Questions to ask?

What is a sterotactic biopsy? It also occurs to me, IF they do find cancer, and IF they don't find clean margins around the lump, what about lymph nodes? When my mother had her mastectomy, they removed her lymph nodes. She had a lot of trouble with her arm and it swelled to twice the size of her other arm. Granted, she didn't stay on top of this like she should have, but I must admit that I find that problem as or more intimidating than sacrificing the breast. What cause that? Can a biopsy of the lymph nodes affect the arm or is it limited to removal of the lymph nodes? Will I be asked to agree to a lymph node biopsy before they undergo the initial biopsy just in case?  Thanks, I covet those prayers!

The surgical consult was yesterday afternoon, and the surgeon's prognosis was grim. Because it is visible without touching, and he had had the benefit of previewing the mammogram, he sat down and stated that if he were a betting man, he would put money on it being a malignancy. He explained that the size (3.3 cm) in conjunction with the dimpling, on top of the mammogram views and visibility gives him confidence that this is not an IF but rather a question of what type of cancer and how involved the lymph nodes may or may not be. My surgery will take place next Thursday, June 4 at 9:30am. After he saw me, he was very much in favor of scheduling the lumpectomy asap. We had to schedule the surgery at a time that a pathologist was available to do the frozen section.

We have agreed to try and save the breast. As it was explained to me, the surgeon will remove the lump, pass it off to pathology, who will determine if I have clean margins or not. Then they will perform a sentinal dissection which will again pass off to pathology. If there is cancer involvement, the surgeon will then deal with the other nodes. His nurse has just confirmed for me that there will be no radiation done at the biopsy. Instead, the radiation will be done within a short time after the lumpectomy. She also told me that radiation is a mandatory procedure. If they find cancer in my nodes, they *may* recommend chemo before radiation. The surgeon explained to us that the tumor sits adjacent to my lymph nodes so he has a concern that the nodes may already be involved. In the event of the worst case scenario, a mastectomy will not considered unless deemed to be necessary  after the chemo therapy at which time they will also begin reconstruction. I'm comfortable with that because it affords me some time to wrap my head around it, and I don't feels as though anyone is rushing to judgement.

My husband is already a basket case. He hasn't stopped crying since we left the doctor's office. I have arranged for some close friends (also cancer veterans of a different sort) to sit with him while I am in surgery. Dealing with his pain is going to present a whole different ball game that I will need to figure out.

As I just spoke with the nurse on the phone, I asked her if I could be handed off to the Susan B Kolman clinic in nearby Peoria for radiation and/or chemo if that were necessary.  I'm assuming that they will be the cutting edge on cancer treatment in our area, thus my chances of survival would be greatly improved. The surgeon's office is in agreement with this. I liked the surgeon and felt comfortable with him.

The chemo treatment may present yet another piccadilly, because I have a significant number of health ailments, not the least of which includes cardiac issues and kidney disease. Another reason for going somewhere well-versed in such matters and thus better able to design a treatment specific to my health issues if necessary. 

 I'm thinking that a lot will depend on the type of cancer that it is in terms of aggressive or otherwise, so the fat lady hasn't sung yet, Any explanation will be preferable to this limbo that I appear to be in currently. I'm ready to move forward and can't do that until we cross this next bridge with the surgery.

BTW, I brought up pet scan to the surgeon and he did indicate that they do them, although he seemed to minimize by saying that they do MRIs, Pet scans, etc but the important thing is how it is treated, not how it is found.  Perhaps whatever that was that I was sensing might be because I think the only availability for a pet scan in in Iowa City. Not sure why, but I'm thinking that if I am handed off to the Kolman clinic or Iowa City (depending on what our PPO will agree to) they may be more receptive to such a scan without the arm twisting. 

Is there anything I need to know before the surgery aside from the obvious?

The biopsy is over, frozen section complete, paraphrased verbal version of the pathology report recited. I will up to the next level. I hope I don't see you there if ya get my drift.

Thank you.