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bythemarina
bythemarina Member Posts: 14

Hi everyone

I have been diagnosed on the 19th of June 2015 with Infiltrating Duct Carcinoma, NST. I had a lumpectomy about 2 weeks ago and 2 lymph nodes removed and "one of which shows a single group of malignant cells in the subcapsular sinus. I will be seeing the Oncologist next Tuesday and will probably know / understand a bit more about the exact status of my cancer.

Although I have done a bit of research in the last 2 weeks, I am totally lost and not really sure what to expect. I have always said that I would never go for chemotherapy but am feeling confused about this decision. The surgeon explained as best as he could but to be honest, I saw his lips move but couldn't make sense of what he was saying. What I do remember is that he said that I would probably need hormone therapy, definitely radiation and probably chemotherapy. I have copies of the pathology reports but it doesn't make much sense - I was very ignorant about cancer. There is reference of -HER2 neu score 1/3. ER I=2/3; P=5/5. What is even more confusing is that the tumour scores are T=3; M=1; P=3. Can anyone shed some light on these results?

I have decided that I would definitely not go for chemo therapy and still not sure if I want to subject myself to radiation. I have drastically changed my diet and been eating only fruit and veggies. I'm not overweight and fairly active, although I have been too tired and miserable to do as much as I used to in the past.

I would love to know more about the disease and your personal experiences.

Thank you in advance!


Comments

  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited July 2015

    hello and welcome, bythemarina! This is the club you never wanted to join. But there is a lot of good support and information here.

    I am putting a link here that will help you understand your pathology report.

    http://www.breastcancer.org/symptoms/diagnosis

    There is so much info thrown at us at once in the beginning. Try to learn all you can and don't worry about making serious decisions about chemo or radiation until you know more.

    It will also be helpful to those who want to help and support you if you fill out your diagnosis (dx) info in your profile section.

    I had a double mastectomy with an early stage cancer with clear margins and no mode involvement and because of new types of tests they can do to predict recurrence, (oncotype dx)I was recommended to do chemo. I didn't want it to come back. So I did it.

  • bythemarina
    bythemarina Member Posts: 14
    edited July 2015

    Thanks Jackbirdie. It is exactly as you're saying and yes, I feel overwhelmed. I really wish that I had paid more attention when friends and family talked about their cancers. For some odd reason I thought it would be rude to ask questions about it.

    I was devastated when the surgeon had to remove L nipple and areola, so can only imagine how difficult it must have been for you to decide on a double mastectomy? That was a brave thing to do. Mine too was early stage. I felt a small lump in January. It felt 'different' but I convinced myself it was probably nothing. The lump was small according to the sonar and MRI, done in June 2015. After the needle biopsy, it seemed to have exploded and nearly doubled in size in a matter of 2 weeks. I'm wondering if the biopsy did not cause the cancer to spread to the sentinal node? My cytology report diagnosed Ductal Carcinoma In Situ but this diagnosis changed to Invasive Ductal Carcinoma after lumpectomy and pathology there-off.

    I would really love to hear about your chemo and radiation experiences. Because I had a score on HER2 neu, the surgeon said that I might be put on hormone therapy, so would also love to know more about HER2 neu and treatment there-off. I really am clueless. Dr Google did not do a good job in my case!

    Okay, let me try to complete my profile section properly although I suspect that not all the information is on the histology report. According to all the articles I have read, Stage 2 up to stage 4 are sub-divided. The report does not indicate the stage at all. I phoned the surgeon and he texted the following: T1N1M0 Stage 2. However, the histology report clearly indicates M1, so I'm a really confused. He says the Oncologist would be better equipped to explain everything.

  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited July 2015

    Oh you poor dear. I swear this is the worst time. The waiting. The heavy decisions. You must be good to yourself and stay off Dr. Google. Come here for your information. There are so many good, dependable, researched, articles. Make bco your universe for your information and support. You will get an unconditional placeto rant when you ( and your friends S&C family) just don't get it.

    Here is a good place to start

    http://www.breastcancer.org/symptoms/diagnosis

    I will write another post on my chemo experience in a minute. Need to gather my thoughts.

  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited July 2015

    here is a more specific link to help you interpret your path report

    http://www.breastcancer.org/Images/Pathology_Repor...

    So. I didn't have to do rads, but I did do chemo. I had 6 rounds of taxotere/cytoxan it was pretty hard, but doable. My last infusion was 4 weeks ago and I'm definitely starting to feel better.

    Because my tumor was ER/PR+ I was recommended to do hormone therapy probably for ten years. it will offer me twice the benefit of chemo. I wanted to throw the kitchen sink at this thing, so after my oncotype dx test results came back with a fairly high % of recurrence, I went for it. I don't want to go through this again. The oncotype score is usually used on early stage women who wouldn't be automatically being recommended chemo anyway, due to tumor size or node involvement- you can ask your oncologist about it.

    About HER pos, I'm not very knowledgable. Generally you get "targeted" therapy like Herceptin and Perjeta, which are infusions, but not considered chemo.

    I didn't know about this place when I had my surgery I live alone and went through some hard times by myself.

    Luckily, just before chemo started I found this place. Here on the discussion boards there is a group starting every month for surgery, chemo, rads- you will travel through your treatment with others going through the exact same thing. It saved me. I learned more about handling various side effects than i did from my doc. You can drop in and lurk in some of the groups that are very active right now and get an idea of the support, love, and camaraderie that goes on.

    If you have any questions, or are just worried and scared, just keep coming back here- we will be here to help you through whatever you need.

    You will feel much better after you meet with your medical oncologist (MO) and decide ona treatment plan. Whatever you decide. Your body. Your decision. But it will help a lot if you can educate yourself as much as possible so your time with the dr is at a higher level.

  • queenmomcat
    queenmomcat Member Posts: 3,039
    edited July 2015

    I don't pretend to be an expert--I'm only a short step ahead of you in this process--but I just wanted to toss in a few thoughts beyond "We're so sorry you've gotten this diagnosis. You are not alone in any of this."

    The short and personal: I too fell apart COMPLETELY when the surgeon told me he'd have to remove my nipple and areola. He hadn't gotten clean margins with our first surgery--facing the physical and emotional stress of another surgery hard on the heels of the first was hard enough, but the loss of such a personal part of my anatomy? I still haven't gotten over it!

    The what I figured out/was told by the lovely participants here on the boards (and which you may have been told already/started figuring out for yourself)

    Brain freeze: totally normal. We hear the words "You have cancer." and nothing after that registers. The American Cancer Society has a lot of good information, as does this site, but keep in mind that much of it will not apply to you (my radiologist's wise words to me, after my very first mammogram eight years ago showed an abnormality) But mention it to the oncologist.

    "I don't want to do this.":also totally normal. Fear of cancer, of treatment, of side effects, of loss of control, of recurrence, of the unknown...and many more ifs and ofs. Make sure the oncologists explain WHY they're recommending this, and also separate the likely treatment from the possible treatments, and when

    Yes, you'll almost certainly learn more at your meeting with the oncologist. Start writing down all your questions now, and take them with you to the oncologist's office. Even better, bring someone else with you; they may catch something you miss. Don't be shy about asking us/your oncologists questions, even if they aren't directly related to your diagnosis and treatment plan. Childcare, health insurance, income loss, getting groceries during recovery, body image, whom to tell and when and why.

  • bythemarina
    bythemarina Member Posts: 14
    edited July 2015

    Thanks Jackbirdie. I truly am sorry that you had to go through most of this on your own. Let me assure you, although my youngest son lives at home, it still feels as if I'm lost and alone in a dark hole. Some days I wallow in self-pity and other days I feel sorry for my children.

    My health problems started last year. After a few visits to my GP, a blood test confirmed that I have the H-Pylori virus. I was surprised to learn (via dr Google) that there is a link between cancer and H-Pylori?? ...and apparently itchy feet and ankles. Who would have thought there could be a link with cancer? Or is Dr Google misguided?

    By October/November 2014, my left arm became painful. This got progressively worse, to the point where I could (still can't) fasten a bra. Getting dressed is a battle, not to mention brushing my hair. My GP diagnosed a frozen shoulder and gave me a Cortisone jab. This made absolutely no difference. An MRI of my shoulder and neck, showed a lesion on one of the vertebrae's and a bone scan was recommended by the radiologist. The Neuro Surgeon did not think it was necessary at the time although, according to him, it needed to be followed up.

    Meanwhile I felt more tired every day and the excruciating pain in my left shoulder kept me up for nights at a time (still does). Getting up in the morning is a mission because I have aches and pains everywhere. I had a routine Mammogram and did NOT expect the news given me. On the day of my biopsy appointment, I actually walked out. I thought it was a waste of time and money. Had my GP not phoned and explained the seriousness of my situation, I would probably still be in my bubble of oblivion and denial.

    After the breast cancer diagnosis, the doctor immediately ordered a bone scan. The bone scan report mentions an "increased uptake in the sternum" and "degenerative changes in left shoulder" but no bony metastasis. Strange that everything seems to be going wrong on the Left side of my body?

    After reading your post and some others, I'm only at the beginning of a long bumpy journey even though it feels as if I've been on that path for more than a year. :-(


  • Spookiesmom
    Spookiesmom Member Posts: 9,568
    edited July 2015

    I am another one who said she'd never do chemo. It killed my dad in the early 90s. But when I heard MY name and cancer in the same sentence, my mind changed, fast.

    I had 4 a/c, one Taxotere, was supposed to be 4. The a/c was rough but doable. The docs have a lot of meds to help you along. I had a severe allergic reaction to the T, chemo was stopped. Would I do chemo again? Yes. I still have my port, and I want to make sure I have done all I could to kill the beast.

    Rads. Total of 32 treatments. Even though my skin broke, it wasn't bad. The worst part was going Every. Single. Day. Would I do it again? Yes. Same reason.

    I'm on Arimadex. The first week or so I was moody, snappy, hot flashing. It's all settled down to tolerable. Again, the docs can help you with the se's. I'll be on it 5-10 years.

    DrGoogle is NOT your friend now. Go to reputable sites. Mayo. Am Cancer. Here.

    Waiting for test results is the worst part. Once you get a plan, it gets easier. Try taking someone with you for extra ears, or ask doc if you can record the visit.

    Hope this helps. Best wishes.

  • bythemarina
    bythemarina Member Posts: 14
    edited July 2015

    Thanks Queenmomcat. I completely understand what you're saying about losing your nipple and areola. My sister and both daughters were like "it's only a nipple, your life is worth more". It is DAMN awful! I don't want to touch or look at my breast! I can only imagine what it must be like having to go through surgery again and having yet more of you anatomy removed. That is a double whammy!

    After my op, I developed an allergy for the plaster and had to rush to the ER one evening. When the doctor took the plaster off, I looked the other way and told her that I cannot look at it. She was such an angel. She took my scarred breast in both hands and said "it is still so beautiful and it can be fixed". I started crying when she said that. It will never be the same again, no matter what anyone says.


  • bythemarina
    bythemarina Member Posts: 14
    edited July 2015

    Maybe I will change my mind Spookiesmom. At this moment, I am horrified at the idea of chemo and radiation. Seems like I have a very long way to go ... and no detours via Dr Google


  • queenmomcat
    queenmomcat Member Posts: 3,039
    edited August 2015

    Oh God, the "It's only a breast! What are you so upset about?" cluster of responses. Sometimes even from someone who's gone through breast cancer themselves. Not to mention explaining to the surgeon what, precisely, you're upset about; for me, not just the appearance change but the loss of sensation.

    There's a range of normal reactions. NOT wanting to look at, touch or even think about how your breast looks now, and not just when you pass a mirror, is one of them. I still struggle with showering, and insisted that my husband be right there with me when I took the dressing off after the second surgery. The staples the surgeon used didn't help! Though it did help just a little bit getting the sense from Dr. Surgeon that he knew quite well how women feel in this regard, and was very sorry to have to do this anyway.

    Also normal to be horrified by and resistant to the treatments involved in cancer. One question you might ask the oncologists is "How will this reduce my chance of recurrence?" I was flailing desperately to get out of radiation while keeping what remained of my breast. But my MO said something along the lines of "Based on what we do know of DCIS and of your diagnosis, my professional guess is that radiation would reduce your 10-year chances of recurrence from 20% to 5%. Lifetime? We don't have forty years worth of data on this."

    How to handle that? Again a range of ways depending on you. Getting an idea of what treatment options you have might help. So might demystifying the process: my RO walked me through the process of getting a radiation treatment (not the actual simulation, just a nickel tour) and that calmed me down a great deal. But don't be shy about mentioning all this to your oncologists: "I'm having trouble accepting this. Can you help me?" If there's something specific, mention it, but there may not be, not yet.

    As for Dr. Google, let's just say that there's a lot of information that's in the pre-experimental theory stage of development, whether causes or cures. Where you draw the line between truth and conjecture is up to you, however.

  • bythemarina
    bythemarina Member Posts: 14
    edited July 2015

    Kayb, as I said early on, I was completely ignorant of cancer. I was considered a "low risk" for breast cancer and therefore hardly took note of the breast cancer awareness programs. Before the diagnosis, I went through a very stressful period and my diet suffered as a result. Naturally I'm inclined to reconsider and adjust my diet. In the event of chemo or whatever treatment, I think it would be unwise not to prepare one's body ... not that I'm considering chemo but that all depends on what the oncologist tells me on Tuesday. I don't know why the surgeon mentioned chemo.

    As ridiculous as this sounds, I am still inclined to get a second opinion. It is really hard to come to terms with this diagnosis.


  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited July 2015

    Great post Kayb- Bythemarina, I was also low risk and entirely ignorant. Entirely. It was an awful shock to hear the dx and I sat in my car in the hospital parking lot, in the rain, for a long time after I got my first biopsy path results. Crying.

    I've come a long way from then, with the help from the ladies here, and also my doctors. I also think second opinions are good, for the reasons Kay mentioned,

    You WILL get through this. It does get better. Promise

  • msphil
    msphil Member Posts: 1,536
    edited July 2015

    hey sweetie,i was diagnosed with idc, stage 2, 3 nodes positive, L mast(thought about lumpectomy was making wedding plans when found lump) we put wedding on hold, i had 3 months of chemo before surgery and then 3 months after, we got married, and then i did rads after our honeymoon, and then 5 yrs on tamoxifen, and sweetie, i am now a 21 yr Survivo(Praise GOD),just wanted to Inspire you. msphil

  • bythemarina
    bythemarina Member Posts: 14
    edited July 2015

    So I have been to see the Oncologist. I don't need chemo and will start radiology within the next 2 weeks and after that, the Oncologist suggests Tamoxifen. I am HER2- and grateful for that.

    I have decided not to take the hormone therapy and yes, I have done loads of research and spoken to cancer patients. One of my friends had a lump >5cm. She went for chemo, then mastectomy, all lymph nodes removed and 5 years on Tamoxifen. She is not the picture of health and constantly complains of aches and pains in her joints and bones.

    Thank you msphil. It is wonderful to hear such positive news.


  • tshire
    tshire Member Posts: 239
    edited August 2015

    Did you do Oncotype or Mammaprint? Those can help with the treatment decisions.

    My Oncotype score was a 20 and I am considering chemo even still. It might give me a 4-7% better chance against Stage 4. Waiting on Mammaprint now.

    I absolutely plan to do hormone treatment. Even though I am premenopausal, studies have come out showing that ovarian ablation + AI works better than Tamoxifen. Some studies have even shown that premenopausal women who do chemo benefited more from getting their ovaries shut down as a side effect of the chemo than the chemo itself! Go to Dr. Susan Love's website for good information.

    And just a note- I've been a lifelong (literally raised) vegetarian, with a fully negative genetic workup. It still happened to me. Now I am a vegan teetotaler and exercise 300 minutes per week though. ;)

  • bythemarina
    bythemarina Member Posts: 14
    edited August 2015

    Tshire, thank you so much for responding and for the information. I'm sorry that we have to meet under these circumstances but hey, as Eleanor Rooseveld once said: "A woman is like a tea bag - you can't tell how strong she is until you put her in hot water".

    Over the last 2 weeks I have watched many documentaries about breast cancer and causes of BC, so I am one step closer to making a decision. After all that I have seen and heard, I was a good candidate for BC despite my so-called 'low risk' status.

    In one of the research papers about psychological make-up of a person contracting cancer (I have a psychology degree, hence my interest in the psychological make-up of an illness), it is stated that the person experienced a traumatic event approximately 2 years before the cancer diagnosis and could not deal with the issue . My brother died in October 2013, 2 days before his birthday. Unfortunately we were not on good terms for years. The news had a devastating impact on our family and myself. My 82 year old mother deteriorated fast and that caused further stress and worry.

    6 Months after my brother passed, my hairdresser told me that something is not well with me and she could see it in the condition of my hair. By her estimation, it is something that started happening 6 months before that day. I suffered from daily heartburn, itchy feet and ankles and worst of all, diarrhea and vomiting for no apparent reason. My GP ran some blood work and diagnosed H-Pylori. After 2 different antibiotics and 2 treatments, those symptoms improved somewhat. Possibly I just got used to the heartburn and occasional vomiting and diarrhea. Over the last year I often skipped meals, sometimes for days at a time and then binged on pastries, chocolates and fast food at other times. Add to the mix home renovations and stress of rescuing abandoned, abused and neglected animals = walking time bomb!

    I'm hoping to see a medical oncologist soon. All the best with your treatment!


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