So confused! Please help me understand some of this nightmare.

Dear Deborah,



Welcome to the group none of us wanted to join! You will find a lot of love and support here so please feel free to vent!



We have all been where you are right now and beleive me this is the worst part of the whole process. Your lost little kid analogy is absolutely perfect! I know this is hard, but try to take a deep breath. I know you want to protect your family from this but you are going to need all the support you can get so you are going to need to let them in and let them support you. My husband was also an instant angel and he was able to run interfearance when my family and friends starting closing in with the "you have to's"



First, can you call your primary care doc and tell hirm or her what has happened and ask for some xanax or lorazepam to help you get through? I know I wouldn't have been able to get through all the waiting for test results without a little help. Some of the ladies here also have gotten ambien to help them sleep at night too.



Try not to be hard on yourself, you are not being vain when you are upset about losing part of your body. This is really horrible, there is no question about it. You need to alow yourself to be angry and cry. People will also pressure you to be "positive" all the time like its bad luck if you aren't. Well, its ok to be sad and angry and scared because this whole thing sucks!



You may want to bring a third person with you to the oncologist to take notes. That is what my husband and I did. That way, he could take care of me and our friend could pay attention and ask the questions we were too numb to ask and remember what happened at the appointment.



There are tons of ladies here who are much better at explaining things than I am but I just want to say that we are all here for you honey!



Love

Robyn

Deborah, I'm so sorry you had to join this club.  When your family says "get surgery, the sooner the better" I think they are speaking out of a basic impulse, and a logical intuition -- but that is NOT the state of the art of medicine today!  Especially with a moderately differentiated (grade 2) tumor that is positive for estrogen and progesterone receptors, this is most likely a slower-growing, less-aggressive type of tumor, and you can take a little time to learn your options and decide on them. In my case, that meant a wait of 6 weeks was not a problem.  It's much better NOT to be rushed into a surgery before you learn about your options.  I think your oncologist will be able to confirm this -- or the doctor you saw on April 9 can confirm this in a phone call -- if you feel it will be helpful to have a literal quote from a doctor to convince your family that you don't need surgery right-this-second.  I had a grade 2, stage I, highly ER/PR positive tumor -- and the experience of the surgeries and loss of my breast was the BIGGEST hurdle for me.  For me, anyone minimizing the breast loss, and anyone "maximizing" the fear of cancer ("get it out right away") would have been the worst of both worlds, in terms of not "getting" what I was feeling!  I wanted to believe, based on the stage/grade and what my doctors were telling me, that I have a good survival prognosis -- and I didn't appreciate people who minimized what it meant for me to have a mastectomy (necessary because of tumor location).

[But, I will say, two years later, life is good!]

Hugs and best wishes,

Ann

Deborah,  I know you don't want to be here, but since you are it's a Wonderful place for support, guidance and friendships.  I'm really sorry to hear of your bc dx.  My dx is very similar to your's.  I was dx 12/07 with IDC--see notes at the bottom.  I chose to have a lumpectomy, chemo and radiation.  My oncotype score was 17, which is considered at the top of the low range.  So this meant having chemo would probably reduce my chances of a reoccurance by only 2-4%.  Though this wasn't much of a gain in % I chose to be very aggressive with my treatments and give it all that I had!!!!   And also since I was 42 (young age) at dx my oncologist thought I should have the chemo, I actually had 2 oncogolists tell me the same thing.  But at the end of the day it was my decision.  Chemo is not easy but doable!  If you choose to go this route you WILL survive it, I promise! 

Good luck with all your decisions.  Thinking of you.

Tiff

Hi, Deborah.  Hugs to you.

Everyone here is right.  For most of us, the worst part was waiting for the next step in our diagnosis or treatment, or waiting to find out more information.  I lived at this discussion board from mid-January through mid-June of last year.  (Well, I still sort of live here.)

You've received replies explaining most of your path report.  The little bit that has not been explained is this:  "The Scarff-Bloom_Richardson score is 6: Nuclear grade 2-2; absent tuble formation- 3; no mitoses identified -1."

The "Scarff-Bloom Richardson score" is an indication of the "behavior" of the tumor cells, based on what they look like under the microscope.  It is used to determine the overall histologic grade of the tumor.

Cells that look like normal breast epithelial cells and are not dividing rapidly, and that form the tubules one would normally see in breast tissue, are considered "well-differentiated."  They are less likely to grow quickly or spread to adjacent tissue.  Cells that have bizarre shapes and are dividing rapidly, and that do not form any of the typical "tubules" of breast tissue, are considered "poorly differentiated" (or undifferentiated).  Those are more likely to grow quickly and to spread.

Your tumor had a score of 6.  That's the sum of the individual scores for the appearance of the nuclei of the cells (the "nuclear grade") (2 of a possible 3), the amount tubule formation (3 of a possible 3, because there were no tubules), and the number of dividing cells (cells undergoing mitosis) (1 of a possible 3, because there were no dividing cells).  Your total score of 6 corresponds to a histologic grade of 2 (on a 1-2-3 scale).  As Deanna said, that's the middle grade, indicating "intermediate" differentiation of the tissue.  A grade of 1 would be better; a grade of 3 would be worse.

Here's a website with a nice explanation of the histologic grading of breast cancer, based on the Scarff-Bloom-Richardson scheme: http://www.imaginis.com/breasthealth/histologic_grades.asp

Be sure to ask your oncologist to explain all the details in your path report.  That's part of his/her job.  Actually, your breast surgeon should be able to explain the report, too. 

otter