pre-surgery jitters ?

fac03

I have finished chemo (4 ACs and 12 T) and will have a lumpectomy along with lymph node dissection on Monday (tomorrow). I am really worry with lymphedema. My surgeon also confirmed that I am at high risk. At this point, I even questioned whether I really have breast cancer. I looked back at the whole process, I am not sure whether anyone even read the biopsy report. (I changed oncologist before treatment and it was a long story). Isn't it true that the biopsy report was the ONLY piece of information positively determine whether we have cancer?

I read many posts where many of you talked about the size of the tumor, the stage/grade level etc. I did not know. I asked my oncologist, she did not really know, but pulled out the report and read the first number she saw to me, she did not give me a direct answer on what stage I am on. Are we supposed to know how many lymph nodes will be removed? I read some of your doctor discussed whether there is a need for radiation etc, but it was never given to me as an option and when I raised the question to my surgeon and my oncologist, I was told it was based on clinical experience, chemo -> surgery -> radiation.

I plan to have the surgeon answered me those questions tomorrow. Am I crazy?

Yogatyme

fac03, I’m so sorry you are not feeling confident in your team. This is hard enough without the added burden of wondering if your team is on board with you. What they have apparently neglected to tell you is that the final size of the tumor and staging are done at surgery. However, it takes about a week to get the final pathology report. My initial biopsy report indicated approximately 3mm tumor but final pathology report was 7mm. Grading is done at biopsy as well as ER/PR/HER2 status and type of bc. Typically they don’t know how many lymph nodes will be removed until they get into surgery.....they inject radioactive fluid to find sentinel nodes (nodes where bc is likely to go to) and remove those nodes for biopsy and maybe a few more for safe measure. As for lymphedema, the most important thing is to follow post-op directions to a T!! Trying to do too much too soon puts you at great risk, so follow directions. Of course, with your team you may have to research this on your own. You may develop lymphedema regardless and there are some good threads here that you may find helpful. Good luck with surgery and recovery. Let us know how you are doing.

fac03

Yogatyme, thank you.

When you wrote "Grading is done at biopsy as well as ER/PR/HER2 status and type of bc", you meant the initial biopsy, right? I heard from the other doctor that I am ER+. I asked my oncologist, I had the impression that she was not sure or did not know, I didn't push further, what did you mean by the type of bc? I asked for the biopsy report which my oncologist gave me, but I just do not understand it.

I met a PT ceritifed for lymphedema, she made some measurements and gave me some suggestions on exercise, but when I asked her when should I begin the exercises, she told me I had to ask the doctor and the doctor will have to write another script.

bkerber

Im sorry that your doctors have not been more informative with you. Thats the only way I can cope. My surgeon sat down with me for 1/2 hour and drew everything out and explained all aspects of my pathology report.
Wishing you much success tomorrow with your surgery..

Yogatyme

fac03, yes, I meant initial biopsy. As you will learn if you stay on this forum, breast cancer is not one disease. I had no idea either until coming here. There are hormone receptive positive and negative breast cancers, HER2 positive and negative bc’s, triple positive, triple negative, and a number of less common types. The type determines the treatment. I so hope things take a turn for the positive for you. Stay on this forum.....it is a treasure trove of info. Read all posts by Beesie, she’s the bomb!! Loads of info.

fac03

Yogatyme, thanks. I am ER+/PR+. I was on this forum for a while, but after an infection and hospitalized during chemo. I became tired easily.

Does anyone know whether the percentage of ER+/PR+ mean anything?

In my report, it stated ER Positive 95% / Strong

PR Positive 20% /week to moderate

fac03

I found some more articles that may explain the result.

https://www.breastcancer.org/symptoms/diagnosis/ho...

https://www.breastcancer.org/symptoms/diagnosis/pa...