Diagnosis with IDC

Go to profile then diagnosis and go through the steps. You only have to answer what you know from your reports. Then if you have questions come here and ask. You can list them. Don't forget to save you can change or fix later

Hi Marijen and EnglishMummy:

InTshire's case, she had no treatment prior to surgery. The difference observed was between the predicted size from imaging and the actual size determined from the lumpectomy. It turned out that the pathology report from the lumpectomy contained an error regarding dimensions. After review of the pathology slides and correction of the pathology report, the imaging and surgical sizes were indeed congruent, and the imaging had indeed provided an accurate estimate.

Marijen - Am I correct that you have not had any surgical procedure yet? (Neither lumpectomy or surgical biopsy (under anesthesia)? You have been treated with endocrine therapy for six months prior to surgery, which is scheduled for next week. This is what you said before about the diagnosis elsewhere:

"It says on my original report - no invasive component identified on specimen. But I also have a turmor in my armpit, so it is metastatic. Six months ago she called it DCIS and Metastatic Breast Cancer. Stage IIIA because it's matted."

It is very difficult to figure out what is going on in a complex case like yours, because we are just fellow patients, and we cannot have a clear/full understanding of all testing, relevant reports, and the expert advice you have received. In another thread, members are guessing that your diagnosis is IDC with DCIS, which is very common. What is less common, is that there is some indication of regional disease in the lymph nodes (matted nodes, possible sampling), meaning that invasive disease is present somewhere or was present at one time, even though no IDC has been identified in the breast yet. They may find an area of IDC when they do a lumpectomy, or if not, then it would be a case of an occult IDC ("T0").

The upcoming surgery seems to be intended to remove any remaining DCIS and IDC (if present) in the breast. Imaging taken prior to treatment with Femara may be less informative than more recent imaging in this regard. Please ask the surgeon to explain to you what imaging he will be relying on to guide him during the breast surgery, and why that imaging is the most relevant for guiding surgery (e.g., versus prior imaging).

BarredOwl

Hi Marijen:

Don't hesitate to contact him, and raise the question. I am not really sure what is going on, but possibilities include that there actually is some inconsistency (in which case it should be noted and accounted for in the strategy), or perhaps he will be able to reconcile the information for you, or provide an explanation of why certain information is more relevant or controlling for the purposes of surgery. You should not be seen as an anxiety-ridden patient just because you want to understand your diagnosis and surgical strategy. You are engaged and seeking understanding or clarification.

BarredOwl

Hi Marijen:

That sounds like it might be a mammography-guided needle-wire localization procedure? However, do be sure to include that in your question list to be certain, and so you are prepared and understand what will be happening.

On the day of my surgical biopsy (which was essentially a lumpectomy), before the surgery, they used seated mammography to visualize the area of concern (calcifications in my case), inserted a needle into each area of interest, and threaded a wire through the hollow center of the needle (under local anesthetic). Then, the outer needle was removed, leaving the wire in place to mark the area to be removed later by the surgeon ("wire-guided localization"). They placed two wires. Accurate localization is important to achieving clean margins, and hopefully avoiding the need for a further procedure(s) ("re-excision" or "resection") to obtain clean margins.

http://www.ucsfhealth.org/education/biopsy_for_bre...

Again, please confirm what is planned in your case.

I wish you and Marie good luck in your upcoming surgeries!

BarredOwl

(waving at) BarredOwl.

Marijen - Always ask any questions of your medical team - they are supposed to be working for you, who cares if you seem like an anxiety ridden patient?Perhaps you are, perhaps you aren't - More important is that you are satisfied with the answers to your questions. That is good news if Femura shrunk the lesion, right?

Good Luck with your surgeries - wishing you speedy, uneventful recoveries. Keep us posted.

Hi Marijen:

You could send a short note to the BS's nurse to ask for the full names of all procedures that are scheduled for you. Ask if she can provide any written materials explaining these procedures to you in layman's terms. Also ask if any written information will be provided to you regarding preparing for surgery (when to stop eating, limits on liquids, what not to take, etc.)

You should contact the surgeon if you have questions about how the imaging relates to the upcoming surgery, and what imaging information will guide the surgery for localization purposes. If the surgeon responds to written inquiries, that is one approach. My surgeon only dealt with me by phone, so I would leave a message requesting a call back. If by phone, write down your questions in advance, and take notes during the call. At the end of the call, recap your understanding of the take-home message. This gives them an opportunity to correct any possible misunderstanding.

I will be going off-line for a while.

BarredOwl

I called the surgeon's office today because I never got an answer.

Maijen, just wanted to let you know Barred Owl is off line for a few days. I think calling the RO is a great idea. Will be thinking of you Monday.

I found this:
http://www.biomedcentral.com/1471-2407/13/328

Measurement of tumor size in IDC - sonography underestimates, MRI most accurate..

Good News, Marijen, at least someone got back to you and you have an answer.

Just so you know, it is quiet because gremx started this thread within the IDC Forum - here is the link to the actual forum and you can pick a topic under it to post or read. https://community.breastcancer.org/forum/96 - you can also start your own thread there too if you need?

I just don't want you to feel deserted or that no one is listening. Hugs, L x

You will get used to waiting to talk to people.

Well the surgery is behnd me now. Not keeping anyhing down yet and there is a large incision on the breast and a large one under the arm. I am waiting for 11/3 fo post op to find out what all was done. They moved it up from 11/9 so the wait is shorter. He is telling me I have to keep things down or he will have to put me on IV. I am trying all crackers, breakfast drinks, etc. I have to keep my meds down to control my BP which is usually high but since the surgery its running low with a fast heart rate. I will check in again soon.

Englishmummy, now sure what you are asking? Surgery tomorrow. Or you mean IDC people. Still not much activity. Read my post at DCIS with high grade - I'm aggravated.....

Gremx003, It is really hard when you are going through the whole diagnosis process. I cried a lot to. This diagnosis came at the totally wrong time for me. In reality the stress of the diagnosis was worse than any of the treatments. I was told originally I had a 1.7 cm amorphous area by the radiologist. He was not able to confirm anything with a ultra sound. No lump could be felt. The surgeon said it was really larger more like 2.1. He had me totally scared. After the lumpectomy, which I had done twice because the surgeon did not get clear margins, I learned that the tumor was not as large as suggested by the mammogram because part of it was a benign fatty necrosis. Hang in it will get better do you have anyone who is there for you right now.

Hi gremx003, wow you went from not knowing anything and being to lost to being done with it already. I'm impressed. Missed you. Let us know the results. How big are your incisions? Sounds like you're going to make a good recovery.

I found out after my grandson got sick that I can keep down crackers so I am taking meds with crackers for now. My DIL had some coconuts and we were going to try your fix but I had to come back home to get away from two sick grandchildren who have strep throat. I cared for the oldest all day yesterday. We didn't know it was strep throat till today when they sent my other grandson home and we took both of them to the doctor. Yesterday the oldest had fever 102. DIL is not going to school till kids are well, so I just hope I don't get it.

Take care I am keeping all of you in my prayers.