Diagnosis details after surgeon meeting today - gd 2-3 DCIS/IDC

Aussieprime

So met the surgeon today and have a bit more of a clearer diagnosis..

Not given me a stage as I have to have CT scan and bone scan Wednesday and blood tests to check it's not spread past lymph nodes ( another anxious wait where every ache I'm convinced the worst)

But it's a 3.5cm lump on ultrasound but surgeon says around 4cm. Grade 2-3 combination of DCIS/IDC.

ER - PR- Her 2 +

Surgery booked for 02/07/18 - mastectomy with immediate implant recon and axillary node clearance ,then chemo with Herceptin and possible radiotherapy after.

I was upset about this and hasn't really prepared for the mastectomy word as was hoping I could have a lumpectomy but trust my surgeon

I dont really know what any of it really means even though I've spent 2.5 hrs there with them...not sure I was in the frame of mind as just kept giving me so much information

Meeting surgeon again Thursday to go through CT/bone scan results....hoping they come back ok if anyone has similar to me I'd appreciate some comments or thoughts

Thanks in advance xoxo

nonomimi5

Aussieprime - I am so sorry you are going through. Your BC is different from mine, but from what I know. ER/PR negative BC does not respond well to hormonal therapy that uses anti-estrogen to kill off cancers that thrive with estrogen. Her 2 positive BC is more aggressive, and that the recurrence rate is higher in the next 5 years vs Her2 negative which is slower growth and recurrence risk is lower initially, but becomes higher later. Your lump is also not big, but not small. How old are you? Younger women's BC tend to me more aggressive than older women. I think your team of Drs are doing the best for you. Not many drs will spend 2.5 hours explaining to their patients. I know this is so hard right now, but you will get through this. Keep us posted on your results and if you post more info, I think others can help you more. My BC is the opposite of your's and I am not the best person to help you. There are threads for your type BC if you want to look it up.

Peregrinelady

Aussieprime, I would suggest that you search for a thread that has your stats. ER-, PR-, HER2 + is not common, but talking to women with the same diagnosis would benefit you more than someone who is not familiar with this diagnosis. I will say that even though HER2+ is more aggressive, Herceptin has been shown to be very effective. Also, don’t be afraid to ask for anti anxiety meds, if needed. Good luck and keep us posted.

Peregrinelady

https://community.breastcancer.org/forum/80/topics/767013?post_id=5225544

I think this thread might be helpful.

hapa

I would think that with ER- PR- Her2+ breast cancer you'd want to do neoadjuvant chemotherapy. If the tumor shrinks on the chemo, you might then be a candidate for a lumpectomy. And if your response to chemo is really good you may be a candidate for sentinel node biopsy instead of a full ALD, which would reduce your risk for lymphedema. Can you consult with an oncologist before your surgery? Does your surgeon work in a hospital or cancer center where he/she is teamed up with oncologists to formulate a treatment plan?

Peregrinelady

After checking out the thread I posted, I agree with hapa. Your treatment decisions should involve an oncologist. It looks like most women with your stats do chemo first.

wlo002

Hi Aussieprime. I'm Her2+ and I'd be happy to share my experience so far. I had a large mass and my surgeon suggested chemo first and contacted my oncologist who agreed. She felt that disturbing a large aggressive mass wasn't the best idea. That being said, I know other women who did have surgery first, but don't know the reasoning. Each case is different, I'm sure.

I'm on TCHP and after the first infusion, my mass shrank from over 5 cm to about 1 cm. Because I've had such a good response and I have large breasts, I have been given the choice of lumpectomy with oncoplasty or mastectomy. I'm currently meeting with my surgeon, plastic surgeon, etc to make an informed choice. I will have radiation with either choice because my mass was so large.

I wish you the best of luck!