through this again, but I refuse to act like a nervous wreck around her.

She's been getting checked every 6 months for years so I'm praying that they caught this in the earliest stage. Apparently the growth was so tiny they had a difficult time even finding it, but I know size doesn't dictate stage. Based on your experiences, what should I expect going forward? She went through radiation therapy the last time around. She does not want to go through chemo but the doctor knows best obviously. Thanks in advance for any clarification/insight.

FLtricia

Just a word of encouragement for your mother. I was diagnosed with IDC, had mastectomy, chemo, and 5 years of AI. Six years later I was diagnosed with a new primary on the opposite side! I was devastated. I followed all the rules and it came back anyway. Well that time I had lumpectomy and radiation I am coming up on 5 years out from second diagnosis and am doing fine.

Mine was smaller the second time, I am sure because of regular check-ups. It is upsetting and discouraging but your mother is a seasoned warrior. One day, one step at a time and before you know it you will be looking in the rear view mirror at this unfortunate chapter. I found the second time experience a bit easier once over the initial shock. You are a good daughter to advocate for your Mom. God bless you both.

Pat

Icietla

Welcome, downandunderit. I am so sorry you all are having to go through the breast cancer experience all over again. I know the diagnosis is always a terrible shock to cancer patients and to those who love them. You will both feel better -- much less anxious -- when she has a treatment plan.

In connection with the treatment surgery -- that would be lumpectomy (or partial mastectomy) or mastectomy -- for a breast that is known to have invasive breast cancer, yes, it would be customary practice to remove at least the sentinel node/s for Pathology Laboratory examination. Knowing whether any lymph nodes there are diseased or not can be essential to guide treatment decisions, to have the (likeliest) most effective treatment plan. That information (as to the node/s) is also needed for accurate staging of one's disease state.

Whether she needs Radiation Treatment and/or Chemotherapy for this (newly diagnosed) breast cancer will likely depend on numerous considerations, any of which might make the difference as to the treatment/s that would or might be advised. The choice of surgery types can make a difference. The tumor tissue's proximity to the chest wall or the skin can make that difference. Lymphovascular or perineural invasion may make the difference in treatment to be recommended. Diseased nodes can make the difference.

For some tumor types/characteristics, Chemotherapy is always recommended. In other cases, though, it may depend on considerations such as tumor IHC characteristics, Stage, nodal status, and Grade -- but the patient's age can make all the difference as to what is recommended. Early stage breast cancers that are both ER+ and HER2- can have OncotypeDx genomic assay testing to help guide in the Chemotherapy decision.

For continuing treatment after active treatment, there is Endocrine Therapy (anti-hormonal treatment) for those with hormone receptor-positive cancers.

Yes, the Doctors know best.

Do you have access to the Pathology Report in which your Mom's new diagnosis was made?

downandunderit

Thanks so much, Pat! I'm hoping as well that in time this will all be in the rear view mirror. She's the type who can't not work and is always putting others before herself, so she's understandably annoyed that she has to go through this again. I know there's little I can do except wait and hope for the best, but in the meantime I'll be reading plenty of books and trying to bring some normalcy to her schedule.

Icietla, thank you as well! That's very informative. Her last bout happened so long ago that she didn't remember whether they looked at her lymph nodes, so it bothered her a bit. She meets with her surgeon within the next couple days so she'll have a better idea what her treatment plan will be soon. I'm trying not to pepper her with questions and I do believe he mentioned favoring radiation, but I know nothing is ironclad this early in the game.

They initially discovered this growth a couple months ago. It was such a tiny blip on their radar that they had her come back last week for some more tests, which brings us to today. Unfortunately I don't have access to the pathology report but will have more info within the week. Thank you again!

downandunderit

Update on mom: She met with her surgeon who said that this is very treatable. She has an awesome team being assembled including the oncologist from her first bout. Surgery will be happening in the coming weeks after some more testing. I don't think it's Stage 0 like it was her first time around, but I could be wrong and I'm hopeful they caught it early. Lord knows she gets checked frequently enough. In the meantime we're just trying to keep things as normal as possible and I'm doing everything in my power to stay the hell away from doctor google.

Anonymous

Please understand that even if a lymph node were +, it doesn't mean stage IV (or even III) and that it has metastasized anywhere else in the body, either. It sounds like your mom's second go-round was caught early, which is exactly what we want.

You might ask for the Oncotype test (you can look it up online). It's a test using tumor tissue to determine how well it will respond to any suggested chemo before she actually has chemo. If it doesn't respond well, then chemo won't be recommended and a different line of tx ops will be recommended. It's relatively new, and probably since your mom's last experience.

downandunderit

Good to know! This is all sort of new to me so the info is appreciated. She recently had an MRI which came back normal (except for the initial little growth) and she just had some genetic testing done which also came back normal. Her surgery is booked for a couple weeks from now, so I'm just praying that we get good news Re: the lymph nodes. So far her doctors are talking about radiation treatment but I know that's premature.

Anonymous

Radiation tx is very doable. I found it more an annoyance because I had to do it 5x a week for 6 weeks, but after the initial set up visit I was only radiated for 15 min at a time. And other than skin irritation which healed up right away after tx ended, it wasn't bad.

Claire

Linda19152

I had a mastectomy 13 years ago and last December it came back in the other breast I had a double lumpectomy 6 weeks later I'm going to tell you the truth it was not terrible not terrible at all did not hurt the lumps were small 2mg to mm or less they gave me a pill afterward to block estrogen they said because of my age I didn't over 70 I didn't have to have radiation and I said I didn't want chemo and they didn't give me a hard time so I'm telling you it was really not terrible when you first hear it's terrible when I first heard I was upset for 3 months but after the surgery I feel a lot better and I feel more confident that it was not as terrible I think and if the outside they want to scare you so that the person patient is cooperative but when I got beyond what the doctors were saying and had the experience I feel like it was really not so bad but nobody could tell me that then

bluepearl

I think your Mom will do well. I just read somewhere that radiation, no matter what, is a good thing to have as follow up. I had my second one two years after and usually, the further out your are from the first, the better the prognosis. I am hoping mine didn't go anywhere, small as it was.

Linda19152

I had a mastectomy 13 years ago and last December it came back in the other breast I had a double lumpectomy 6 weeks later I'm going to tell you the truth it was not terrible not terrible at all did not hurt the lumps were small 2mg to mm or less they gave me a pill afterward to block estrogen they said because of my age I didn't over 70 I didn't have to have radiation and I said I didn't want chemo and they didn't give me a hard time so I'm telling you it was really not terrible when you first hear it's terrible when I first heard I was upset for 3 months but after the surgery