invasive ductal carcinoma.....what now?
So, I just got the call from my biopsy. Invasive ductal carcinoma. That is all I know so far. Any suggestions on how to prepare for my next appointment with the breast specialist? The tumor is 2.5 x 2.2 destruction of fascial planes and all that good stuff. There are so many words that are read to me and yet when I ask a question I'm told "we don't know yet". I would like to have both boobs removed. I don't want to mess around with "let's see if we can get it and preserve as much of the breast as we can". I have considered this ever since I first felt this dumb lump. I just want them gone...like yesterday lol. I know it doesn't cure all but that's just what I would want done if possible. What are the key words I should listen for in the meeting with the specialist? What questions should I ask (I'm really good at asking a gazillion questions lol)? I understand there is a possibility that it may have spread to other organs. I'm Okay with my diagnosis, it's obviously not what I or anyone would want...but I'm Okay and I will fight it with everything I have. Now, IF it has spread to other organs, what then? Are there certain organs that will drastically change the survival rate more than others? If so, which ones? I know that some people will consider this "getting ahead of myself" but I am one of those who need to know every possibility and hope for the best but prepare for the worst. I feel like if I know the worst that it could be, I am prepared and any news different will be like a happy surprise. I'm not trying to be a downer but so far every time I go for something it's worse than what I thought it was going to be and I start the whole in shock thing all over again. I have had swollen lymph nodes behind my ear and stuff so I'm kinda thinking that it may have spread....don't know. That was about a month ago and PCP gave me antibiotics thinking it was just an infection. I hadn't felt the lump at that point so we didn't even consider the possibility of something else. So......I'm going to get in bed and cry a little more and then I will be back and hopefully get some advice about questions to ask and steps to take from here. I'm not going to lie, I still have a little (sometimes big) meltdown every once in a while but it passes and I feel strong again. I know the doctors will help make a plan and stuff, but I'm sure that I can avoid mistakes and unanswered questions after my appointment with the help of people who have been through this. I know that people are always afraid of scaring someone when it comes to this and they are afraid of saying to much, but I'm pretty strong and I like to know everything and be prepared for any possibilities. I feel that knowledge is power. I'm not trying to get carried away with myself or anything, but the more I know when i get to the specialist the less time will be wasted trying to teach me what everything means and what my choices are. I can get this bus moving down the road of recovery faster maybe! I'm not good at waiting for the docs or ANYTHING, I have even been known on occasion to sneak a peak at Birthday or Christmas presents and I'm 45 years old.....kinda pathetic huh lol.
Comments
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Hi Annie;
We are so sorry to hear of your diagnosis, but you've come to the right place to get support and answers! We know there will be some other members offering advice and encouragement soon.
In the meantime, you may want to check out the main Breastcancer.org site's list of Questions to Ask Your Doctor about Your Diagnosis to help you prepare for your appointment with the specialist.
Please keep us posted on how everything goes!
--The Mods -
Hi Annie -- sorry you hear you received confirmation that you have IDC. You will get through this, but its going to take some time.When you meet with the breast specialist (assuming that's a surgeon), he/she will likely go over the next steps in the plan. You might ask him/her to provide you with an expected timeline. A lot of women do surgery, then chemo (if required), then radiation (if required), then hormone therapy (if required.)
If you end up having a choice re: lumpectomy vs. mastectomy, I would encourage you to read the threads on this forum. Lots of good discussion there to read and listen to your body/gut as well.
The percentage of women diagnosed with breast cancer evident in other organs at the time of initial diagnosis is small -- like 5-6%. Some centres check for spread and some don't upfront. Find out what your centre does. I understand that its impossible not to worry about, and if you are like me, everything in my body started to hurt when I was fine before!
Good luck -- come back with your specific questions.
Ridley
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Hi Annie,
So very sorry to hear about your diagnosis. I am 45 years also and everything in your previous thread and your post above really resonates with me. I remember the beginning phase of all this some 2 1/2 years ago like it was yesterday. I too had a lot of questions and found this website to be a wonderful resource. My advice to you besides taking a deep breathwould be to get a 2nd opinion for everything and don't be afraid to ask lots of questions!
Start a binder ( I am a little bit OCD so I like to get everything organized) I got plastic sleeves for all of the reports, I also found vinyl CD storage for all the discs that are three hole punched (ask for all your CDs from any scans and MRI's), and lastly I keep all the Drs business cards in a separate sleeve. -
Hi AnnieeC,
I'm sorry to hear of your diagnosis. I also had IDC and Her 2+ in 2011. My tumor was over 6cm and had spread to my lymph nodes. I went through 6 rounds of chemo, rested a month, had a right mastectomy, rested a month, radiation, rested a month, then resumed another 7 rounds of one of the chemos. Just last Monday, 10/7/13, I had a left mastectomy for prophylactic reasons and began stage 1 of reconstruction. My reconstruction was delayed due to my staging (Stage 3c).
I believe, as it was in my situation with my team of physicians, once you've been diagnosed it's up to you whether or not you have 1 or both breasts removed. I agree with you on not wanting a "partial" mastectomy. That would scare me to death. But let me tell you, as advanced and spread as my cancer was, I STILL SURVIVED. I kicked butt and won. With prayer, family, friends, and tons of support, I beat it. I have been cancer free for 2 years now and I believe with all of my heart that I will continue being cancer free for the rest of my life!
Ask as many questions as you want. This is your life and you only have it once to live so ask away! The best fighters are those with answers and the only answers come from those who ask. I even asked my oncologist, "Am I going to die?". She smiled very sweetly but boldly said, "Not on my watch". I would ask the craziest questions and she would answer them the best she could. She never left me in doubt of what was going on, what was next, and what I should expect.
So I said all that to say this: you ask every question you think of. If you don't get the answers you need, not want to hear, but need, find another team. You deserve the best.
Take care and God Bless You!
Bethany
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You came to the right place. This forum has been so helpful to me. I got most of my information here that doctors neglected to mention. Do lots of reading here and keep coming back for support. The women here are amazing.
I had both boobs removed even though I only had a lump in the left. I had huge boobs so I would have been unbalanced with only one. The surgeon told me after surgery that it was a good choice since the other one showed precancerous characteristics.
Does your biopsy report show whether you are hormone positive or whatever they call it when treatment involves hormones? Triple negative (no hormone receptors) usually requires chemo post mastectomies. -
I do ask a lot of questions!! I ask and ask until they break down and just give it to me straight. Both Radiologist where grilled by me and they both said that they thought it was malignant and the 2nd one said invasive also. I had done my research enough that I knew that they could make a pretty good educated guess about what they saw and I wasn't going to leave until I had their opinion. I knew it wasn't fact until biopsy came back and it was just an opinion and I told them that. A lot of people seemed shocked that they would share as much as they did, but they were right and I am so glad that I was prepared for what I heard today. I even took my radiologist report with all of the words that were foreign to me. I got online yesterday and found some of the manuals online that are used for someone studying to be a radiologist. I read as much as I could and found a section that listed ultrasound findings that indicate malignancy. There were about seven key things they look for in malignancy and my report had stated 5 out of the 7. So even if the radiologist hadn't said a word, I'm so stubborn I would have figured it out anyways lol. I knew what I would be told today pretty much. -
where I am a radiologist would be fired for giving you that information. They can't really know for sure before seeing pathology so it was a gamble. I am glad it gave you a bit of relief for being prepared but it could have been ugly had they been wrong.
Did the pathology tell you whether it was hormone receptive? There are so many different types and grades and stages that you need to be sure what you are dealing with before you do too much investigating. It gets scary out there on the internet. Once you have things narrowed down there are many many knowledgeable women on here who can help you.
Again sorry you are having to deal with this. :-( -
Annieec,
I am so sorry you are here but you will get thru this. I was also diagnosed with IDC in 2011 and chose to have a bilateral mastectomy. While I know things seem scary right now, please know that it is never as bad as we anticipate. I was nervous starting treatment but found it much easier than expected. I had surgery and am now taking Tamoxifen. Totally agree with Babyswim about the treatment binder and recommend taking a friend or family member to the initial appointments. You will be given alot of information and will likely only retain a third of it. Take your moments as needed and reach out with any questions as need be.
Sending hugs.....
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The only part of the test that came back was that it is invasive ductal carcinoma. They said the other information will come in a few days, for some reason that takes longer. The imaging place that I went to has something called a patient portal and all of your appointments, diagnosis, lab reports, names of doctors, phone numbers and addresses included go onto a page that is assigned to you and you can log in at anytime to look at upcoming appointments and lab reports and all! Everything I have done and all of the doctors will then log into my account and enter their report or whatever. It tells me when I have a appointment and also allows me to fill paperwork out online on my account prior to going to my appointments. I'm so glad because I can't keep all of this straight! I am grateful for all the people who are helping me but for some reason just trying to recall any of their names right now is a chore. -
Some of the other info you will receive is whether your cancer is estrogen or progesterone receptor positive or negative, and whether in is HER2 positive or negative. This helps with treatment planning. In terms of spread, they will likely do something called a sentinel node biopsy when you have your surgery - they take one or more lymph nodes to see if the cancer has spread. You won't know that until after the surgery. Talk about everything with your doctors and don't rush into anything. Mastectomy and lumpectomy + radiation are equal in terms preventing recurrence. Good luck on this journey. -
I just read that about no difference with mastectomy vs. lumpectomy. I still can't help but feel like I just want them gone. My husband is going to be home soon and now I have to get myself together enough to help him digest this. I'm working on making some sugar paste flowers today (I enjoy making cakes and decorating them as a hobby mainly). I was making the flower (a peony...not that it matters lol) and it hit me that I had just spent 1/2 hour not upset! Then I got upset again. What a emotional roller coaster ride! I feel like if I stop thinking about it that I'm ignoring it and in denial. Sounds weird, huh? I just spoke with a lady from the American Cancer Society and she had me read her the size of the tumor and she said that means I'm stage 2 as long as it hasn't spread. Wow, I'm halfway to the last stage is the first thought that came to mind. I bought a life insurance policy on my husband a couple of years ago but not myself.....silly me, I thought I was healthier than him and going to live forever. UGH. He is a such a wonderful husband, I wish I would have gotten one on me. -
AnnieeC, I think you are ahead of the game just because you can express yourself. I think it helps so much as far as emotional health goes. We are all nuts from our diagnosis but some of us get stuck in "scared stiff" and shut down. I think it is good that you have come here to share how you are feeling. It is good for you and good for us to read. -
Being stage II does not mean the cancer is going to kill you. They really can't give you the stage and grade of your cancer until you get your pathology results back after your surgery be it lumpectomy or mastectomy.
I had a lumpectomy first and then ended up having a bilateral mmastectomy.
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I thought "grade" was based on the tumour size and "stage" was about whether it was contained or not? I think that was what the surgeon told me but i may be remembering it wrong. -
AnnieC.. sorry you have to join us but glad you found this site, this has been a real blessing for me. I chose mx, but not bimx, but everyone is different. my idc was very small but the bad part was it is grade 3 so that is one reason I did what I did. I had my surgery, consultation etc at mayo in rochester,mn. They told me there is just a slight advantage in mx over lmpx but I really did not want radiation, especially on the left side where heart is.. I would have surely had it had my stage been higher and if they insisted. Stage ll is still considered early so dont get too far ahead of yourself.. they gave me an indication of what stage and grade where but made it very clear that the final pathology report after surgery is the one to go by, turns out in my case it was head on, but i know not all are. even the frozen section that they do in surgery is not final but usually correct but they also warned me of that as well. Take time and glad you arent afraid to ask ??, good advice from others to take someone with. good advice to keep cards in a sleeve too, mayo gave me one that had everyone/s card and nurse and all contact numbers etc. as mentioned above that is good as well. Take care and keep us updated.. remember we are all here for you and have been through the same scary stages as you are going thru now.
hugs.. Linda. -
grade has to do with the characteristics of the cells, lower grade means the cells are dividing at a slower pace, among other things. Stage is based on tumor size and spread, if any, of the cells to lymph nodes, other organs, etc..
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that's how she explained it to me. I'm stage 2 now but it's only based on the tumor size. Once they look into the lymph nodes and check organs then it could change. Im confident that I can fight and beat it as it stands now. I'm scared that it has spread, then I don't know how I will feel! I have been through a lot in life. I realized I AM a strong person, not weak like I thought for so many years. This is just one more thing that I have to take control of and I'm in charge. I'm not gonna lie, I am scared and I have a mini melt down randomly. But I need to stay strong and fight at least that's what my PCP said.
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Hi
I can hear your anxiety and relate to how you feel as I am two weeks out from surgery myself for invasive ductal carcinoma. Waiting to start radiation and the results of Oncotype DX.
That first phone call telling you that its cancer and its invasive gives you just enough information to get the wheels turning and needing to know more. The initial pathology and tissue samples are small in size and may not tell the whole story. As one of our posters said- the world wide web has a lot of information (good and bad) approach with caution haha
The "I don't know yet" is hard to hear too. My surgeon was pretty direct and said until you have surgery some things are our best guess and we won't know til I actually get in there.
I am fortunate to be part of a health plan that provides fantastic care and resources. They gave me a binder on my first visit that had tabs for me to put any test/pathology results, lined pages to write questions, phone numbers and names of everyone on your care team. Its great being able to email all my physicians, read research articles they send etc. If you don't have that where you are at-search Mayo Clinic and other world class health systems- they put an amazing amount of their stuff on line for anybody to read.
Once I actually got the full details of my treatment plan I started coming here more and searching one specific topic at a time in small doses. I am an RN and worked in surgery for years - I needed to act like a patient not the nurse
I hope you come back when you feel you can- sometimes its too overwhelming other times you need to be here. Its a great support community. I wish you all the best on your journey- one none of us would have chosen but here we are. -
WYO, I just took a your look at your other post about being positive. Trust me , I do not feel positive at allllll. My PCP said I had to stay positive cause anxiety causes some stupid something gets released when your under stress and it's like crack for cancer cells. I'm mad and scared and just wish I never even went to the doctor that day. I AM a strong person as far as fighting, I will fight hard. But I'm only pretending the positive part so my body won't attack me even more! -
AnnieC here is a link about being positive. I found it helpful. -
I'm with you Kayb, the unknown scares me the most. I want to know every possibility. Of course it's scary thinking about the worst case scenerio but I'm not good with surprises. -
Thank you so much Wrenn. I needed that. I feel like when I show the times I feel sad to people that it is a sign of weakness. I always think that they probably would deal with it better than me and I'm just being overly emotional. -
we are here for you and know your feelings we have went thru the same, so come here often and we will guide you thru, A 19yr Survivor(Praise GOD). msphil(idc.stage2,0/3 nodes,L mast,chemo and rads and 5 yrs on tamoxifen)
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Thank you everyone! I do feel better having people to talk to that are going through the same thing. -
I hate mornings. I wake up every morning crying...... -
AnnieeC what you are feeling is so normal and this is the hardest part. As soon as you get a treatment plan you will feel you have the ammunition to FIGHT this and WIN! Right now you have been put against enemy line without any back up. Of course you are scared. I was also waking up in the middle of the night crying, but as soon as I met with my oncologist and very reluctantly asked the dreaded question (which I could barely get out) "can I survive this?" she made me realize that yes, with the treatment plan she had devised, we could beat this.
I was like you in that as soon as I heard I had BC, I wanted a MX. My BS kept saying that there was only a very slight survival difference between LX and MX and that because of where my tumour was located, I was a very good candidate for LX. In a way I was lucky because I needed to have neoadjuvent chemo first, which allowed me lots of time to research my surgery options. I ended up having a LX and feel good about this decision. Make sure you make a list of all questions and it helps if someone can go with you to remember the answers. My DH went with me to find out biopsy and plan and we both decided that neither of us would probably remember all the answers-so we brought along a tape recorder!
I know you will feel better when you have all the info. We all go through so much with this DX, but everyone here is so supportive, so come back and know you are not alone. One last tip that my aunt gave me when she heard of my DX. She told me she started a grateful journal which helped her live for each day. I got a journal app on my ipad and it allows me to post pics. Some days it has been hard and all I can record is a pic-but it has really taught me to live for the day. I was always one to live for tomorrow-no longer! -
I hate mornings. I wake up every morning crying...... -
it doesn't last more than 15 minutes or so. -
big hugs-you can do this. We are here for you -
I have always loved mornings it's my favorite part of the day. I wonder if it's because I take Ativan before I go to bed then when I wake up its worn off?? Anybody else have this morning cry and it's just part of the process?
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