Suggestions/tips on what to expect with a Grade 1/T2/N0/M0

gds

Hi everyone - looking to get support/suggestions/tips on what to expect with a Grade 1/T2/N0/M0 ER/PR+ HER2- Diagnosis.

Recently had a lumpectomy, Sept 29, 2020 - with 2 sentinel nodes and 1 axillary node removal - pathology shows no abnormal cells in safe margins or lymph nodes.

I am meeting with my Medical Oncologist for the first visit on Oct 19 - from my research sounds like an Estrogen blocker med will most probably be prescribed. I am post menopause so it sounds like one in the Aromatse family will be suitable.

My next meeting on Oct 23 is with the Radiation Oncologist - my understanding is that with a lumpectomy radiation is always suggested to ensure that any possible abnormal cells around the incision area is nuked. This is expected to commence approx 8-12 weeks post surgery - so late December 2020/early Jan 2021.

I do have a hematoma which is concerning - any suggestions as to how to deal with this - it's not 3 weeks post surgery - again it says icing is recommended.

Thanks in advance for your suggestions/tips and most important your support!

gds

Beesie

gds, welcome!

With an ER+/PR+/HER2- grade 1 tumor and being node negative, it's unlikely that you will require chemo. But given the T2 size, I expect that the MO's decision will be made based on the results of an Oncotype test.

Here is some info about the test: https://www.oncotypeiq.com/en-US/breast-cancer/patients-and-caregivers/stage-i-iiia-invasive/about-the-test

Although your pathology suggests that a low or intermediate score is most likely - which at your age (63, as per your other post) would mean no chemo required - sometimes there are surprises. So chemo is a possibility, although a low one.

Certainly being ER+, endocrine therapy (estrogen blocker) will be recommended. And yes, Rads is also sure to be recommended, since you had a lumpectomy.

The NCCN treatment guidelines are the gold standard guidelines used by most doctors in the States (and elsewhere). Here are the two pages that are relevant to your diagnosis, in terms of what comes next:

Note that the "21-gene RT-PCR assay" is the Oncotype test.

As for the hematoma, I know that they are usually left until they re-absorb and I don't have any helpful hints to get it to absorb faster. I had a hematoma develop once after a biopsy. I was developing so many large cysts in those days that my surgeon aspirated it, thinking it was a cyst. We were both a bit surprised when the aspiration fluid was red. I don't think aspirations are usually done, although in my case it worked out fine and the hematoma never refilled. Hopefully someone else comes by with some suggestions (but weekends tend to be slow around here).

There are lots of helpful threads on this site about getting through rads and dealing with hormone therapy (which is what it's often called although it's really anti-hormone therapy). As you get closer to starting those treatments you should search out those threads.

Jons_girl

hello gds. welcome to the forum. I was stage 1. Yes med and rads will probably be suggested. I hope all goes well for you in your recovery. We are all here for you.

gds

Thanks for your replies.

Has anyone been on Letrozole Hormonal Therapy?

Any feedback - my medical oncologist is suggesting this after Radiation - but I want to be proactive and get feedback.

gds

Beesie

Letrozole is the generic name for Femara. Here's a thread on Femara that you can read and join, although it may take you a while to read through it, since there are currently 344 pages of posts:

FEMARA https://community.breastcancer.org/forum/78/topics/726592

kathabus

Hi--I started letrozole in August. You'll read lots of different side effects, as it affects everyone differently. I was waiting for my life to fall apart after taking it, quite frankly. But honestly, it's been very tolerable for myself. I exercise for 30 minutes every single day, so maybe that helps the bone/joint pain that others have. I know there are others who do everything they can and have different experiences. I just write this because I want you to know there are women out there who tolerate it ok. Will I be telling a different story a year from now? Not sure.....so far so good.

Also...as you probably know....AIs deplete your body of estrogen, so bone loss can be an issue. I had a bone density test around the time I started it and then I get one every two years. I take a vitamin D/Calcium supplement.

quinnie

As kathabus said, the side effects vary. My MO told me that approx 50% will have some side effects. I only have hot flashes and I also exercise amost daily so maybe that helps. I have also gained 5 pounds but that could be due to my over eating during the pandemic and not the letrozole!!! To help with possible bone loss I also take calcium/vit D suppliments and weight bearing exercises. So far so good. I started taking it in June.

gds

Beesie - thanks for the detailed response.

I actually was finding the hematoma so uncomfortable since my lumpectomy is totally in the tail end of my left breast (in other words the armpit) - it feels like it's a ball in my underarm.

I decided to go and see my surgeon - who was kind enough to see me without an appointment and she is going to aspirate it tomorrow.

gds

gds

Beesie - thanks for the link - it's a great read!

gds

Quinnie - sounds like it's not too bad side effects for you!

Yes the Nurse Practictioner already suggest both Vit D and Calcium supplements while taking Letrozole.

Taking one day at a time - trying to look at the forest and not the individual trees - lol:-)

Much love to all my sis-stars...gds