Bad news
So i go to the doctor yesterday to get the results of my lumpectomy and lymph node biop last week and whoot there it is... many abnormal cells no clear margins recommend double mastectomy... my surgery is April 8,,, 4 hour surgery with the expanders and then implants a few months later...
my head is spinning... seriously...
my surgeon is from Fox Chase Cancer program good reputation should i get a second opinion??
im thinking not...
its not like i havent thought about this, i had DCIS 6 years ago
and i swore if cancer came back this is what i was doing... and there
are upsides no more bras no sagging EVER no more mamograms etc etc ...
the girls have betrayed me... THEY MUST GO... have
a friend who went thru this 5 years ago and she is helping me out a
lot... trying to stay POSITIVE and upbeat it will help with the
healing... No lymph involvement so that is very good... and the tumor they removed was small less than .4cm
so my long term outlook is very good... i think... HER2 positive however... not sure if i will need chemo or not now... i go to the oncologist Monday morning...
PLEASE any feed back would be appreciated...
thanks ...
Comments
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So sorry to hear this news Pattij! We wish you the best in your decision and hoping that your onc's recommendations will be easy on you!
(((HUGS)))
--The Mods
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So sorry to read you're having to join us here Patty. You are early in the " game " so to speak, so everything is scary. Once you've settled into a tx plan you'll feel better.
I HAD a stage IIIC Her 2 positive BC .. Lots and lots of bad prognosticators... That was almost 9 years ago. I am fine now. Happily reconstructed and living life large.. you will too
Come here often for support. The ladies here are knowledgable, an they will help you down the road that nobody wanted to go down.
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I am having panic attacks.... breaking down crying hyperventalating etc im afraid it has spread thru the blood because it is her2+ grade 3 and the surgeon said abnormal cells 'everywhere' ... what are the chances that happened without lymph node involvement??? i need some reassurance bad...
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Patti, take a breath & try to think "calm." Don't go to that "worst case" scenario in your mind - it won't help you. Know that we are here for you. But so sorry you have to be facing all this.
I doubt if the cancer would spread throughout your body with clear lymph nodes. Usually, that's a worry when there is lymph node involvement - that's why they check those lymph nodes, anyway. I assume the abnormal cells "everywhere" are still contained within the breast? Is this perhaps some DCIS in addition to the small (tiny) tumor that was found? I believe that with more widespread DCIS, mx is often recommended.
Remember that there are many of us with worse staging from the beginning - and we've still here! For me, it's been almost 10 years since my diagnosis of stage III, grade 3, 5 lymph nodes. And look at lkc - she was stage IIIc!
And I suspect there is a good chance your Dr. will recommend chemo and/or Herceptin (I think you expressed a concern about this in another post). Especially Herceptin if you are Her2+. Herceptin is a wonder drug!!!!
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With her2+ you will likely get chemo+herceptin. herceptin *is* a wonder drug. And so much research is being done on her2+ cancers, they are learning more all the time!
rent the movie "Living Proof" about the research that led to using herceptin, it's very uplifting.
Best of luck with your treatment!
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pattij - Try to remain calm. I know it's hard. I remember - we all do. Anxiety is a very
real thing and it can be debilitating. You might want to call your PCP and see
if you can get some anxiety meds. (He must have an off hours number...) Having something going wrong with our bodies
is incredibly hard - the waiting for
appointments, tests, test results, and the tension that it produces is
something we are all familiar with. You own mind becomes your worst enemy.I'm not going to lie; the BMX is tough but you can get through it.
Give yourself a chance to get used to the idea and try to find some peace in
the fact that this will eliminate the enemy. Give yourself plenty of time
to heal and don't push yourself as so many of us are prone to do.That will pay off in the long run. If you start reading the
forum, there are lists of what to take to the hospital, how to get your house
ready, etc., etc. Just remember If you need help, advice, or just a laugh
and a stupid game to take your mind off everything, come here. There is
always someone here, so never be afraid to reach out. No one knows how
this works better than the women who have already gone through it.Also, I learned early on that it is a great idea to take someone with you
to these kinds of appointments because (at least for me) my brain went into
overload and there were things they said that I missed, but my friend was able
catch (heck she even took notes). So please arrange to take someone with you on Monday morning to your appointment with the oncologist. Good luck and try not to worry too much. Just take It one step at a time and try not to get overwhelmed. Also, it 's a good idea to get a copy of the pathology report for yourself. You can do this!
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thank you all ... SO MUCH
i am better today... i do have xanax and they help a lot i just have to keep telling myself NO LYMPH NODE INVOLVEMENT!!!!! i can handle the double mast i just cant handle the uncertainty that it has spread outside the breast... the abnormal cells were all around the tumor they removed, my sister and my sister in law and a good friend are all nurses and they are thinking that possibly these abnormal cells would have eventually joined up with the tumor forming but since they found the tumor so early they didnt have a chance...
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i think i saw someone post on here that HER2+ is sneaky and that it can get in your bloodstream without lymph node involvement... but my sister says that's not possible... the cancer is in the white blood cells and these travel through the lymph system if that was going on they would have seen it in the lymph nodes...
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patti, I haven't heard that specifically about her2+ cancers, but it is possible for it to get in your bloodstream while being node negative. As I understand it, there is a 7% error rate on the SNB and a 4% chance that it can get out some other way. Not sure how those stats work together. That being said, there are a lot of us her2+ women that are node negative. I do worry about that myself since my tumor was rather large. You can still be considered early stage with some lymph node involvement. You will very likely be recommended chemo b/c of the her2+ part, whether or not you are node positive. It's not exactly fun times but it's doable. Anyway that would very likely kill anything that spread, esp. in the lymph nodes.
I know you are er/pr-, but there is a triple positive board which is very active and there are some really well informed women over there. Feel free to join us over there.
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..and I would be interested to hear if anyone else knows whether her2+ tumors are more likely to spread without lymph node involvement than other cancers.
also, does anyone know -- does a SNB include just the armpit lymph nodes or also the ones in your chest area?
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Her2 is a more aggressive tumor, so probably yes if LVI is involved (lymphvascular invasion). Her2 makes tumors sneaky. That said, node negative doesn't guarantee anything for anybody with breast cancer. They usually don't do lymph node dissection of intramammary nodes...the most likely tumor to go there are, I read, inner lower tumours. We all worry cypher.....the trick is learning not to worry so much. You've done all your treatments available and that makes a difference.
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bluepearl, thanks for your response. That makes a lot of sense. I wonder what the stats are on it spreading not through your lymph nodes if there isn't evidence of LVI.
My tumor was I would say around 10 o clock, towards the outer/upper. It is hard not to worry sometimes because it is such a sneaky disease!
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I am not sure but I think most of the time if you are Her-2 positive, you will have chemo as you need to get the herceptin.
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yes i having chemo THC plus herceptin..
i dont know if i can do this ... and these co pays are KILLING ME... i figured it will be about $600 a month once i start chemo, have to go every week plus somewhere else every week for neuroplast shot then every week to the plastic surgeon for the saline injections...I HATE THIS... I REALLY REALLY REALLY F'ING HATE THIS...
and if it every comes back, i am not doing anything .. none of this is normal nothing about this is normal nothing about the way people live anymore is normal... we are not meant to live forever
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Patti,
Hang in there, I see you have gotten a lot of good advice already. It is scary. I was diagnosed in 2008, triple positive. chemo and herceptin treatment. Not pleasant but all doable.
I did work a deal with my plastic surgeon to hold off paying the co pays until after my herceptin treatments were done. Try asking. I am doing ok now , have been back to work for over a year. Problems with Aromasin but not cancer. The what if's got to me in the beginning too. and still do when I get pains. The movie living proof helped me calm down. and So many new drugs are out for after the herceptin. Take things one day at a time. The Xanax did help me stay calm and focus. Yes you are in a fight for your life. But as you can see we are greatly benefiting from the research demanded by our sisters before us. Your in a club now, sorry you had to join it, but here your always welcome to vent, get mad and be understood. I have 8 sisters yet on this site my bs sisters were the ones who carried me thru and understood my fears and concerns.
And no this is not normal, your entering a new normal. Sometimes I felt like this just couldn't be happening to me and why me? WHY Why Why? It does S...
Your in my prayers and sending you hugs, my hearts breaking for you but it does get more manageable. Mine was invasive but contained within my left breast. no node involvement. and it been at bay since treatment. so grieve , cry, get mad and then get ready for your fight.
Bring someone with you to your appointments and know that you can do this and start a new chapter in your life.
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Good morning, Pattij, I hope you are feeling bettter today. You've gotten lots of advice, but I see nobody answered your qeustion about a second opinion. I opted not to get a second surgical opinion, like you, I knew I was having a double mastectomy, no matter what. Another opinion wouldn't have changed that. If I hadn't of liked the doctor, I would have gotten ten opinions until I found someone I liked. Make sure you LOVE your plastic surgeon and your oncologist. You will see you PS more than your BS after surgery and there will be subsequent surgeries. And, I believe our relationships with our MO will be long lasting as well. SO important to be comfortable at the treatment center.
My sister is in PA - also with docs that are part of the Fox Chase organization, lmk if you want me to hook you up with her, she starts chemo next week. Seems like you have similar dxs.
Good luck!
jen
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My insurance works on a co-pay system but I did not have co-pay obligations for fills. That cost was included in the surgical fees for the expander placement. I also did not have co-pays for weekly labs during TCH, but did for each chemo day and Neulasta injection.
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Cypher - re the SNB - Mum's sentinel node biopsy indicated 3 nodes - one in the armpit and 2 in the chest area. They only removed the one in the armpit, but the surgeon did poke around to have a look at the ones in the chest. I think they are very hard to remove, but he seemed to believe that they were all clear, and this was confirmed by pathology for the armpit one. It's hard to understand how the cells can spread when there's no indication of positive lymph nodes or vascular invasion, but the possibility is apparently still reasonably large. BUT thats why they have wonder drugs like herceptin, and the rest of the chemo to nuke any horrid little cells that might have snuck past the surgeons.
Negative nodes is a wonderful thing to concentrate on pattij!
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I am so sorry you are facing this. Yes it is terrifying. But there is a lot of reason to hope. I had a bilateral and it's fine. Don't worry about that.
Moreover, literally in today's news is an awesome item about a company called Puma biotech that just released a great study on their new drug that seems to work even better than herceptin. This is exciting, because herceptin itself is a wonder drug and it's not as bad a chemo as other types.
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Beacon800 - thanks for posting about the new drug. It is so exciting just how quickly advances are being made in this area!
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I trouble understanding the article but glad it's good news!
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I googled Puma Biotech and was excited to see that the drug they are talking about is Neratinib. I participated in a clinical trial for this drug in January 2010 - Jan 2011 (I found out about the trial here and was lucky that my onc was an administrator.) I never did find out if I got the real drug or a placebo - since I did not get the extreme side effects that many of the others in the trial experienced, I feel like it was probably the placebo, though.
I did TCH in 2008, and I am doing well today. It amazes me to see the number of drugs in development and/or actually being used for Her2+ breast cancer today. The Puma website says their stage 3 clinical trial of Neratinib includes many other types of cancer that overexpress Her2.
Thanks for the information! Best wishes to those of you newly diagnosed and in treatment.
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Suemed, 6+ years out, that's great to read! I was on the aphinity trial (early stage her2+ for perjeta). I also think I was probably in the placebo group.
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