Newbee with IDC

I start with this website -- look at the links on the home page (like "understanding breast cancer" and "treatments and side effects") -- that will probably generate some questions of your own.

Clean margins are good, you're on the right path.  I'm not sure why they chose the steps they chose but getting the lump out with clean margins is a good start. When I had my lumpectomy they took some lymph nodes... did they not do that for you, or are they just waiting on results?  Sorry, I just wasn't sure from what you posted. 

My first questions were very basic:  what type (you know that already), what stage, what grade, the HR/PR/HER stuff.  

There are tons of questions and I'm sure others will have more suggestions but part of it will stem from the details of your diagnosis.  Chemo may not be needed for you but if it is, there will be lots to ask about that (port?  what kind of chemo, how often, what are the SE's and how will they help you manage them?, and on and on). 

One thing that helped me a lot was to take a notebook with my questions and write down the answers.  Also, if you have someone you feel comfortable with going with you, sometimes it's good to have a second set of ears alone.  Everything for me was so sudden, happened so fast, and was so overwhelming. 

If they aren't answering your questions in a way that you understand, keep asking.  Remember, too, you can go for a second opinion if that would make you more comfortable.  It really helps to have a bs and oncologist that you trust and that are supportive.  The nursing and other staff is important, too, because you may see them more than your drs.

I know this isn't much help but I'm sure others will have some good thoughts for you.  Best of luck and a big hug.

Usually they do both at the same time mainly so they don't put you under twice. But I do understand that maybe because you didn't have a biopsy first they didn't know what they were dealing with. No need to remove lymph nodes if it's not needed.

It takes at least 1 week to get the path report if I remember correctly depending if they do it on site or have to send it out… HER2 status can take longer because they have to send it out to a special lab.

Tideknott,

I had mammogram, then ultrasound, spoke with four doctors (I have other medical problems that I could not have radiation.), they with two weeks had a fine needle biopsy, that came back IDC, 1cm but grade 3 and ER+,PR+, were 100%, then I had one lab say HER2 positive, I had may results in four days.  Then I was told that surgery and mastectomy would be my best bet given my other medical problems.  So they did the mastectomy, and sentinel node biopsy, and Onc test all at the same time.  Then I got an infection immediately, because doctors didn't listen to me and my Immunologist and felt it would be okay, it wasn't I had to spend a whole 7 days in the hospital.  While in the hospital they told me nodes(5) were positive, and the HER2 was questionable it was 2.5, Onc was 20.  So they said while I was in the hospital anyway they had to do another surgery for auxiliary nodes, under arm and side.  So five days after iv antibiotics they did the surgery and wah lah more cancerous nodes.  In the short time from discovery of mass and actual surgery it grew to 3.9cm.  After three weeks I did chemo ATC from June through September.  But I had complications with health so they stopped in September.  Now they say I need more tests etc.  It was so different than most women with the same cancer and the steps they took with them.  What I find it should be what is best for each woman, it's sometimes similar steps, and medication but with others it's a whole different ball game.  Don't worry.  Search your own heart and mind and do whatever it takes to rid yourself of this cancer.   You must do the steps and treatment in your time frame and what you feel will work best.  A lot of women have chemo first then surgery and some vise versa like my self.  It's really up to the way the doctors and cancer center work where you are getting treatment in.  Dr. Oz said last week that if you can drive to a larger city with labs and doctors who do at least 5 a day and treat thousands a year will be the most up to date with how to treat and what will work with your diagnosis.  I hope this helps at all.  Keep knowing that this too will pass and you can always speak with women on this site and friends and family, I will make it through this a stronger woman.  I learned more from women who had come before me than from any doctor or nurse.  Sisters in the Same Time Frame if you read that site for IDC you will see all the different ways people are being treated for the same diagnosis.  It might give you some deeper insights to which way you want to go with treatment.

Take Care!

   M 

Take Care and Good Luck 

A. Right Breast, core biopsy:
- Invasive Ductal Carcinoma of Breast. See Note
- Nottingham Histologic Score: 4 (Grade 1/III)
(Tubule Formation: 1; Nuclear Pleomorphism: 2; Mitosis: 1)
- Tumor Size: 10.5 mm in greatest linear dimension on one core.
- Lymphovascular Involvement: Not Identified
- Perineural Invasion: Present
- Focal Ductal Carcinoma in-situ (DCIS) of breast (<1mm), cribiform type, low nuclear grade, without necrosis.
- Rare microcalcifications are associated with invasive carcinoma.

Note: Immunohistochemistry for SMMHC demonstrates loss of a SMMHC(+) myoepithelial cell layer in the invasive component, supporting the diagnosis. Additional studies for ER, PR, and Her2/Neu are pending, and will be reported as an addendum.

UPDATE:
ER: Pos
PR: Pos
HER2: Neg

Thanks so much Renee and Cuetang for your posts and concern. We were at Shands all day yesterday and met with Dr. Spiguel from Shands and found that she thought that it is a nice littel slow grower and that as long as no sentinel node involvement was observed during the lumpectomy, then the Intrabeam administration of high dose radiation on the site of the excised tumor, should be all that is necessary. She uses a 5cm orbit shaped device to zap with radiation during surgery. Of course, all of this is great news, so far. Rad performed a MRI with some contrast for the nodes to identify any other unforeseen hotspots. Waiting this morning for results...It seems that she is a conservationist and I am very hopeful that this will be our eventual course of action. Here is a link regarding her past experience....

On the way to the appointment, I called the Moffit Center in Tampa. Dr. Cox is no longer practicing (Doing mostly research) but I had read that Dr. Kiluk was a good one down there.
Paintedlady and Tideknott both seem to like him and I had read other good reviews. The only thing that is a little bothersome is that he cannot see her until next Thursday. So another almost 10 days before he can take a look. I am having Shands send the slides, films and all results down to Moffit and asking them to fax a copy for our folder as well. (Per the “just diagnosed - get prepared” post. (great stuff) Now we just have to wait on the MRI and to meet with Kiluk. Do you think 10 days more is a problem? I know she would like to get this thing out of her.

Still waiting on results.  MRI's Wed and Thursday.  Doc was to call last night after surgery, still no call this morning...waiting on the call sometime this morning, hopefully.  She has dense breasts and expecting some false (hopefully) positives.  You all were right..the waiting is the worst part.  She is nervous this morning.