Potential heart problem before lumpectomy

UpstateNYer

I just had a pre-op physical and found to have a very low pulse rate on EKG. My doctor is new and I tried to explain to her that my pulse has always been low. Now I have to see a cardiologist for sonogram and stress test. I am so afraid that they won't do lumpectomy that's scheduled in less than 2 weeks. Feeling quite overwhelmed. Anyone else have this issue?

ceanna

Upstate, sorry for your additional stress. It might just be that after the tests, they will only monitor your heart more during the lumpectomy, which is a good thing! Make sure the anesthesiologist knows before the surgery! All the best for a good set of tests and successful, as scheduled, surgery.

UpstateNYer

thanks , Ceanna. I am hoping that surgery will go as planned. I guess it is better to be safe than sorry. I will have to just roll with this. Yes, I am sure that the anesthesiologist will be made aware of the situation. I wish that they could do the lumpectomy under a local anesthetic, instead of putting me "under". I really am not looking forward to that, but I have no choice than to place my trust in them. How did your surgery go? Are you doing estrogen blocking meds now? Take care. Pat

ceanna

Upstate, I, too, wanted a local but told they couldn't do. I think it's because they can't risk you moving during surgery. My surgery was several years ago and it went well, minimal pain, and I had SAVI radiation, and no chemo. I do not take estrogen blocking meds due to a different type of heart problem. I had a second consult after the LX and rads about the estrogen blockers with a heart specialist. If they can't figure out cause of your slow heart rate, you may want to see a cardiologist or electrophysiologist before you make decision on your ongoing meds after surgery. All the best for the tests and LX. Keep us updated as you learn more.

UpstateNYer

Hello Ceanna, I will see the cardiologist on this Tuesday. Hopefully, they won't detect a "real" problem with my heart rate. Yes, I do plan on getting a second opinion for anti-estrogen drugs. I am not too keen on doing that. I am fearful of side effects. Glad you are doing well not being on them. Sometimes I think that less is more. Will keep you posted. Pat

UpstateNYer

hi Ceanna. Saw the cardiologist today. Did stress test and heart ultrasound. Doctor was concerned as first EKG showed possible ischemia (possible blockage) which scared me half to death. But, ultrasound showed all normal. Still was scary. Stress test was very easy for me, so I guess I will live. Now looking forward to lumpectomy with IORT next week. Best wishes to all.

ceanna

Upstate, glad your tests, while stressful, turned out well and you can go ahead with the surgery as scheduled. Your diagnosis is the same as mine. I know you'll do well. Are you having chemo also? I had SAVI brachytherapy rads and no chemo. Let us know how you're doing, and please ask if you have any questions as you move forward.

UpstateNYer

Hi Ceanna. Can you explain about the Savi brachytherapy? Did you go for a shorter length of time for rads? I was not led to believe that I will need chemo , but won't have full pathology report until after surgery. I hope not. They will probably do anti estrogen meds. My first cousin got dx last year with BC. She is much older than me. She is stage 2 with nodal involvement. Not sure of her grade or er/pr status. They did surgery and rads but no chemo due to her age. I think she does anti estrogen meds. She is in good health otherwise, so I am not understanding why no chemo with her lymph nodes positive. She lives in California. Hopefully she will be ok. Thanks very much for your kind words of encouragement. May I also ask you how you felt when you came to after surgery? I am so fearful of having anesthesia as I have mentioned before. I guess that I am just a natural worrier.

ceanna

Hi Upstate. Worrying is our natural state!!! Going in for surgery is the unnatural!! If you have not had anesthesia before I can understand your fears. My experiences have been okay and I have tended to be instantly awake and not groggy, but that often depends on length you're under (you probably won't be out that long with LX), the type of anesthesia given, and how your body reacts to it. You will meet with anesthesiologist before your surgery in addition to your surgeon so express your concerns with them, ask for the lowest dose possible (they can adjust in surgery as needed) and mention any allergies you have to meds before so they go with the most appropriate meds. LX is most often out patient surgery so they probably will give you only enough anesthesia for the short surgery, your recovery room time is lessened, and you will be on your way home before you know it!

SAVI is a type of brachytherapy with a device inserted in the effected breast for about 10 days. Twice daily rads are done for 5 days through this device. Long term results are similar to full breast radiation and often have fewer burns and side effects, especially if your treatment is on left side where the heart is. Just search the BCO site and type SAVI in the search box to read more. Otherwise send me a private message and I can give you more detail. Not every breast center has the capabilities for SAVI, and I'm sure some things have changed in the 4 years since I had it. If your center does offer SAVI, they would be asking you before your surgery if you wanted it, since I think they leave the surgery site a little different than when you have full breast rads. There are also new or different types of brachytherapy rads, so ask your doctors what's possible where you are.

Your questions about your cousin would probably need to be addressed by her doctors. There are so many factors that determine things like that. My guess would be that it depends on ER/PR/HERG status, grade (how fast cancer is growing), and how many of the nodes they took were involved (Say only 1 of 4 nodes showed). Your cousin having BC does beg the question as to whether or not you have had genetic testing for BC. That often happens from the biopsy sample or breast tissue removed in surgery so, again, ask your doctor about that if you haven't already had it.

If they are proceeding on your original schedule you are probably going in the next week. Please ask if you have any more questions or concerns. You may send me a Private Message if that works for you also. All the best for fast, successful, uneventful surgery! Blessings, Ceanna

AliceBastable

UpstateNYer, the newer standard of care seems to be 3 positive nodes or fewer with a low Oncotype score means no chemo.

ceanna

Thanks Alice, that's interesting to know.

UpstateNYer

I did not know that, Alice. I would think that any positive nodal involvement would require some sort of chemo. I will have to wait and see. I have not yet met with a MO. Surgery is next week for lumpectomy with IORT.

UpstateNYer

hi Ceanna. I just private messaged you. Thanks.

AliceBastable

UpstateNYer, I had micromet in the sentinal node and an Oncotype score of 17. No chemo.

UpstateNYer

oh, ok Alice, that is good to know. Thanks for your input. Is that considered a low info score? Best wishes to you. Hope this is not a too personal question. I noticed in your profile that you had kidney cancer. May I ask you how it was discovered? My brother had kidney cancer in 2005 and had to have his kidney removed. It was a very bad cancer and he was lucky that they found it early. They only found it because he had suffered from kidney stones and had a scan done of that area. God bless.