Birads 4c after normal screening mammogram

tntnsd

I am recovering well with my MX surgery. I will have my post op appointment with my surgeon, have the drains removed mid next week; and will have video-appointment with my MO as well. The last several days, I am alright, surprisingly calm; however, last night and now I start to worry about the likelihood that I will need chemotherapy if pathology report turns out to be IDC (or even with (multifocal) DCIS with no lymph nodes). I started to read many threads about chemo, on this board, i am freaking out again. People around me seems to think now that I had my mastectomy, the worst is behind me, I just don’t have the energy to explain that is just the very first step to fight breast cancer. I am looking for some assurance that chemo is not as bad as it sounds, and it will be done soon

Is it normal to feel scare in waves like this ?

Beesie

Yes, it's normal to feel scared in waves.

As for chemo, keep in mind that even with an invasive cancer diagnosis, chemo might not be recommended. It depends on the pathology, including the hormone and HER2 status of the invasive cancer. Even with positive nodes, if the cancer is ER+/HER2-, chemo isn't always recommended. And if the final diagnosis is DCIS, no matter how much you have and no matter how aggressive it is, chemo is never given. DCIS is a localized disease; chemo is a systemic treatment, so there is simply no reason to give chemo for DCIS.

And if you do need chemo, there are lots of people here who will tell you that their own experience with chemo was not as bad as they feared. I was just reading a thread yesterday - one where someone will be getting chemo and is very scared - and people came on to assure her that chemo these days is not the way you think of it from the old days.

Take it one step at a time.

Fingers crossed that your final pathology is a good one!

tntnsd

I got to tell myself every day:

“Listen to my husband, don't over worry. Just one step at a time.

Listen to Beesie, take one step at a time.

Listen to everyone else, one step at a time".

Darn it, I need to listen harder.

Thanks Beesie, for reassurance that chemo might not be as bad as it was in the old days

LivinLife

Maybe it would help if you put a sticky note or two or three with a word or two that reminds you grounding words, phrases, etc. If you choose what helps you will only need a word or two to remind you of the full sentence or so... You could put these in places around the house you often are.... Just some ideas while you're waiting. I hope the appointment is early next week?

MinusTwo

LivinLife - Love the sticky note idea. How about "let go of what you can't control" or "treat yourself with love". I have a short list of tips for self care taped to my bathroom mirror and those are both prominent.

tntnsd

Thanks LivinLife and MinusTwo, I like the suggestion about the sticky note. I will try that.

I should have the pathology report by next Wednesday (I think). Fingers crossed and praying hard for a good one

tntnsd

My breast surgeon nurse just called about my pathology report:

No invasive (no IDC). It remains DCIS stage 0.
Margins clear 4mm. Negative lymph nodes. No further surgery.

ER positive,

She said the report did not mention anything about PR, or HER2 status (am I correct to think since it mains DCIS, they don't check for HER2 ?)

I am so so relieved with this . I feel like a huge burden lifted off my shoulders.

I am looking forward for the official report shown up in portal and go over that with my doctors this week. But this is the best outcome that I am praying for.

Thank you all you wonderful amazing ladies who were helping me, sharing your wisdom, experience in this path. I can't imagine how would I be without your help, comfort.

From the bottom of my heart!

2019whatayear

Great News! Celebrate!

Beesie

That's great news!

And you're right, with DCIS, the HER2 doesn't matter. Some pathology reports provide it, some don't, it has no impact on the treatment plan or prognosis.

With ER+ DCIS and having had a UMX, it's possible that anti-hormone therapy will be recommended. But if it is, it is mostly as protection of your remaining breast, to reduce the risk of the development of a new, separate breast cancer there. Once any of us have been diagnosed one time, our risk to be diagnosed again, with a new primary breast cancer in either breast, is higher than average. For your current diagnosis, with pure DCIS, your risk of a metastatic recurrence is virtually nil, and after the UMX with 4mm margins, your risk of a localized (in the breast area) recurrence is only 1%-2%. Anti-hormone therapy can reduce both those risks but they are already so low that the benefit would be extremely small (at most a 1% risk reduction on the localized recurrence risk). So protection of your remaining breast is the only reason to consider anti-hormone therapy, with this final diagnosis. And that is the only other treatment that might be considered after a UMX for pure DCIS.

tntnsd

Hi 2019whatayear,

Great news indeed. So much to thankful and celebrate. I will continue to pray for all of us who are facing this diagnosis to have strength and good news along the way

tntnsd

Hi Beesie,

You always amaze me on way to help me and othersthrough this. You make it so easy to understand the diagnosis and what to expect with the treatment. THANK YOU.

LivinLife

Soooooo happy for you!!!!!

tntnsd

Thank you LivinLife. I wish that more and more moment of good news under circumstances like this will occur to many of us. Truly!!

sasamat

That's so fantastic! I also want to thank you for sharing the steps along the way. It's helpful to others to explain all of these diagnostic paths and how they end up. I wish you a continued smooth recovery.

tntnsd

Hi sasamat,

It’s been a roller coaster for last few months, and boy do I wish no one, absolutely no one have to go on this ride !!!

Being able to share my steps, learn from people who were in my shoes are what getting me through the stressful time. If my sharing could help another woman, that’s the least I could hope for.

Thank you for your wish on the recovery.Best wishes to you too.

everythingwillbefine

Hi tnt,

So happy for you!!!!

Are you going to take Tomaxifen?

tntnsd

Hi Everythingwillbefine,

Thank you, I am very relieved with the report. Could not have asked for a better outcome.

Yes, I will give Tamoxifen a try (staring next month) to protect my remaining breast (my oncologist suggested it for 5 years) . I hope I can tolerate side effects of it well.