3 choices of treatment

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Dublingirl
Dublingirl Member Posts: 2
edited June 2015 in Just Diagnosed

I have been diagnosed with breast cancer . I have stage 3 invasive duct carsanoma and the tumor is around 4cm . It is also her2 negative. The cancer has spread to my lymph nodes. I have had all the scans done and had a meeting with my doctors and support nurse on friday .

They have given me 3 options of how to treat the cancer but I just don't know which one to choose and what would be best for me .

The first was to have the lump removed with the lymph nodes and chemotherapy.

The second was to have my breast removed & lymph nodes & chemotherapy.

The third is to have intense chemotherapy for 6 months once a week with herceptin with the hope of shrinking the tumor and then operate .

The third option is what the doctors are recommending but I have some concerns about . I have a meeting on Wednesday with the doctors to tell them the option I would like to go with and to come in with any questions I might have .

They think the 3rd option is best because they might not need to remove the breast or only take a small amount of tissue and my breast won't be as disfigured. And my age I'm 60 later in the year and suffer with arthritis.

A few of my concerns would be what if it doesn't work ? What if the cancer spreads ?

The doctor examed my stomach and said that they would take tissue from there to rebuild my breast . I'm only a size 10 uk and wouldn't have much there to take now . What if I loose more weight while I'm having chemotherapy I definitely won't have anything there to take .

I'm really looking to see if anybody has been given these options for treatment and what one they chose .

It is all good the doctors saying this is the best one but I would like someone opion who has gone though it and to see if they felt it was the best one for them .

Thank you in advance



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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited June 2015

    Weekends are a bit slow around here. I have no experience but have seen other women on these boards who have done it and it is a unique opportunity to find out how well the treatment is working. And as you mentioned it could be a good opportunity to save your breast and avoid a more difficult surgery. I'm sorry you find yourself here. Sending you gentle hugs from across the sea. Hang in there.

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  • Dublingirl
    Dublingirl Member Posts: 2
    edited June 2015

    thank you

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  • movingsoccermom
    movingsoccermom Member Posts: 225
    edited June 2015

    You might want to look at the surgery discussion groups to see if anything catches your eye. Also put each option in the search engine and see if something pops up. Some of the choice is also how you feel about your breasts. I knew no matter what was found I wanted to preserve what I could. Prior to surgery, based on imaging, I was expecting stage 2, but got lucky. Best wishes

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited June 2015

    Dublingirl,

    Are you sure you are HER2 negative? Your doctors wouldn't be recommending Herceptin to you if you weren't HER2+. I did option #3, and it dissolved my lump and cleared my positive lymph node of cancer. The PET scan and MRI showed no active cancer after chemo. As a result, I was able to get a lumpectomy, which removed a small amount of tissue around my surgical clip. I wanted a lumpectomy because I wanted a shorter recovery time and I didn't want to go through reconstruction. Those might not be issues for you, but they are factors to consider. By the way, I have a small dent in my breast but it otherwise looks pretty symmetrical with my "good breast." Best wishes in making your decision!

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited June 2015

    I would definitely do option 3. That way you KNOW whether the chemo is working or not (and change course if necessary), plus it gives you more time to really think through and research the lumpectomy/mastectomy/reconstruction choices (reconstruction is not that simple, so I think it is something you really want to study so you really know what you'd be getting into). Most people actually GAIN weight during chemo.....less active and more comfort food!

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  • Claire_in_Seattle
    Claire_in_Seattle Member Posts: 4,570
    edited June 2015

    If I were to do it all over again, I would do Option 3. Taking less and not more tissue is always a good thing. But chemo prior to surgery was very uncommon 5 years ago. I was thrilled not to need the breast removed.

    As an aside, it was assumed going in that I was Stage 3. However, only one node tested positive. So I was 2b.

    My breasts aren't symmetrical, but you can't tell with a good bra. And my guy certainly didn't complain.

    Good luck! - Claire

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  • Scwilly
    Scwilly Member Posts: 489
    edited June 2015

    I agree with Ruthbru and Claire_in-SEATLE - I did Neoadjuvent chemo and I'm very happy I did. If you need chemo then you will be starting on it as soon as possible, and not be delayed though surgery. For me with IBC it is the standard protocol and I would have to have the modified radical MX anyway. The chemo certainly shrink my IBC and reduced the selling leaving a very much smaller mass. this made me feel so much more confident that any stray cancer has been zapped.

    I wish you well, it is so difficult before you know what tx you will do, I know that a lot of people are concerned to know what stage they are at dx - but I try not to dwell on that. My radiation Doc said it well - I should remember that I have done all that I have been asked to do. I have also had DIEP reconstruction (beg April) and I love the result and my new breasts with the added bonus of a very flat tum.

    Sarah

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  • regatta21
    regatta21 Member Posts: 42
    edited June 2015

    Please research implants, too. I had a flap surgery which has ruined my life. Taking fat from the stomach is a huge deal. It also is major surgery. Please google diep flap video and see how invasive it is, it removes your belly button and they reposition it. Implants feel just fine. One of my breasts died and I have an implant there. I was fine after three weeks. But still recovering from flap surgery a year and half later. I'm disabled now and can't work. Please seek three Opinions. Implants have come a long way. Gummy bear implants are to be the best right now. Also, the surgeons make about $500k. Huge monetary incentive. And you will need more than one revision surgery with a flap. cutting up a part of your body that has nothing wrong with it for no real reason (old deformity) to me is not worth it.

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  • Trvler
    Trvler Member Posts: 3,159
    edited June 2015

    I am having neoadjuvant chemo. I am also having a DIEP in Sept. As far as the DIEP, I believe it is crucial to find the very best surgeon you can find to do it. Lots of doctors may do it but the results are based on who does it. As an example, I interviewed 3 PS's. The first just wasn't much in the way of bedside manner and he didn't make me feel comfortable. He might have been very good but he didn't communicate that to me. I didn't meet the second one but I had an appointment and cancelled it because after a lengthy conversation with his assistant, I was told 85% of the time, they convert from a DIEP to a TRAM in the operating room and that made me nervous. I then consulted with NOLA and their doctor made me feel completely comfortable with their competence level so I chose them. The doctor DOES make a difference. Do your research. This is a very specialized surgery and not just anyone can do a good job. As far as the neoadjuvant chemo, I have mixed feelings about it. I am doing it for the same reasons.

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  • Trvler
    Trvler Member Posts: 3,159
    edited June 2015

    Cont. I had to finish my post here because when I type a long post, it starts slowing down.

    Anyway, my cancer is not gone yet after 4 AC's and 3 TAxols and it is somewhat unsettling to me. My MO says it feels smaller so maybe but I can still feel the stabbing bee sting pains in my breast.

    Good luck with your decision. Don't rush so you know it's the right one. If you meet a doctor that makes you feel uncomfortable in any way, please choose a different one. I spent 2 months going to more and more doctors. I still hate my MO and maybe will change.

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  • jbdayton
    jbdayton Member Posts: 700
    edited June 2015

    I had grade 3 (aggressive) IDC, you mentioned stage but not grade. That is one of the questions I would ask. I was told chemo likes aggressive tumors. I did 6 rounds of neoadjuvant chemo. At my doctor visit before my 2nd treatment he said the tumor appeared to be 40-50% smaller? This allowed us to know this chemo was working and to continue on. By the time I finished the tumor could not be felt.

    I did this to shrink the tumor and try for a lumpectomy and rads. My scans after chemo showed the tumor was all but gone but I showed areas of DCIS remaining. At that point I decided to remove the breasts anyways, but it did give me time to research all my options and make an informed decision at the end.

    I am very glad I did the chemo first because I know without a doubt that the chemo worked. Only a very small inactive tumor was found in the original tumor bed at surgery. The only thing it didn't kill was a small area of DCIS in the original tumor bed but up against my chest wall. This changed my final decisions. You do what you have to do and you feel most comfortable with.

    I just realized you had your appointment yesterday. What did you decide to do?

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