New here

Pepper44

I've been lurking on this site for a few weeks reading a lot of helpful information so thought it was time to make my first post. I think i was in some denial the first few weeks after my diagnosis because it was such a shock. My mass was found after a routine mammogram, I never felt it or saw any symptoms and I don't have any family history of breast cancer. It's all starting to sink in now and I've finally started to tell people at work. I have a team I lead at work and am involved in a big project right now and I know people were noticing my distraction and absence for all my tests and dr appointments. In any case, I've got IDC 1.5cm mass and right now am planning for a lumpectomy if nothing else shows up in my genetic testing. I'm married and have 2 kids (15 and 11) and they've been doing good with the news but I feel like things are about to change once I have the surgery and start the whole treatment process. So far this has been very mentally tiring and making me just want to hide from the world in bed!

Right now my biggest stress is deciding between 2 surgeons, one that is at my local regional hospital and the other at a top university cancer center a few hours away. I see pros and cons to each option so am still not sure. I think both are good surgeons but I feel like the university cancer center probably has more current techniques and mindset on treatment , though also it's so big and so many patients I'm feeling likejust a number. At the local surgeon I'm getting more personalized service so I'm just not sure. Any thoughts on choosing a surgeon are welcome!

cayogagirl

hi there, welcome! I just had surgery on Monday 4/1, a Breast Reconstruction revision surgery (both sides), had both saline implants removed and replaced with silicone. I've never left the breast cancer community, felt it was important to know medical improvements and changes and for some reason i just felt safe.

With my old and new surgeries, i had to decide what surgeon and facility would do best for me as the patient, based on experience, recommendation from other doctors or patients, the care at their office, and bedside manner, all were important to me. I do suggest you see any and all surgeons in person.

I followed my intuition and in all cases, no regrets on my choices. I love my new plastic surgeon, recommended by my oncologist, I moved from CA to VA so needed a new doctor. My consultation was amazing, the PS made me feel special, asked me so many questions, looked at me directly, shook her head a few times, was very direct with her questions. I knew she would take care of me and do the right procedure. She said she had a "plan B and C" in her head if what was planned didn't work. She wouldn't know until i was on the operating table. A revision surgery is close to my previous surgical procedures.

Stay positive, sounds like you have a good attitude. I'm a yoga teacher now and that helped me after my first surgeries and is keeping me strong through this surgery. I can't practice physical yoga but mentally it is helping me.

DX 5/1/2003, DCIS, IDC, Pagets, 2.5cm RIGHT, 4 tumors, Stage 2b, ER/PR-, HER2+. Modified Radical Mastectomy 5/12/2003, followed by 6 months chemo AC, then Taxotere. Delayed reconstruction 2004-2009.

Moderators

HI Pepper and Cayogagirl!

Welcome to you both. We're so very sorry that you find yourselves here, but we're really glad you've found us.

You're sure to find this space a wonderful resource for information, advice, and support -- we're all here for both of you!

Thank you for posting, and we look forward to hearing more from each of you as you navigate your diagnosis and treatment.

--The Mods

ElaineTherese

Hi!

Lots of people here will advise you to go with the big cancer center, especially if it is a NCI facility. I just thought I'd give you the perspective of someone who went to her local regional hospital. I worked through treatment, and didn't have time to keep driving back and forth to my nearest NCI facility. Secondly, my case wasn't particular difficult -- I had a large tumor and an aggressive form of cancer (triple positive); no matter where I went, I would have been advised to do surgery, chemo, targeted therapy, radiation, and hormonal therapy. I did a lumpectomy, so I wasn't planning on getting reconstruction. For me, my treatment was fine at the local facility.

But....if I got reconstruction, the kind of reconstruction might have driven me to a different facility. (Some plastic surgeons offer a wider range of options.) If my case were more complicated (e.g., cancer on the chest wall), I might have gone to a bigger facility. If there was some debate about my treatment options, I might have gone to a different facility for a second or third opinion.

I've found that my relationship with my medical oncologist has been the most important in the long run. (I haven't seen my surgeon in years.) I will be seeing my oncologist for a long time. Having a good relationship with her is what matters the most to me. Good luck! ((Hugs))

cayogagirl

hi Elaine! You are so right! Your Oncologist will be with you for life! So important for anyone newly diagnosed to have the right medical support as well. I fly back to California from Washington DC every 4 months to see my Oncologist. Thank you! Be well

Pepper44

thanks everyone for the comments and perspective. Yes I am choosing from an NCI facility and a regional hospital. My surgery and treatment plans seem very standard for my type / stage of BC and both surgeons basically advises the same. The one difference I can see so far is that at the NCI facility, the surgeon can have pathology review the margins on the tissue right when I’m in surgery Incase they need to remove some more. At the other hospital they can’t do that in ‘real time’ and it sounds like that gives me a slightly higher chance of then needing a second surgery? I really need to minimize time away from work and so possibly avoiding another surgery isappealing. I haven’t even started thinking about choices for the oncologist but it seems like I should get on that.

letsgogolf

My team looked at the pathology during surgery and one margin was too close so they took more tissue while I was still on the table. Makes for a slightly longer surgery while they wait for results but not having to return for a second procedure was great. My sister had to have a second surgery because her doctor and hospital didn't do this. Glad you found a facility willing and able to take care of this for you.

Anonymous

Remember, you can interview docs at both facilities and then choose. Questions to ask might be how many patients they've treated with your particular dx and pathology, and treatment protocol they'd recommend. My local cancer center is not highly thought of, so I drove two hours to MD Anderson in Phoenix and talked to an oncologist there--then saw one about 45 min from my house. I found that the closer one had the same treatment protocol as the Anderson one, and she was more amenable to my desire to combine naturopathic support with conventional treatment. I went with the closer one, but not because she was closer.

We deserve the best treatment we have available to kick little c's *ss once and for all, and if it means driving or flying to it and we can, then we should. I didn't want to look back and feel regretful that I went with the "easier" logistical choice instead of a respected tx center and doc. Just something to think about...

Claire

CasM

cayogagirl - would you mind sharing your surgeon in VA name?

Ingerp

My choice was between a large teaching hospital and a smaller private one. I really believe the treatment/outcome would have been the same regardless. The private hospital in town has the reputation of better bedside manner. I’ve had all of my treatment there with state-of-the-art equipment. Keep in mind that if you have a lumpectomy, you’ll likely need radiation, which is 4-6.5 weeks of treatment five days a week. That’s difficult if a long commute is involved.

FWIW, my 2016 lumpectomy required a re-excision but it’s a simple surgery and quick recovery. It would delay the end of total treatment a few weeks (to allow the second incision to heal) but I probably only lost about two more days of work.