Starting Chemo in December 2013
Comments
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FYI interesting article, little too late for use now but for FU maybe helpful
Lymph Node Ultrasounds More Accurate in Obese Patients With Breast Cancer
ROCHESTER, Minn -- April 30, 2014 -- Ultrasounds proved to be more accurate in overweight and obese patients than in women with a normal body mass index, according to a study presented at the Annual Meeting of the American Society of Breast Surgeons (ASBS).
Researchers studied 1,331 patients with breast cancer who received ultrasounds of their axillary lymph nodes to check for cancer before surgery. Of the patients, 36% were considered obese, with a body mass index (BMI) of ≥30, 33% were of normal weight, and 31% were overweight but not obese.
Obesity can change lymph nodes, including the way they look in imaging studies, and make physical examination of underarm lymph nodes more challenging.
The results of the study showed that higher body weight didn’t muddy ultrasounds of the axillary lymph nodes in overweight or obese patients, and that their ultrasounds had better specificity and accuracy than those of thinner women, meaning that when ultrasound showed no suspicious lymph nodes, it was likelier to be correct.
“I think we were surprised at these results,” said senior author Tina Hieken, MD, Mayo Clinic, Rochester, Minnesota. “It should be very reassuring that regardless of the weight of the patient, axillary ultrasound is helpful.”
Dr. Hieken speculates that soft fatty tissue can be compressed during ultrasounds, and physicians now have more experience in knowing what lymph nodes may look like in overweight and obese patients. In some thin patients, ultrasounds may not yield as much information because underarm lymph nodes can be so close to the surface, it may be difficult to get good images, she said.
“For most patients with invasive breast cancer, if the axillary ultrasound is negative, we perform a sentinel lymph node biopsy at the time of the breast operation to make sure cancer has not spread,” said Dr. Hieken. “When the preoperative axillary ultrasound shows suspicious lymph nodes, we then do a fine-needle aspiration of the lymph nodes. If that shows cancer, we may discuss other strategies with the patient such as giving chemotherapy before surgery.”
More research is planned, including looking at different techniques of lymph node ultrasound to improve accuracy and perhaps to avoid axillary lymph node surgery altogether in some patients with breast cancer who have small tumours and negative axillary ultrasounds, she added.
SOURCE: Mayo Clinic
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Ok ladies. Loved the RO in Austin. Seeing the one that is closer tomorrow for consult to compare. But one in Austin even offered for his staff to watch my kids while I have treatment. He was great.
But he brought up something that hadn't been brought up to me before. He mentioned 3 reasons for rads. Two we already knew about - positive nodes and margins. But he said something about cancer cells in the lymphatic space or vessels or something like that. Close to my chest wall and if I were to have reoccurrence that it would most likely in my chest wall. He wasn't being pessimistic or fear monger. But no one ever brought that up before. I was too shocked to ask more questions. Anyway heard of this?
He recommended 6 1/2 weeks with boosts.
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mine said rads will get something they might not have seen, so I guess yes. Rads is good for hiders. Not sure about chest wall reoccurance. That would be best case reoccurance and not bones or organs but I had not heard that. And really chest wall might not be better, I just think it is because they can get it perhaps.
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yes my taste buds were really off until my next infusion (2weeks) only to start all over again. This was in AC and taxol. Everything to me tasted like metal, or no taste. Everything still has an after taste and salty things taste really salty. Barb, My mouth is also really dry and at night I get dry all the way to my throat including my tongue and then it wakes me and I have to work to actually swallow! Anyone else in the same boat?
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My Herceptin was supposed to be 12 weekly doses with the Taxol, then extended to every three weeks to finish up the year. My weekly have been extended because of my low WBC. Easier to keep an eye on it that way. Next week I should switch to every 3 weeks. Meet with RO on 5/5 will already be taking my Tamoxifen( hormonal) when I start rads.
Speaking of rads, I read a blog from someone about their upcoming treatment. Extranodal extension for her means more extensive area of treatment. I have extranodal extension x9 and lymph/vascular invasion. Should be an interesting discussion with RO. Was supposed to be 6 weeks, wonder if that will be changing.
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Robin- that's what the RO said ...lymphatic vascular space invasion. First I had ever heard of that. What us it ? How did he know? From the path report? I was caught off gaurd so I didn't really ask
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Holli,
Here is the info I found. (From John Hopkins) My petscan did not show any further spread past the nodes. That is why the treatment has been what it is though.
9. What is “vascular” or “lymphovascular” or “angiolymphatic” invasion? What if my report mentions D2-40 (podoplanin) or CD34?
Tumors cells can break into small vessels seen under the microscope and this is called “vascular” or “lymphovascular invasion”. The presence of tumor in vessels is associated with an increased risk that the tumor has spread outside the breast, although this does not always occur. D2-40 and CD34 are special tests that the pathologist may use to help identify “vascular” or “lymphovascular” or “angiolymphatic” invasion. These tests are not necessary in every case. If your report does not mention this type of invasion, it means it is not present. Even if it is present, your cancer could still be very curable, depending on other factors. How the presence of this finding will affect your specific treatment is best discussed with your treating doctor.
All still treatable!
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Holli - They are zapping my underarm, chest area up to my clavicle, and side where my drainage tubes were. Wonder why they don't just zap my entire chest area, why only one side of it? I think I will ask my RO that question next week. My BS told me the same thing your RO told you about the chest wall. I had some rogue cells in my chest wall that showed up on my PET Scan before I started treatment. They didn't seem worried about it.
Barbara - I am not trying to be funny, but people are complaining about weight gain and you post that obese women should have ultrasounds on their nodes... I am laughing.... and you post pics. of mouth watering cupcakes!
Robin - I am going to have to research what you just posted re extranodal extension. Does this mean positive nodes? I had node removal with positive nodes. I am having 33 tx with boosts.
I found AC the worst on taste buds. My taste buds are fine now... I am 7 weeks today PFC. Always wondered what the F stood for, thanks for clarifying that ladies.
Kim
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thanks Robin. Reread my path and it's right there in black and white.
Lymphovascular invasion : present
This is just the first time anyone had brought it up.
We shall see how the other RO consult goes tomorrow.
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Kim, yes to the positive nodes. The definition is below on the rest of it. If you had it, it should be in the path report with the rest of the info about your nodes.
Extracapsular/extra-nodal extension means that the cancer went outside the nodes.
Not considered a major factor in determining recurrence or life expectancy.
These are just some of the factors that go into determining which treatment options are best for each of us. The grade, size of tumor, type of cancer, receptors....etc...are other factors. It is why each of our treatments are similar but not exact. Our breast cancers are individual to each us in their makeup.
Go us!!!!
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hallelujah!! The last session of poison done! No pics, I was too excited to get the hell out of there! I been out on the couch from Benedryl and now awake from steroids....just want to get this stuff out of me now and feel good....I can't remember how it feels to feel good! Congrats to my chemo day buddy, Barbara we got here, we did it, we are done! I'm loving life and everyone today!!
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yea Jackie and Barbara!! Doing the Happy Dance for y'all!!
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Jackie. Isn't is a wonderful feeling that it is done. A bit scary but overall good. Did you at least ring the bell as you scooted out the door.
Already had 2 Soaking head sweats from the darn decadron already. Took an Ambien tonight to try to sleep. Has not kicked in yet but will soon. I agree, I need my old life back.
One week from now I will really party. Best to J4DC tomorrow.
Barbara.
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WOW!! Congratulations to those who are DONE & almost DONE! It has been a loooooong winter!
I am about 2.5 months post chemo, I'm getting stronger,I can feel it. My lashes came back pretty quick, I never quite lost them all at once, they kind of started growing as I was losing the long stragglers. They were super short but are almost back completely now.
I do notice I'm sore in the hips & low back if I sit too long, age or chemo??
Someone mentioned hiccups, I get them more frequently now, also indegestion.
MY PORT SCAR- was raised & very noticeable. I used Curad scar therapy pads, I cut them in half, I used it 2 nights in a row, I can already notice it flattening out! They're awesome!
My MO said to give myself the amount of time from DX to completion of treatment to get back to normal.
Here's a pic of my hair growth, I stopped wearing scarves, the comments i used to get:
"Ooh, you look like a pirate"
"A gypsy"
My favorite: "you rock that shit"
I mean really😒
One of the nurses at my worked asked if I was stage IV already??? WTF? I'm trying to figure out if she misheard something I said..
Anyway,take care & keep the updates coming💙
PS, I'm driving myself to Boston this morning for surgeon follow up, first time! I hate driving, especially in the city, but it was one of my goals, my husband is afraid for the car!
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congrats Jackie and barb! Let the recovery begin!
Neskir99- you look amazing, how about that for a comment, no one said that? Humph, people are funny. Hair growth great, eyelashes super! Can't wait!
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Neskir, you look lovely with the short hair. Did you cut off the early white stuff?
Good advise on the time it takes to feel back to normal again. Glad you are feeling the recovery starting.
I am feeling little stumbles on my lower eyelids. Still have at least half the upper lashes hope they stay put.
Barbara
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Neskir - you look beautiful.
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Neskir, you look great, and thanks for answering so many questions I have. I last shaved my head, oh about 6 weeks now, I have quite a bit of growth now, but half of it the fuzzy white stuff. The back is dark but the top and sides white. I know it's chemo hair, but I'm going to keep it, I can't wear that wig all summer and have these known hot flashes Tamoxifen will cause. But should I color it as soon as it's long enough? Not sure what to do with it.
Well, the ambien knocked me out for 5 hours, now I'm up, and have so many things racing through my head now that chemo is over....now I want to rush it all, lose this weight, grow my hair, my lashes, brows....get my energy.....argggg more hurry up and wait.
Planned my last chemo party with friends and family for May 10, I figure I should feel good then without the last round bad side effects...I have so many travel plans coming up, and so many projects to finish at work....and I'm so excited about just feeling good again..I want to head out for a 5 mile jog right now, but know I wouldn't make it half a mile yet! Oh Lordy, patience needs to find me!
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made it to Boston, the traffic Ugh! Thanks for the kind words.
I didn't really get the white fuzzy hair, my growth came in way darker than my hair when I lost it. I used to keep it pretty light. I think I'm going to keep it short, (not this short) I like the ease of it!
Jackie, I feel like that too, I just want to hurry & get fit again! Patience, that is the key.
I went out in a limo for my friends 50th Saturday night. Her DIL and all her gorgeous friends, my gorgeous friends, me & my super short do, got a few stares but I could not have cared less.
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Good morning ladies -
I too can't wait to be strong again. I just want to add some encouragement to those of you who are trying to lose those pounds from chemo. I have been working at it since the end of Taxol and am back to my pre surgery weight. I want to lose as much as I can before Tamoxifen. Anyway, I think that I mentioned that I am eating mainly a veggie based diet with fresh fruit and not a lot of processed food or sugar. I do eat organic chicken or chicken a few times a week. I am walking at least 5 days a week. I want to incorporate weights, but am going to wait until I am finished with rads. My energy level still stinks and am still dealing with achy legs.
Neskir - You look great. It is so nice to hear from you. That nurse should learn to keep her mouth shut... you just don't say comments like that to anyone.
KIm
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Congrats Jackie!
Neskir, good to hear from you-great photo! I think my hair is about that length, but since a lot of it is gray/white, it doesn't look quite as full...I think I am liking the shorter hair also. So easy peasy!
Enjoy the week-end, ladies!
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congrats Jackleak and Barbara!!!!!! Wooooo Hoooooo! What an awesome feeling!
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Neskir, you look awesome! My hair is filling in and getting darker. My eye brows are starting to come back quickly. Eye lashes...only a few left and instead of curling up, they are hanging straight down. I don't know what that means. Maybe they are waving good bye when I blink.
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Congratulations Barbara and Neskir! Best feeling to be done, it really took me a day or two for it to really sink in.
Neskir, you are beautiful, so much dark hair, looks great. I just have some white peach fuzz, it is mainly on the sides, have this fear that I will be bald on top and look like an old man.
I have had a feeling that lymphadema was developing. Both arms had issues with swelling under the skin due to a really nasty chemo rash but my right seemed to be bigger. MO looked at it last week and said to wait till the rash went away. Well I guess the 5 hour ride to Savannah made it more obvious but the right hand was swollen and the left wasn't. It swelled again yesterday and the left didn't. Slept last night withe the right one elevated on a pillow, swelling was down this morning, will see how the day goes. See the BS on Monday, will show him. Have appt with RO on the 13th. For set up.
Cancer, the gift that just keeps giving. F***!
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I got brave and changed my avatar. This is what I look like now. I'm not comfortable enough to go out without my wig yet. I'm hoping by June I will be. Wigs are so uncomfortable. Oh, I went on youtube and found a diy concoction that is suppose to aid in faster, thicker hair growth. I think it is helping. It's 1/2 castor oil and 1/2 coconut oil. I put it in a bottle that you would use when you travel. I rub it in and massage my scalp. I leave it on until I get in the shower. You could put a shower cap on and sleep with it, but that doesn't sound comfortable to me. It smells great too. Just thought I'd mention it. I put it on my eye brows as well.
Have a great week end everyone:)
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neskir - great photo!!
Mikesgirl - looking great too!
You two ladies are glowing! It radiates from your sparkling eyes!!
Chico - ask for referral to lymphedema certified PT. It is very important to get it treated. Also to learn the do's and don'ts of prevention and care. (ie: compression sleeve, exercises etc...) I have guidelines of when to seek medical care, and stop home prevention methods, posted in my kitchen cabinet.
Today I started my tamoxifen. Monday I meet my MO. Thursday another Herceptin and WBC check. The following Monday is my echocardiogram and that Wednesday is my 6 month follow up with BS. The day after that, my daughter arrives for a 10 day visit from CT. She is graduating from college on Mother's Day. So proud of her. Feeling pissed off and sad that my DX and tx make it impossible to be there. On the flip side, 10 days with her is much better than having to share her with everyone and being in a rush to get home.
Hope everyone is doing well with their treatments whichever end we are on. Forward march.......minimal SEs..... We are getting so close to the summit! Hope we all get to rappel or slide our way back down the other side of this beast! Pick the route that brings the most enjoyment!
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Mikesgirl - You look great. I have been rubbing coconut oil on my head and face for awhile now. It's my favorite go to. I hear such wonderful things about it. I will look for castor oil when I go to the store. Your hair is looking good. Mine is not as long yet. How is your skin holding up with rads? Re your eyelashes. Maybe the newbies are pushing out the old ones. Mine are growing back, but very short still.
Chicopeach - Robin's post re lymphadema is spot on. Daily massage drainage is important too, it gets our circulation moving in our lymphatic system from our arm to other areas of our body. Sending a hug your way.
Robin - Congratulations on your daughter's graduation, what a great accomplishment for her. What line of work is she interested in? Keep me posted how Tamoxifen goes for you. I believe that you are the first in our group to start it. Great analogy.... we are almost all there.
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Kim, she will graduate with her bachelor's in Psychology. She is looking at different jobs, I believe she likes the clinical aspect. I could have it backwards though....stinking chemo brain! She is also looking to move to N. Carolina with one of her college roommates. She is currently frustrated that many employment opportunities in her field require experience, she Is wondering how they expect her to get that...lol...I will keep you updated on tamoxifen. Hoping for no SEs.....today is day one and I am feeling fine, but we all know how deceptive that can be.
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Barbara crazy wabbit ....hey ...from your dx, it looks like you had a lumpectomy even with positive nodes...I am now getting 3rd opinion on mastectomy vs lumpectomy for me...I don't want more surgery and hope I will be ok keeping lumpectomy...my general surgeon feels I should think about bmx...left breast is ok...I think...it has been in the past...did you keep the lumpectomy?? I will be done with chemo June 2....them rads for 6 weeks....then tamoxifen....Thanks. Rosie
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crazyrabbit (barbara) that was a very interesting article! Dr. Heiken was/is actually my surgeon!
She is amazing! I found this interesting because I am overweight, I had all the ultrasounds etc and everybody agreed I had no lymph node involvement based on that....Dr. Heiken was so surprised when I did have so many when she did the surgery back in November. She came into my room the night of surgery, I was out of it but she was telling me there was node involvement, i thought she said everything she removed was positive and i got sick to my stomach and said i had to throw up...she ran and got a nurse, i threw up and she came back in and said....whew...i don't do throw up! haha! I laughed to myself and thought you can cut off a boob but can't handle puke! She is really wonderful....she had actually told me there were 12 nodes involved not all 30. I just heard her wrong!I had a wonderful trip to Punta Cana!! Made it home safe and sound. I think my hair grew a half inch while there. The food was amazing,the spas, the food, (my taster worked this week.....whooohooooo!) The awards dinner was beyond emotional....my song that i walked up to was I made it Through the Rain.....the whole room stood and gave me a standing ovation and we all had a good group cry!!! Was a memory I will never forget. I will try and add a picture to show you a few images.
I start radiation mapping and scanning on Wednesday....back to reality. I have prayed hard for you all whether you are finishing up, trying to find housing, money issues, family issues, SE's, etc etc.....We will all get through this....one day at a time.
Love to all....Be Brave.
Michelle
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