Sister diagnosed today, 3 lumps, but now what?

Monkeybroth

Good evening

My sister has 3 lumps in her breast, one behind the nipple. She went to hospital today (she lives in the uk) and they did a mammogram and then a biopsy. It was confirmed that two lumps are definitely cancer, the third they couldn't get to due to its location. They have said a treatment plan will be formulated shortly.

They have confirmed either a lumpectomy mastectomy will be required. Beyond that I dont know as I wasnt there with her, and didnt want to ask too many questions and thereby make demands of her emotionally,

I want to help as much as I am able, but i could do with understanding the following and am trying to keep a cool head so I can give the best support, so....

1. What happens now...does the biopsy ‘stuff’ go to pathology in order to grade it , and say exactly what type etc, or will they already know that?

2.will they check under her arms for lymph node involvement , and if so when.

3. Will they check for spread of cancer and if so when would this happen?

If anyone could give me any insight I would be grateful.

I have read the moderators guide which is great.

kber

Hi. So sorry that your sister is going through this. I don’t have all the answers but then who does.

She’ll go through a painful, but relatively short period now of tests and procedures which will tell her and her doctors more about her particular flavor of cancer, which will inform her treatment plan.

They will try to determine more about the size, locations, hormone status, tumor differentiation, and possible metastasis. In addition she may be offered genetic testing, which could be personally relevant to you. It’s a dizzying process and seems to take forever.

Let her guide you in how much and how soon she wants to share. Ask if she wants to talk about it, if she wants help, and then read her verbal and non-verbal answers as only a sister can. You probably know her better than anyone. Be extra sensitive to her right now.

Sending positive vibes to you both.

Salamandra

1. What happens now...does the biopsy 'stuff' go to pathology in order to grade it , and say exactly what type etc, or will they already know that?

Yes. I think the stains for testing some of that stuff take some time. I got all my results (including that it was malignant) all at once about 9 days after my biopsy. That said, they won't *really* know exactly what's going on with it until after it's completely removed at the mastectomy or lumpectomy, and they do a more thorough pathology.

2.will they check under her arms for lymph node involvement , and if so when.

At my first appointment with the surgical oncologist, she did a manual exam on my lymph nodes. She didn't find anything obviously alarming, so the next step was the sentinel lymph node biopsy. For me, they did this together with the lumpectomy, which I think is often the case - but it doesn't *have* to be combined. They are two separate procedures.

3. Will they check for spread of cancer and if so when would this happen?

The lymph node biopsy is one way of checking for spread. But other checks will happen likely depending on how things unfold. My impression is that they try to make the checks match the level of concern depending on the pathology of the cancer and the symptoms. So someone that had no lymph node involvement and a relatively small tumor size without indications of aggression would likely not get full body scans for metastases (that was me). Someone diagnosed at a later stage or with more reasons for alarm or with other physical symptoms that could be explained by mets get that more thorough scanning.

Once they knew that Plan A for me was a surgery->radiation->endocrine therapy, they sent me for an MRI of my breasts and checked my genetic testing.The reason for that is to see if there are other areas of concern in the breast that might need investigation and potentially impact the choice of lumpectomy vs mastectomy, and also if I'd had genetic risks, that might also impact the recommended surgery and medical options.

Basically, the whole thing unfolds over time. You get pieces of the puzzle as you go. For the first 3 months or so, I felt like I was just constantly waiting on another test result. It's not the greatest.

Monkeybroth

thanks Kber for your wise advice, I shall be very careful indeed

Monkeybroth

salamandra....thank you so much for explaining, it has made things much clearer,I didnt want to bombard her with questions, or alarm her, thats why I came on here. I really appreciate you going to the time snd trouble. Thanks again