Diagnosis & 2nd opinion questions

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imatthew
imatthew Member Posts: 206
edited June 2014 in IDC (Invasive Ductal Carcinoma)
Diagnosis & 2nd opinion questions
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  • imatthew
    imatthew Member Posts: 206
    edited July 2010
    Hi All, I'm writing on behalf of my wife who is a bit of a mess right now.  To make it short, she's 50, in good health, pre-menopausal, and no family history of cancer.  In June her doctor noticed a lump and sent her for a mammogram.  The mammogram showed three micro-calcifications, all in her right breast.  Last week she had a Stereotactic Core Needle Biopsy and ultrasound guided needle core biopsy.  This morning we got a diagnosis of three instances of DCIS and one instance of invasive ductal carcinoma (2 mm in size) out of four spots they found.  The radiologist advised us to have a bilateral breast MRI this week, then see a breast surgeon for next steps.  He said the MRI would also look for issues with the lymph nodes.He expects she'll need a single masectomy or lumpectomy.  The radiologist also told us that the ER and PR were negative, and that HER2 was positive, so he thought we would need Herceptin.This is a very busy, well-known radiology practice in Northern Virginia, so we're confident of their skill levels, that being said, I have some questions:1. I assume we should get a second opinion.  Should we wait until after the MRI?  Can anyone recommend who we go to for a second opinion?  I'm thinking Johns Hopkins or UVA.  Does Vanderbilt-Ingram do remote consultations?  Should I contact Dr. Lagios?  Do we go to our radiologist/pathologist and have them request the 2nd opinion?  What is the normal (if there even is such a thing) process for getting a second opinion?2. What questions should I ask the surgeon?  3. If the Lymph nodes are clear, does that mean no chemo?  If they aren't, is herceptin all she needs to worry about? 4. How much of a hurry should we be in to start a course of treatment?  If it takes an extra 2-3 weeks for a second opinion does that considerably raise our risk?As you can all imagine (and as you have experienced from what I've read so far today), this is all overwhelming.  Any help/support/advise is greatly appreciated.
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  • twinpeaks4me
    twinpeaks4me Member Posts: 16
    edited July 2010

    imatthew,

    It's wonderful that you have become the spokesperson for your wife.  My husband did the same 14 years ago when I was diagnosed with large B cell lymphoma.  I was 44 at the time with 3 children living at home.  I commend you for doing what she and I were unable to do at the begining.  From experience, it can take time for some of us to get aggressive in our medical care. In September, I was dx with breast cancer.  Mainly DCIS and a  6 mm area of IDC.  This was probally the result according to my doctors of the mantle radiation I received 14 years ago.  I'm hoping to be a 2 time cancer SURVIVOR!

    That being said, how close are you to Georgetown University Medical Center?  My oldest is being treated/watched  for a rare form of lymphoma for his age.   The Lombardi Cancer Center there has a wonderful reputation.  My thoughts would be for her to have the MRI first and then bring all the findings for a second opinion.  Usually they schedule pretty ASAP.  She shouldn't have to wait 2-3 weeks.  The begining is the hardest.  Once a treatment plan is in place, she will begin to feel like she is fighting the BEAST.   I personally went with the second opinion doctors and have not looked back.  She ultimately has to make the decision of her treatment.  We the patient try to have someone make it for us, but the decision has to be hers!  

    Hope that this has in some way helped a little bit.  Know that I will be thinking and praying for her and you.  Post back when all the visits are finished and a treatment plan is in place.

    (((((hugs)))))

    Leslie

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  • thegoodfight
    thegoodfight Member Posts: 560
    edited July 2010

    My first piece of advice...............breathe.   Okay, now my second piece is to tell you with both dcis and idc you have time to make decisions.  Most of us went through a diagnostic process and in some cases it was months before treatment decisions are made.   I know this is all overwhelming.  No matter what our age, the diagnosis knocks the wind out of all of us and our family members.  I also strongly suggest a second opinion for the obvious reasons, but it serves another purpose.   I will say that I did have a lumpectomy right away about a week after diagnosis and didn't get my second opinion until after that surgery, a few weeks later.  In my case I felt it was a no brainer that it had to come out and every doc would have agreed.  I then went to Moffitt CC in Tampa (I live in south Florida) because I just felt I should.  This was the biggest thing that had ever happened to me and I wanted to make sure I was doing it right.  The oncologist at Moffitt was in complete agreement so it made treatment choices a little easier.  But..................here's the bonus I didn't plan on.  When I hit some bumps in the road during treatment, my local oncologist consulted with my Moffitt onc and they came to decisions together.  I now see both of them a couple of times a year and feel I am being well taken care of.  So even though I had the lumpectomy in July, I didn't start my course of chemo, radiation, arimidex until early October.

    All the cancer centers you mention have great reputations.  Personally I know women that have used Johns Hopkins and were pleased.

    We are all with you during this difficult time and I can promise you that it will get easier as you go forward.  The uncertainty and waiting are the worst parts.

    Hugs to you both................................................Caren

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  • imatthew
    imatthew Member Posts: 206
    edited July 2010

    thank you so much for your responses.  We've started the paperwork to have Dr. Lagios review our test results, we're also going to call Johns Hopkins for another opinion, and we have our first surgery counseling appointment set up for the week after next.  We will keep you posted.

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