Just dx at 61 - grade 3 IDC, est+, prog-, Her 2+ - 2nd opinion?

peg645, I'm so sorry for the circumstances that brought you here, but glad that you found us. There are a ton of great people on these discussion boards.

I personally did not get a second opinion since my hospital has a tumor boards where all the docs look at every case and make recommendations together, so I felt that I had multiple opinions built in. If you are trying to decide between lumpectomy and mastectomy, I'd get the second opinion before surgery. They do learn more after surgery. For example, I did not think I'd need chemo, but since one of my nodes was positive and I have an intermediate Oncotype score, I ended up needing it. So if you're only going to do lumpectomy, you might wait until after surgery for the second opinion.

Peg is your surgeon, who is recommending lumpectomy etc., a breast cancer surgeon, or a general surgeon? Like does he/she specialize in breast cancer, or does that along with other things? And no, you don't need a referral for a second opinion. Frankly, I would call Dana Farber and have them help you with the next steps. Let them tell you "We need x,y, and z," rather than trying to guess what they need before you call.

I am triple positive. From what I read prior to meeting my MO, the same tx was going to be recommended to me wherever I went: surgery, chemo, and maybe rads depending on node status and weather I chose lx or mx. So I felt comfortable skipping the second opinion.

With even a small Her2+ tumor, I think chemo with herceptin is going to be recommended no matter where you go. It will basically be your choice if you want to do it. Herceptin is very effective. Neo-adjuctive (before surgery) chemo with an addition of perjeta is now being offered for Her2+, but I think your tumor is too small. But if you wanted to look into this it would be a reason to seek a second opinion before surgery.

When it comes to surgery you will be given two options, lumpectomy with rads OR mastectomy and possibly no rads needed (if node negative and tumor not located near the chest wall). Some people fear rads others say its a breeze. 

Anywhere you go you are going to be told the same thing, ultimately your chance for survival is the same with either option. In the end it's your choice to make. Its a very personal decision and if you go searching for the "right" answer you will be truly disappointed, because it does not exist. Both options have pros and cons and neither guarantee you will not have a recurrance. It is impossible to remove all breast tissue, even with an mx. There are many threads on here that discuss topic.

Many work through chemo, others can't, you won't know which one you are till you try it. I rarely miss work. I took off only a week for a hysterectomy, so everyone was very surprised at how chemo kicked my butt and I did miss alot, and couldn't really function as myself when I was there.

You may want to look into short term disability options and medicare/medicaid/obamacare or whatever insurance help may be available to you to get through this. Its just for a few months. You'll be yourself again soon. Good luck to you.

peg, I had my slides sent to Johns Hopkins for a 2nd opinion. I didn't have to fly (although the slides were packed up and sent). My initial biopsy pathology (before surgery) was written sort of vague and I didn't feel confident with the individual who wrote my first report. The 2nd pathologist read the slides and the report came back much more concise and clear. I was far more confident about my treatment decisions after that. I also physically met with two separate oncologists. The first wanted to treat me aggressively and the 2nd was more conservative. I stayed with the 1st MO (nearby, well recommended, etc.), but requested the 2nd MO's treatment plan. Lumpectomy, chemo, rads and I'm done. 4 years out next week! Good luck in your decisions.