Path Reports - Do they ever reveal something Different?

Shayne- you won't have lymph nodes checked because you have dcis, I think

If the initial testing shows only DCIS and you have a lumpectomy, they will usually not test the nodes. If the path report from the lumpectomy shows IDC, they can go back and do a SNB. But they go with the odds and avoid the nodal surgery initially. If you have a mastectomy, they will usually do a SNB with the surgery because they cannot go back to do a SNB after a mastectomy.

Shayne...I had a mastectomy. I can't recall what surgery you are having.  If you are having a lumpectomy, they probably won't check the nodes (I am not 100% sure of that, so maybe someone else can speak to that further?). 

If you have a mastectomy, it is standard to do a sentinal node biopsy.  This is because once the breast is removed, if the final path report shows idc, they need to check the nodes.  But at that point, it is impossible to tell which is the sentinal node (the first one to drain from the breast) and they would have to take lots and lots of nodes.  At least that is my understanding.

With a prophylactic mastectomy, it is not standard to do a sentinal node biopsy.

 As to your question about the final path report...I have seen several women on these threads who went in with one dx and came out with another.  It is not the norm.  But it happens.  But as to your anxiety...cross one bridge at a time.  You only can go forward with the information you have now.  It is the best available info.  You and your doctors have no crystal ball.  No one does in life.  So try to let go of the uncertainty and cross those bridges if you come to them.  It is enough to simply come to terms with what you've got so far...

Please, remember the sunshine, good food, good music and time and space to cry...

Thinking of you.

Claire

I have been reading several threads on the boards. I came to this one in particular because I have been newly dx with DCIS and may perhaps find some sort of support or just a way to keep my spirits bouyed during this time of uncertainty. The first 'shock', was being called back for a diagnostic mammogram. Imagine my surprise when the radiologist showed me 3 distinct clusters of microcalcifications, one of which is in the retroareolar area that had not even shown anything in the prior years mammogram. I saw faint microcalcifications scattered in a few places on my prior mammogram, but wow....these buggers really proliferated in one years time....My dumb comment of the hour....."so we'll just re-examine this in 6 months?" HAHAHAHA Within 2 days I was having my sterotactic biopsy and 4 days later the path report came in with a nice mixed bag: DCIS, nuclear stages 1 and 2 with papillary, cribriform types and one area with solid, papillary, cribriform types with comedonecrosis. There remains another cluster medial to the comedo site that could not be localized for biopsy........yeah a little more than concerned about that. First surgical consult tomorrow. The journey begins.......

sandpiper1, You are at the worst stage of your treatment now. The fear of the unknown is awful. Once you meet with your surgeon and have a treatment plan, you will feel better. We are here for you every step of the way. Do you have a medical oncologist yet? My primary care doctor recommended one for me and I met with him the day after I saw the breast surgeon. Just knowing what lay ahead helped me tremendously. I remember a staff member at the oncology office saying on my first visit, that no matter what was wrong with me, I was in the right place now. Those words made me feel so much better. Sending hugs to you.

Thanks all. Shayne, I am so glad they could remove everything with the biopsy. I am planning on a bit of the unknown.......well...who really plans for that? HA! One thing for sure, I am thankful that I am able to get appointments in such a realtively short time frame. I will be getting two surgical opinions within the next 2 weeks. My first visit tomorrow is at a university cancer center with a surgeon who has very low seroma rates. I have a few MOs in mind, but will most likely wait until i have more definitive results from the surgery before meeting with any. As my journey begins, I realize I am really vulnerable...and it stinks...when most people see me as the strong 'ONE'. I have never had a surgical procedure......I am anxious about this.....funny how I have prided myself on being 46yo and never having been under the knife! 

I deal with life's curve balls with a great deal of humor........and do a bit of crying when I am by myself. That said.....here's some of the caveats about tomorrows big new adventure......

I get valet parking upon entering the center. (I need to go clean my car!)

I will be personaly greeted, registered and lead to the resource center for my leisurely browsing of written materials, computers for patient use, intro to an array of classes and other support resources. I will then recive my own personal escort to orient me to the facility and take me to my physicians office on the third floor. I have told my sister that she is not to interfere with my 'first-time, princess patient' experience. 

I am going to clean my car, spit shine my tiara, decide what to wear and get a fresh notebook and pen ready for tomorrow. I think I'll procrastinate a bit longer on that list and get out into the sunshine for a nice long walk........Thanks for your support folks......I hope everyone enjoys the day....

To Elizabeth: I thought a lot about your remark on getting to an MO early in the game. TY.

To Shayne: I am not a vain person, however, isn't it funny when we have medical appointments we shave every inch of our bodies, do up the hair, and find a comfy yet cute outfit as if we are going on a date. LOL! You have had your surgucal consult, but have you actually scheduled the surgery? Did they give you a time frame they would like to perform the surgery? Even though I am the type to plan things and get the job done, a part of me would like to delay the surgery too. Another question to add to the never-ending list. 

Honestly........I have never ever had surgery......it scares me....to pieces. It also scares me that there is a small chance that there may be more to this than pure DCIS and delaying surgery would put me at further risk. Bleh.........

I find it interesting that they did hormone receptor status from your biopsy. When I asked about mine, the office nurse told me that would be done on the surgical specimens. I had my biopsy done at a facility known for breast cancer care.....more confusion. I am also confused as to why my radiologist did not tell me there was a site adjacent to one of my biopsy sites that was not accesable. I also did not have a follow up MRI, but a FU mammogram after the biospy. My report states they could not see one of the clips placed at the retroareolar site and that the marker for this area would be the residual calcifications. I am feeling ultra sensitve-this I know-I just think I should have been made aware of these small details at the time of biopsy and not read the copy of my report they sent to my Gyne doc.(I obtained a copy from the breast center-I really wanted the complete path report-but did not realize what they gave me until I got home) I have not yet spoken to my primary gyne. They had one of her associates phone me after the breast center called and I was not armed with any questions at the time. 

At this point I am not sure this is relevant information or not.??? I am wondering if anyone has ever chosen medical management or active surveillance for a short time in lieu of immediate surgery? 

Heh, you all know I am aware I cannot side-step the surgery, but I sure would like to.