Just Diagnosed (again) - Question about treatment order

kathinohio

Back again. I thought my BC days were over but alas, I have been dx'ed with IDC in my armpit. The area is small, less than .7 cm

I am a veteran and am going through VA healthcare this time - in 2011 I had private insurance. My primary put in a referral for a Breast Center/Clinic consult and told me they would handle everything going forward as far as my treatment. I've been waiting by the phone for DAYS (seems like years) for the call to make an appointment but instead today I got a call from the surgeon and have an appointment with her on Friday.

After you were dx'ed, what was the order of appointments? Did you see a breast dr first or an oncologist?

Thanks for any help you can give me. I really appreciate this forum.

Spookiesmom

My first time around, was surgeon first, he took my case to tumor board, they decided what my tx would be. Then a bunch of tests, and started chemo. Then surgery, then rads. Took about a year to do all of it. The waiting is the worst!!! Once you have a plan, it really does get better

The second time around, told MO I felt a small lump on the other side. He ordered PET/ct, it lit up. Off to surgeon again, then rads

Seilien

I made appts with 2 different breast surgeons. I was referred to an oncologist. So the order was actually breast surgeon, oncologist, 2nd breast surgeon. Then I saw 2 plastic surgeons. Actually, it might have been radiologist, breast surgeon, oncologist, outpatient surgeon, breast surgeon, plastic surgeon, while later I met radiation oncologist. It all went very fast.

moth

For my stage 1 dx i saw a surgeon first, then the oncologist.

Beesie

kath, so sorry you are back.

Is this cancer on the same side as the previous DCIS and mastectomy, or is it on the other side? And is it in the breast tissue right at the edge of where your breast meets your armpit, or entirely in your armpit?

To me the question is whether this is a recurrence (which would only be likely if it's on the same side as the previous diagnosis) or if this is a new primary. And if the cancer in the actual armpit rather than within the breast tissue, the question to me would be whether there may be an occult lesion somewhere else in the breast area, which would be possible either with a recurrence or a new primary.

What screening have you had so far? Since this is your second diagnosis, and with the questions I raised, I would think that an MRI might be in order. The surgeon might suggest this, but if not, an MO probably would. I would also think since this is a second diagnosis, it probably is advisable to see an MO prior to surgery - I don't think it matters if you see the surgeon first or the MO first, as long as the MO is on board with the treatment plan prior to surgery. The MO might not change anything from the discussion with the surgeon, but I think it would be a good idea just in case.

kathinohio

Thank you all for your replies!

Beesie - this is new. I had DCIS in my left and full mastectomy with reconstruction in 2011. I have had breast tissue in my right armpit for about 35 years (since I nursed my son who is now 34).

I had my regular mammogram this year a couple months late due to Covid 19 and they saw a suspicious spot in my armpit. I had another mammogram and an u/s. I had a biopsy done about 10 days ago and found out last Monday that it is IDC. As far as I know, they did not see any suspicious areas in my right breast however the tissue has always been dense - the area is totally in my armpit.

The last time I was seeing a breast dr in a breast center. She was also a surgeon. This time I'm seeing a dr in the general surgery area at the VA hospital. I guess I will just have to wait and see - I'm the type of person who just wants to get a plan to get everything taken care of ASAP and this waiting is making me crazy!

mitziandbubba

I just wanted to chime in to say my cancer was in my armpit as well - I have breast tissue there. At first they did think it was the situation Beesie described. Axillary tail breast cancer (armpit area) is VERY rare, but I always have to be different.

I am sorry you are dealing with this but I wish you the best of luck and send good healing vibes

robinorbit

Hi Kathinohio,

I’m sorry you have to go through this again.

After my PCP gave me the results of core needle biopsy, I was referred to a breast surgeon only. She said I will not meet with radiation and medical oncologists until after the pathology report is completed post-surgery. I seem to have a similar tumor to yours, although I also have some DCIS—not sure yet how much or size.

Things are definitely slow going, with a couple weeks at least between every appointment. My initial abnormal mammogram was May 15. The appt with surgeon where we will discuss scheduling surgery will be July 14. I won’t receive genetic test kit until that date, so must mail it back to lab, and those results will take a couple of weeks. I don’t anticipate surgery before the end of August, so likely won’t even be meeting with the full team until mid September to discuss path results.

The waiting is sooo difficult, I know. Good luck with your surgeon appointment on Friday. Sending you good thoughts.

kathinohio

Hi Robinorbit--

Thank you for your reply. I think we are in a similar situation. Did they let you know you needed an MRI also? The surgeon's office called to let me know that someone will be calling to schedule that so I am still waiting by the phone.