Scared a Friend is Being Rushed!!

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arenswife
arenswife Member Posts: 17
edited December 2014 in Stage I Breast Cancer

Hi. I gave breast cancer which is why a former coworker called me for sympathy, support, & guidance.

7 mm lesion (poss tumor) found , by needle aspiration. At first she was told DCIS then was told it had invasive qualities, now it's both. (Weird to me. They didn't say she had 2 different bc's, so how can one cancer not be invasive but have invasive qualities?)

Now, today she had a port put in. What makes me nervous is they haven't done a sentinel node biopsy yet!! They told her she's stage 1 grade 1. Does that require full chemo? She's also her2neu positive. (And was told that was bad...not that you respond better to treatment & have more treatment options)

She has not had a 2nd opinion anywhere. We live in a small town in Mn, but we do have Mayo Clinic. I'm scared she's being rushed into decisions based on fear, not on what us best!

Am I completely off the mark? Is it normal to put in a port, before node biopsy, for chemo? I don't want to upset or scare her, but I don't want her to go through what I did....especially since she's stage 1 grade 1...HELP!!!!!!

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  • jbdayton
    jbdayton Member Posts: 700
    edited December 2014

    I can understand your concern. I had chemo before my nodes were checked.

    I did have a grade 3 invasive tumor but luckily was HER2 negative. After chemo was completed I had a new mammo and ultrasound ( surprise tumor was almost gone but DCIS was found in the original tumor bed ) so I had a bi-lateral mastectomy. During this surgery my sentinel nodes were removed and one showed a possible micromet that had a complete pathological response. So you can have invasive and DCIS in the same area right up against the chest wall. Chemo will not kill the DCIS though. I had to do radiation for that after healing from the mastectomy.

    So the answer about chemo first is yes, it is done without first checking the sentinel nodes sometimes.

    I hope you and she can get more clarity before starting chemo. I sure would not want anyone to have to go through chemo without good reasons.

    Hope this helps. Keep us updated. HUGS!!!

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  • Kathy044
    Kathy044 Member Posts: 433
    edited December 2014

    Arneswife your friend is her2neu positive and with the new drugs available for HER2 treatment, I believe the whole world of treatment possible for her has changed. It could mean that she doesn't need to know her node status if she will be having some sort of chemo before surgery anyway. I don't know, just wanted to highlight the point that you mentioned she is her2neu positive, perhaps someone else can comment.

    Kathy

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited December 2014

    Does she have a copy of her biopsy pathology report?  I had one mass that was a combination of IDC and DCIS also.  If she has an invasive portion of her tumor - and it is Her2+ - it would not be unusual to put in a port prior to knowing her nodal status because it is the Her2+ aspect that is driving her potential need for systemic treatment - not necessarily the size and grade of the mass, and generally anything over 5mm gets systemic treatment.  I knew before surgery that I was Her2+ and had the port installed simultaneously.  My nodal status was not yet known, but I knew I would be having chemo and Herceptin. Also, there is a new drug combination regimen for early stage Her2+ cancer, which includes chemo and targeted treatments (Herceptin and Perjeta), that are given prior to surgery for six rounds, then surgery and a continuation of one of the targeted drugs (Herceptin) for the remainder of the year.  If you are Her2+ and need systemic treatment it lasts for a year, so most all do get a port.  Yes, there are additional treatment options for Her2+ cancer, but it is an aggressive form of breast cancer, and does not necessarily respond better to treatment.

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  • Annette47
    Annette47 Member Posts: 957
    edited December 2014

    Invasive cancer can originate as DCIS so it is very common to have an area of cancer which is both at the same time - that is what I had. What sometimes happens is that an initial biopsy only picks up on one part, so only identifies the DCIS or the IDC and the rest is discovered on subsequent pathology at surgery. In her case, maybe it was a second look by the pathologist that discovered the invasive part.

    As for the port, I do think that is unusual to do it that early, but I am guessing it is because she is HER2+ .... most HER2+ tumors (unless they are incredibly tiny as in 1-2 mm) do get treated with chemo, so node status may not factor in for her.

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  • Sassa
    Sassa Member Posts: 1,588
    edited December 2014

    I had an excisional biopsy. Pathology showed both DCIS and IDC in the tumor. I was also Stage 1, ER/PR negative, HER2 ++++. I knew I was going to have chemo.

    I opted for a mastectomy and and had a port put in and a sentinel node biopsy at the same time.

    No, I don't think your friend is being rushed. Depending on how aggressive her tumor is (mine was extremely aggressive), it is better to start treatment sooner rather then lollygag around and taking a leisurely approach to decison making.

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  • Sassa
    Sassa Member Posts: 1,588
    edited December 2014

    Your friend should also be told she is lucky to be HER2+. I know, I thought my oncologist was crazy when she told me that at our meeting. Now, 8 years later, I understand.

    Because she is HER2+ and early stage, she has an excellent chance of being put into remission by chemo and herceptin and, hopefully, staying there. Herceptin is a miracle drug for us HER2+ BC patients.

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