The FISH test is used to determine or confirm HER2 status:

http://www.breastcancer.org/symptoms/testing/types/fish

Annie.First off I would like to give you a big hug and say I'm sorry for your outcome. I can relate to what you are going thru right now as I am in the same boat... (dx oct 18 got results on oct 22 nd) I had an appt already set up for my results but knew if they called sooner to come in then it was positive for cancer...I got that call so I was ready for the results but still in shock and kind of numb...the dr who gave me the results really didn't have much to say other than looks like you have cancer...IDC. I did ask him about est and prog results and he said positive. I was so relieved at that point I didn't ask anymore other than can I have a copy of my path report. I then had to talk to the referral specialist about a bs so i didn't even look at the report till I got home . Now I'm more confused than ever!!,my her2 has also been reflexed to fish..mine says equivocal (+2).i also have an e Cadherin stain of neg.which is consistent with pleomorphic lobular ..hmmm so two diff types of bc ?....I haven't received a call I'm just sitting here in limbo..tomorrow I have an appointment with my np so I'm going to ask her about the fish test..I hate this hurry up and wait as I am a very stressful person..please update when you find out more info...hoping the best for you...

you are so right it doesn't seem real..a nightmare ...wishing you best of luck today...Bobbie

Welcome Marielnont, It is different for each case. Sometimes if the tumour is larger they do chemo first to shrink it so surgery has a better chance of getting it all Also I think the size of the breast relative to the tumour makes a difference. I would do as much reading here as you can today and ask questions here and then take a list of questions to your surgeon tomorrow. If you can take someone with you to take notes in case you don't remember some of it it is helpful too.

I wish you didn't have to join us but you have come to the right place for compassion, information and support. Hang in there.

Hey MarieinOntario, So sorry about your new BC diagnosis!! In my case it was surgergy first and chemo second. I did not have radiation because I elected for bi-lateral mastectomy. Hugs to you and feel free to PM me with any questions.

Hopefully someone will come along with more information but I would ask what size the tumour is and whether it is hormone positive or negative and what the plan is for treatment and what the outcomes are for and against each thing.

I had no idea what to ask when I went but the women here have been so helpful that I learned a lot and am still learning.

wow I bet your glad to get all the info .I hope you feel better now that you have more info..best of luck to you...is 10 yrs a long time for tam?..

I am new here but I just want you to know that you have to cry! I would stay up at night worrying about everything and what to do and I would have panic attacks and crying fits but my husband convinced me I needed to get a prescription for Klonopin which is like a Zanax! That helped me out so much in the beginning with all the what ifs and being anxious about everything! I was diagnosed stage IV in August 2012 at the age of 30! I did all my chemo (both AC chemo and then Taxol) upfront and then did a double mastectomy with immediate reconstruction and then had radiation after that! The thing I recommend is first, get a port put in!!!!! I cannot stress this enough! I know it is a little surgery and all but I had to have my first chemo (the red devil aka Adriamycin and Cytoxin) in the inside part of my forearm and it hurt so bad! After I got my port, it made matters sooooo easy! Also, I went to several surgeons until I found the one who would do my surgery the way I wanted it done! He worked in conjunction with a plastic surgeon and that plastic surgeon was able to skip the whole expander process and go straight to implants!!! This made it less scary for me! I went in and came out with boobs! My philosophy was I was doing all this other stuff the way my doctors told me and all so by gosh I wanted one thing done my way and I went through several surgeons and was just patient until I found them! I would cry after each visit to a different surgeons office! Some would tell me since I was already stage IV then they recommend to just get a lumpectomy at this point and others would want to have several long drawn on procedures!!! I hope this helps!!!! You can do this!!!!!!!!

If it were me I would have a mastectomy because it is difficult to have correct imaging on fibrous dense.

Hi Annee,

Just came back from my surgeon too, and the news is pretty good.

estrogen +100%, Ki-67 less that 3%, Her2 neg, all the best things under the circumstances.

Maybe because of my age, the size of the tumor and the histology, the surgeon did not even suggest that I needed anything other than a lumpectomy, and if the MRI and the nodes are clean, they have found that a short regimen of radiation for only1 week would be sufficient. She is pretty well known in her field and is in a New York teaching hospital so I am assuming this is good medical advice.

I was not too keen on major radiation, knowing the possible side affects, unless it was really necessary, so this was really good news.

For post menopausal women they are using another new drug instead of tomaxafin, (dont know the name yet) so overall the news is really good. I am really relieved and happy that all your information came back so well too.

It sounds like your doctor feels that having a mastectomy would be more of a psychological decision than a medical one, so if it is not medically necessary, you might want to rethink it. Less is still less - maybe not in long term prognosis, but possibly in long term pain and the amount of time needed to adjust.

I would speak with other women that chose that option and see if it is for you.

For me, unless it is medically necessary, I would like to keep as many of my original parts as I can - but that is just my personal choice.

good luck to you and I will be watching to hear other peoples suggestions.

ritagz - you will be receiving the same dose of radiation, just a shorter time period. If you are having Mammosite, or other brachytherapy radiation, they place a device , usually during your lumpectomy, that is both internal and external to the breast and radiate through that device for 5 days in a row. Postmenopausal women are generally given aromatase inhibitors - there are three drugs - Arimidex (anastrazole), Aromasin (exemestane), and Femara (letrozole) - while Tamoxifen blocks the cell receptors and allows circulating estrogen to continue - which is good for premenopausal women, the aromatase inhibitors suppress estrogen produced by the body. All of these drugs have side effects, but they are different for each of us, and some do not experience any noticeable side effects at all. There are active threads on all of these drugs on this site.

anniee - why was radiation recommended if you chose mastectomy? Generally speaking, radiation after mastectomy is only recommended if the chest wall or skin is involved, or if you have positive nodes.

Annie,

Take a look at my June 20th post in the following thread:

Topic: having real trouble w/ mastectomy vs. lumpectomy choice

I've included there some links to research that compares long-term recurrence and survival results for lumpectomy vs. mastectomy. That's followed by a long list of things to consider as you make the decision.

No one can tell you what the right thing is for you to do. We each have different feelings about our breasts, different concerns about each of the surgeries, and different worries about side effects and future risk. So what's right for me (or anyone else) isn't necessarily right for you. That's why I put that long list together, because it can help you understand the implications of each surgical option and assess what's right for you. Hopefully it helps with your decision.

SpecialK, from Annie's description in her first post in this thread, it sounds as though her cancer might be right up against the chest wall. So I'm guessing that's why her surgeon is saying that rads will be needed regardless of whether she has a lumpectomy or mastectomy.

beesie - thanks - I missed that! I am surprised that they would offer a lumpectomy in that situation, but perhaps thinking that rads would handle potentially slender margins at the chest wall regardless of which surgery?

Annie, some people just know. I knew that I didn't want a MX but then it turned out that I had so much DCIS that I had to have one. Then I found out that I had more suspicious calcs in my other breast and needed another biopsy. So as much as I didn't want a MX, I was seriously considering a BMX. But when that second biopsy was benign, and when the MRI on my other breast was clear (my cancer breast showed up as being completely full of "stuff" on the MRI), I decided to opt for a single MX. By keeping one breast I know that I am higher risk to be diagnosed again, but I evaluated that risk and decided that it was a level of risk that I could live with.

Some women know from the start that they want the least invasive surgical option. Other women know from the start that if they are ever diagnosed, their breasts go. The decision is harder for everyone else. I'm analytical, so I use stats and build pro and con lists. Ultimately the question I asked myself that helped me the most with my decision was: "If something goes wrong with either of those choices, which decision would I regret the most?" In other words, if I had the BMX and then developed major problems as a result of the surgery, or if I developed breast cancer despite having the BMX, would I be more angry or frustrated than if I had the single MX and developed breast cancer at some point in the future in my remaining breast? That was an easy one for me to answer. I don't want to get breast cancer again, but I view cancer as being one of the risks of life. Even if I have a BMX, I can still develop any other type of cancer. So if I develop BC in my other breast, I won't beat myself up about having made the decision to have a single MX only. My attitude will be that I took a chance and I landed on the wrong side of the odds. I will be comfortable that I made the best decision with the information I had. On the other hand, if I had the BMX and then had problems after the surgery, perhaps on-going pain or major reconstruction issues, etc, or if I developed BC anyway, I would be very angry with myself for putting myself though it all, quite possibly for no reason at all. Certainly if I developed BC again, the BMX would have been for no reason, and if I never developed BC but had problems with my surgery or reconstruction, I would wonder why I removed the other breast for something that quite possibly would never happen (another diagnosis of breast cancer). So that answered the question for me.

My question - and my answer - is how I think; it's not necessarily how anyone else thinks. So you need to go through all the pros and cons of both surgeries, understand the benefits and the risks, and then decide for yourself which option you can live with the best, not only if things go well, but even if the worst should happen.

SpecialK, I'm thinking that a lumpectomy is being presented as an option for Annie because the close margin will be against the chest wall, which means that it will be the same close margin whether she has the lumpectomy or the MX. On the breast side of the tumor, I'm guessing that her surgeon is confident that she'll be able to deliver good margins. And if she's saying that rads will be necessary in either case, that evens things out too. Just a guess on that.

Hi AnnieeC,

If you haven't already done so and there is still time, perhaps you should get a second opinion. I think it will help to reassure you if a 2nd Dr agrees with the treatment plan or perhaps another viewpoint will present a different treatment plan for you to consider such a neo-adjuvant chemo (before surgery to shrink tumor for better margins) Or a nipple-sparing/skin sparing mastectomy, or even a single procedure straight to implants vs. tissue expanders. Best of luck in whatever you decide. But as mentioned above it is a decision for you and only you to make about YOUR body, because you are the one that has to live with it (so to speak).