Will I need more tests?
I was just diagnosed on Dec. 12th with Invasive and In-Situ ductal carcinoma in Florida. On Dec. 18th my husbands company relocated us to California so I left Florida with nothing but a CD of images, a pathology Addendum Report, and a report describing the Protocols, Procedure, Post Biopsy, Clip Placement, Pathology Results and Recommendations.
Due to relocating I had to find a Breast Surgeon here and don't have an appt. for another 2 weeks. They have my reports, cd, and have obtained my slides to be looked at by their pathologist. But I HATE the waiting.
According to the Doctor that did my biopsy the good news was that my tumor was only 4mm but very near the chest wall. I saw the placement of the clip on my post mammo and the technologist had a very hard time even getting the clip to show in the mammo.
There is nothing in any of these reports that gives me a Grade or if Lymph Nodes are involved which makes me think I will need more tests and /or surgery. It does tell me that I am ER+ 100%, PR+ 88%, and HER2 Negative.
Does anyone have any idea what I may be looking at in the future I know I have to wait for the final word from the surgeon but trying to do some research and calm my nerves! If that is even possible!
Thank you!
Comments
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My guess is they will recommend a lumpectomy which is not that bad. I was home in a couple of hours and had minimal pain. Then they will probably suggest radiation and a hormonal to take for 5 years.
PS Possibly they will do an ultrasound and maybe an MRI before the lumpectomy.
I found my lump myself. Had a mammogram and an ultrasound. Then a few days later the MRI; but the MRI was only done because I had a lump in the opposite armpit (which turned out to be nothing) Then a biopsy and the following month (it was around the holidays; thus the delay) the lumpectomy.
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I'm sorry that you've been diagnosed. The good news is that 4mm is very very tiny!
One addition to dogsandjogs post. At the time of the lumpectomy, you will also have a sentinel node biopsy (SNB) to check your lymph nodes. This involves the removal of a small number of lymph nodes to check for cancer. This is necessary for anyone who's been diagnosed with invasive cancer.
Normally information about the grade of the cancer is available in the pathology report from a biopsy, but sometimes a cancer can include more than one grade of cells, so getting the grade info in the final pathology report after surgery isn't a problem and will be the most accurate. Lymph node info isn't available until you have the SNB. And final staging (which is based on pathological tumor size and lymph node status) can't be determined until you have that final pathology report.
Hope that helps!
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Thank you for your input! Everything helps and it does make the waiting a bit better!
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Beesie, thank you for your info. I am thinking that what will happen is exactly what you have said. The doctor did say that the good news was the size and the bad news was that it was 2 types. What I didn't add to my story was that this all started because of an abnormality seen in the right breast which I was told to wait 6 months and have another mammo done. I opted not to wait and asked for an MRI. I had to 2 cyst aspirations on the rt. which came back benign and an MRI guided biopsy done on both breasts. The rt side is all benign and the left side has the cancer which would not have been found had I not asked for the MRI. Thank goodness I have good friends who pushed me to ask for the MRI!
Thanks again!
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Hi--I just wanted to chime in and a) agree with the other posters about what they think will be recommended and what will happen b) say again that 4mm is very tiny, so that's great news and c) tell you that my tumor, which was 6mm, was also very close to the chest wall. This was noted on the MRI they gave me after my biopsy, which was used to check and see if there was anything in the other breast or anything in the cancer breast they had not seen on mammo/sono. My MRI note also said that in spite of its location, there was no evidence of any invasion into the chest wall, and in fact this turned out to be true. It was just that: the location. So try not to worry too much about that unless someone tells you to. I don't know that they would be able to see that on a mammogram.
Also, just to make you feel a bit better, I didn't know anything at all about my cancer until after surgery. They didn't get enough of it in the biopsy to test for hormones, etc. so I was totally in the dark and I know how the waiting is just terrible. The other good news is that my tumor was originally seen as 8mm, but turned out to be 6mm in reality. This doesn't always happen, but it can.
If what your doctor meant by two kinds of cancer is that it is DCIS and IDC, well, that's not so awful. DCIS would be preferable, of course, because it means nothing was invasive, but it is very very common for IDC to be accompanied by DCIS. Again, the great news is that of whatever amount of DCIS you have, only that very tiny amount became invasive before you caught it.
Good luck. Come here often. Everyone understands.
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You didn't mention if you had already had any scans (CAT/MRI/PET/bone) yet?. If you haven't had any, then the new Drs may want one/some/all if there is any reason to suspect node involvement. If you will be doing chemo some sort of a heart test will be most likely be done before starting it.
What were your Drs in FL telling you your TX plan would be? This could give you an idea of what to expect with new DRs.
Being ER+ you will most likely be on some form of estrogen blocker depend on your age which one but that will start some time later.
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The only tests I have had are the initial bilateral MRI, the Biopsy with MRI Image Guidance and Vacuum Assisted on both breasts and the aspiration of two cysts on the right breast. The Florida doctors only told me that I had cancer and to find a team of doctors in CA since I was leaving so soon. Had I not been relocating she said she would have sent me to a surgeon, oncologist, and reconstructive surgeon. I guess that's why I really felt left in the dark as far as what is next. I know I will find out in two weeks but this has been going on for almost a month now and I am about at my wits end. I just want to get on with the treatment whatever that might be.
I am living in a small town so getting the recommendation for my surgeon was pretty easy. She came highly recommended so I feel good about that. Just wish I wasn't waiting so long. I hand carried all of my paperwork and CD's to her office to make sure they were received quickly (not trusting the mail) and I am assuming she has looked at the images. I was told that if she felt I needed to be seen sooner that they would call and I haven't heard from them. I am taking that as a good sign
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