Partial Pathology report

kris1114
kris1114 Member Posts: 82
edited January 2015 in Just Diagnosed

I have an appointment with Oncologist tomorrow, but I knew my final report was back. Called surgeon voice shaking and on the verge of crying. They put the surgeon on the phone. Here is what I know so far. 4 lymph nodes tested benign! But 1 of 4 isolated tumor cells, but not enough to be positive. Diffuse cancer in affected breast. 8.6cm. BUT mixed invasive AND in situ (contained). Ductal invasive and in situ and lobular in situ. 8.6cm not total cuz of the mixed features. He said excellent choice removing the unaffected breast as the lobular in situ cancer held equal risk in developing in the benign breast. Confirmed Chemo and he says Radiation. They could not stage the cancer. I guess cuz of all the mixed features.

I have had great advice moving forward with Chemotherapy, any other words of wisdom let me know.

Kristin

Comments

  • bride
    bride Member Posts: 382
    edited January 2015

    Kristen,

    I don't have much wisdom -- I'm only 10 weeks out from my rads. I have learned a few things. It's okay to whimper, weep, rage, feel fear, hopelessness, and out of control. But don't be shocked if you also feel silly, empowered, and brave. Cancer kicked my butt, but I kicked its butt. Now all I have to do is reassemble my body -- somehow my psyche is doing okay.

    I've learned to ask others for things, that accepting my limits doesn't mean I'm a wimp, and that I can handle the roller coaster that is cancer.

    And I bet you can handle it too.

    bride

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    Thank you! I can say I am surprised that I am not bothered by having a bilateral mastectomy. I have other health issues that I need to attend to before reconstruction and I am not sure I will even go there. All the failure rates scare me and I'm not sure how important it is to me anyway. It is weird how I go from brave and even silly and euphoric to scard sh*tless! A long strange trip indeed.

    Tomorrow is a big day. I will know my chemo cycle and the drugs they will be using and hopefully the oncologist can make more sense out of the pathology report.

    Kristin

  • Moderators
    Moderators Member Posts: 25,912
    edited January 2015

    Kris-

    We're hoping for a good visit where a lot of your questions are answered, and a clear start on your treatment journey! Please keep us posted, we'll be thinking of you!

    The Mods

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    Thank you so much! I can't wait for my appointment. I do want to be more healed from my BMX, but want to get the show on the road!

  • bride
    bride Member Posts: 382
    edited January 2015

    Kris,

    You might also want to check with your RO before you decide about reconstruction. My RO didn't want skin expanders in her way. But I imagine that varies by each person and her type of cancer.

    Still, it might be worth checking out.

    bride

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    RO = Oncologist?

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited January 2015

    Radiation Oncologist

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    I don't think I will be set up there for about 5 months though. I will know more today, but I think I am on the same track for 4-5 months chemo and 5-7 weeks of radiation.

  • bride
    bride Member Posts: 382
    edited January 2015

    RO is short hand for radiation oncologist. MO is medical oncologist. SO is surgical oncologist. It's confusing I know, but our mods have made a list of all these: it took me forever to get DIL -- daughter in law... Your MO, RO, and RO are the main players on your medical team.

    Best wishes,

    bride

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    So final report. Stage 2A. No lymph node involvement, but one had micro metastisis, but still benign. Margins clear, non vascular, nerve invasion. Mixed Ductal invasive and in situ and extensive Lobular in situ. Total measures 8.6cm

    Drains out today hopefully and ask about lymphedema which was confirmed by Oncologist.

    Monday education on Chemo which will be Adriamycin and Cytoxon every 2 wks X 4 treatments. Then weekly Taxol, then small break, then 5-7 weeks radiation, then hormone therapy. Tamoxifen 5-10 years and Triptorelin monthly shot in but, OR radiate ovaries.

    Then port placement, and bone scan, ct scan and echo.

    1st Chemo treatment is Feb. 10th.

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    Oh and I was told I would have to be careful if I opt for reconstruction as some of the methods would not be an option for me due to radiated tissue.

  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited January 2015

    Kris, you can schedule a consult with your radiologist well before your radiation treatment begins - in fact, I think it's an excellent idea to do so. I learned a LOT from meeting with my RO and she answered many questions that helped me move forward in decision making. In fact, she was more helpful than my MO and the first surgeons I saw.

    Good luck getting all of this organized and underway. It's a long haul but we'll support you every step of the way.

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    You guys are the best!!

  • bride
    bride Member Posts: 382
    edited January 2015

    Kris,

    Within 3 days of being accepted by Emory, besides the endless tests, my MO set up appointments with my SO and RO even though I would have 7 months of chemo before I had surgery and 9 months before I saw my RO. In my case, because of the nature of my IBC, my RO didn't want to work around skin expanders but my SO evidently created all sorts of innovative surgerical stuff and really wanted (and wrongly assumed I wanted) to do a reconstruction using some of her new techniques. And, I admit, my SO is smart as can be. Unfortunately, when she's not in the OR -- as in seeing patients, she's a tightly wound, big time Alpha dog. I didn't want a reconstruction: actually, at that point, I was lobbying for her take every thing she could out of my body because suddenly I had this thing called IBC and I really, really just wanted it to just go away. I was pretty freaked out after my SO. Two hours later, I saw my RO, who is the most complete doctor I've ever met. She handles things that my MO would have gladly done, but my RO wants things done immediately and will keep fighting until she gets things done. Yupe, another Alpha dog, but one who gets it that we are not yet up to speed, are scared witless, and are having to move at warp speed while we're still learning how to say the words "I have cancer." Yes, my MO is another Alpha dog but she's young and Emory is fast tracking her so she's pretty stressed. For some reason, there is a wee bit of unease between us. My caregiver thinks the tension is there because my MO isn't used to patients like me. I've spent over 30 years doing and reading other's research so, with the help of a medical dictionary, I can read "scholarly articles." Plus I'm lucky enough to have a secret weapon: one of my dearest friends is a hotshot infectious disease doc (5 years ago, she delivered the keynote address at the yearly international AIDS conference) who has watched my progression like a hawk while also sending me those evil scholarly articles. On the other had, my stone-faced SO becomes a different person in the OR: she does little happy dances and makes an endless number of jokes, some which were actually funny. The point I'm wandering to is this: you're the only one who will have the full knowledge of your cancer. And each of your oncs will have a different knowledge base -- different yet, in many ways, overlapping. Thus, my MO could tell me right away that I would have radiation therapy, but she didn't know that my SO was pleading to me to let her recreate my breast while I was whinging about wanting both my breasts to be gone and my RO didn't want this did want this but did want that. I made sure I had damn good docs. But even though Emory has its stuff more together than any medical group I've ever encountered, I knew (unless someone had the lifetime it would take to get a real knowledge of my disease) that it was my job to get and keep sight of the overall situation. It was also my job learn from each of my docs and to make sure we were all on the same page. Each of my oncs gave me information that shaped my treatment plan -- information which sometimes originated from me. The only battle I lost was that I didn't have BM but a UM. The powers that be have decided that doing a BM when only one breast is involved entails more risk than benefit (yeah, like they'd know) and I couldn't convince them nor would my insurance cover it. Kris, this rambling post really has an important message: you are surrounded by hotshot docs. They will hopefully tend you well. But you are the pivot point. You know what you're feeling and you may receive conflicting advice that, if you don't mention it, won't be addressed. That's why I urge you to meet with as of your docs as soon as you can. Beyond learning about your cancer, it is ultimately empowering for you to be very proactive.

    Now comes the reality check. Although I've use the words I, me, and mine with regard to this early onslaught of tests and docs, more often than not, especially in the beginning, the person keeping everyone on the same page was my caregiver. She'd talk and I'd sit there quietly honing my ability to disassociate. Over time, I did become the one with the bookmark, but I wouldn't have made through my DX process and first weeks of treatment without her. And that is my second (repeated, I know) bit of advice: take someone with you who is capable of dealing with the morass of medical and emotional fallout that cancer causes. If that idea makes you feel as though you should tough it out on your own, think of your caregiver as your administrative aid. For some unknown reason, my caregiver loathed that word so she declared that she was my keeper, not my caregiver. Yes, even during miserable times, my keeper made me laugh. Kris, try to remember to laugh. It helps.

    I daresay you know all this but it nevers hurts to be told (at an untenable length) that you're what all of this is about. Let yourself be taken care of and, as much as you can, be proactive. Wow, that sounds sort of like real life. Because it is real life. In between tests, infusions, and doc appointments you still have the ability to feel Joy, Delight, and even Reckless Abandon, if she decides to visit. I embraced good old Reckless and went out and bought myself a brand new bicycle. I hope this trio comes to be with you often.

    Take care,

    bride

  • kris1114
    kris1114 Member Posts: 82
    edited January 2015

    So I have physical therapy beginning this Thursday for range of motion and lymphedema. And port placement on the 28th. Testing on Feb.3rd and Chemo beginning Feb.10th.

    I love the Doctor and her staff. I love that it is all in one location. It is 35 miles away, but it only takes 30-40 minutes. My Mom is begging me to get closer to home, but I feel since I felt connected from the beginning, that it is important to stay put.

    I will however likely ask for a referral closer to home when radiation comes into play as that is daily.


  • bride
    bride Member Posts: 382
    edited January 2015

    Kris,

    I drive down from Rome, GA to go to Emory. During my 6 weeks of rads, I (and my caregiver) stayed at the Hope Lodge -- it's free if you live over 50 miles from Emory. While my MO and SO were excellent, my RO, Dr. Mylin Torres, is the best doc I've ever met: she knows and cares more about her patients, how to cope with their SEs (even if a SE is not rad-related), and how to keep everything in line. If you're headed to Winship/Emory, I'd urge you to use Dr. Torres as your RO.

    Best,

    bride

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