Diagnosis with IDC

Hi gremx003:

So far your results look pretty good. Waiting for the results and worry about the unknown was very hard. I also remember being bothered under my arm a lot. I found that keeping a pillow under my arm (to keep my arm away from my body) while sitting helped. It can be a small cushion or a soft full-sized pillow.

In September, I had my 2-year anniversary of surgery, and my next appointment is in December.

Hoping for good results for you.

BarredOwl

BarredOwl I sure hope you were gone for fun reasons. Glad your back. Yes I tend to jump around the site to check on friends. Praying for all to feel better and heal. Thanks for the good luck wish. I still haven't heard from the RO.

BarredOwl

I will call Monday morning I got the BS office to send them a message this morning. They don't take phone calls I was told, unless you have already started treatment and then they give you a list of numbers.

So glad to here it was for fun reasons Be well, Hugs to you!

Marie, “Grade 1” and “tubular” are GOOD news--that means your tumors were very slow-growing (some use the word “indolent”). Unless your tumors were estrogen-negative or HER2+, you had lymph node involvement and didn’t get clear margins and you’re peri-or-pre-menopausal, chemo is quite unlikely.

Hi MB12:

After I met with the surgeon to review imaging, pathology and options, things were a lot clearer to me and I felt a lot better. I hope the same for you!

BarredOwl

Age 52 at diagnosis - Bilateral breast cancer - Stage IA IDC - BRCA negative; Bilateral mastectomy and SNB without reconstruction 9/2013

Dx Right: ER+PR+ DCIS (5+ cm) with IDC (1.5 mm) and micro-invasion < 1 mm; Grade 2 (IDC); 0/4 nodes.

Dx Left: ER+PR+ DCIS (5+ cm); Grade 2 (majority) and grade 3; isolated tumor cells in 1/1 nodes (pN0i+(sn)).

Hi Barredowl,

Thank you for the encouragement. 😀 I'm trying to get work done this weekend and stay in. I decided I will start reviewing and researching options on Monday/Tuesday. I have everything in order anyway.  I need a break from the last 32 days. 😉 

Doc said surgery for sure, but I can tell she doesn't want to tell me over the phone she is opting for mastectomy. I don't think I want radiation. I think id rather have chemo.

Can anybody help me distinguish the 2? I've read up and know that each cancer has different treatments. 

Happy Friday☀️

Michelle

BarredOwl - Well I have seroma now and its a bumber. Praying it will not affect starting treatment on Monday. I had surgery again Thursday and BS evidently drained the fluid out during the surgery but never said anything to me about it. I woke up just before midnight and called the emergency nurse on call because it was like my breast blew up leeking yellow fluid and blood. I was scared to death. She got the on call Dr. filling in for m BS on the phone with us and he said to either go to the emergency room or go to BS office in the morning. I went to the RO's office in the morning because my dressing was soaked through and they changed it after the surgery when they did the mapping for starting treatments Monday. My RO is upset with my BS because he didn't inform us of the seroma. I was put on Bactrim and pain meds and sent home with a small bag of dressing supplies to get me through the weekend. I can hardly do anything with my left arm now and I know it has to be up over my head for treatments I guess I will see how it goes Monday. I had a temperature but the meds have brought that down so far.

Its cold and rainy here, I am going to take my meds and try to sleep again. You take care. Hugs to you.

Hola,

Can anybody tell me about the menopause deal😳 Can I take something to avoid it during chemo or not get thrown into it after chemo? What usually happens? 

I want to be prepared.  Meeting w the BS tomorrow.  Also, there is a clinic that freezes cancer patients eggs for free. I meet with them on Wednesday, as I wanted more children and am not going down without a fight on my eggs, either. 💪💃I'm up for adopting, as well. 

The Sher Institute for Reproductive Medicine will freeze your eggs for FREE. 

Haveababy.com

They have 8 locations in the US.

Barredowl - thank you for the excellent advice! I took the weekend off and back at it!😘

Waterstreet - sending prayers, hugs n love!! Hang in there😘

Michelle xoxo

They put me on Bactrim and I thought it might keep me from the treatments but once they put that device in there they are going to use it.This was a horrible day for me. Read the post I sent to PontiacPeggy. I don't want to go back but I am just to get it over with. Mine was yellow fluid mixed with blood, but they can't sew it up till the last tretment is over Friday thats when they will remove the savi device. Take care,God Bless I am headed to lie down. I gave up the pain meds so I can drive myself to all these appointments, only eight left, if I live through it. I will live to see my Grandkids grow at least a few more years. Hugs to you.

I did - I had a funny feeling of congestion all around my armpit and shoulder, I bothered me for two months and I went and got a deep massage that made it worse. I tried to find the source of the pain myself and that's when I found a big old lump! 4.1cm. It was on a Saturday, I turned myself into the breast center on Monday.

I was freaking out when in the few days before my lumpectomy I felt pangs in my breast and a lump near the biopsy site--I'd never had a lump before (my bc was discovered via routine annual screening mammo). I went in the morning of surgery for my radioactive seed placement, and the radiologist said, “oh, there's a small seroma at the biopsy site." And my post-op results came back: clear margins and negative sentinel nodes. So no need to jump to any dire conclusions just yet.

Just want to add I love the Sher Institute. My daughter went to the one in NYC after years of a fertility struggle. Happy to say I now have 2 beautiful 18 month old grandsons. I do remember that they freeze eggs for free for cancer patients. Good luck and keep us posted...

Hi Laura (englishmumm)  - Tysm 😘  Had a busy last 2 days and one more blood draw today.  I'm in good spirits! 😁

Hi dtad - that's great to read!! I loved my dr at Sher.  I told her what you said and she was very happy to 👂 that!  

Here is my update, below. 👍

Hi Ladies 👯

Surgery 💉🔪💊 is set for Dec 7th. Starting fertility around Dec 4th and will hit it fast while in the hospital, as well. Harvesting eggs around the 14th. I was happy to see that I have a great egg supply!  My doctor is amazing!!! She's proactive and aggressive. 🙌 I should have 1 - 5 good eggs out of the bunch that make it.  Kinda bummed that I may not get to be prego, again. However, thankful that I was able to be once before and can get my eggs frozen. 🙏😀

My plastic surgeon is awesome, also! He is ahead of the game. I'm very, happy with the excellent team of doctors that I have in St. Louis. I honestly didn't expect it and was leaning on going back to UCSF, but they all have great experience and they are hip to new tx, etc. My BS trained w one of the best in LA. PS is best in my county on reconstructive bs and fertility doc is from John Hopkins and has a wall of awards. I did my research on them! 😉

Hope the oncologist and I get along. 😂

Ok, focusing on work the rest of the week/weekend and organizing all the doctors info to go in file folders and flash drive. Will review forums for info to integrate in, as well. 

Stay positive and don't give up!!! 😘

Michelle xo

Waterstreet:

I did go over to the Lumpectomy Lounge for your post to PontiacPeggy. Not a good day. Hoping things are improving.

Later on you said: "All I have left is an appointment with the MO January 25 and the bone density test in January. I just have the thought going through my head every since they found the second tumor that I have't really done enough to fight it. Especially with my 28% likely to recurr. And before it was Radiation, Chemo, meds and some targeted therapy."

It sounds like you are not entirely comfortable, so of course, I have some questions for you (numbered for convenience).

(1) When will you be done with radiation therapy?

(2) Also, may I ask if you already met with an MO or not?

(3) If you met with an MO already, was that meeting at a time when the surgical pathology from all surgical procedures, including lymph node status (2/2), was available and was considered in any recommendation?

(4) In your profile, the diagnostic information is:

DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/2 nodes, ER+/PR+, HER2-

(4A) In your comment, you mentioned a "second tumor". Do you mean all told there is (a) an area of DCIS; and (b) one IDC tumor? Or did they find a second IDC tumor that is not reflected in your profile?

(4B) Different tumors may have different features For each IDC tumor, what are the sizes, ER, PR, and HER2 statuses from the surgical pathology report?

"Targeted therapy" refers to agents that are directed to HER2, such as trastuzumab (Herceptin). So, if all invasive tumors are "HER2-negative", then "targeted therapy" would not be recommended.

But like you, I am also wondering about (1) possible endocrine therapy (an aromatase inhibitor for a post-menopausal woman); and (2) possible chemotherapy. Whether the latter would be considered depends on the pathology and diagnosis, and sometimes the results of an OncotypeDX test (hence my questions). Also, in some cases, there may be good reasons to depart from what the guidelines provide, but if so, it would be better to understand why.

Hope you don't mind my asking.

BarredOwl

Hi Waterstreet:

How awful for you with this device.

=> Please obtain a copy of the full surgical pathology report (plus any addenda or appendices) and let us know what you find out.

Regarding the pathology and treatment plan, often both DCIS (ductal carcinoma in situ) and IDC are found. DCIS is confined to the ducts ("non-invasive"), which is good.

In contrast, the IDC is "invasive" and presents the higher risk, so the features of the IDC control the stage determination and treatment decisions (although the DCIS should be adequately removed/addressed).

Imaging and stereotactic biopsies may be used to estimate size, but the surgical pathology should contain the actual sizes of both the IDC and DCIS.

Removing two blue lymph nodes means there were two sentinel nodes removed, but does not indicate whether they are positive or negative for cancer cells in them.

At least the node status, tumor size, ER, PR and HER2 status of the IDC must be known for one to generally understand or recommend a treatment plan.

Sometimes the MO has the surgical pathology report available to him, but it is not released to you until you have met with the MO. He didn't discuss it with you effectively, but he could have had access to it.

=> I am having difficulty understanding where you are with your MO. Is it your understanding that he has finalized your treatment plan (lumpectomy plus radiation only, no chemo, no endocrine therapy), and January is a follow-up meeting? If you aren't sure either, please ask about it.

If the pathology report does not clear things up, or you still have questions about the pathology findings and/or treatment plan, you do not have to wait until January for help. You can request (insist) on another appointment with the MO-- or even another MO at the same practice-- to review your pathology report with you, explain your options and treatment plan, and answer any questions you may still have.

Optionally, or in addition (and if possible under your coverage), you may wish to consider seeking a second opinion with an MO at another place. In Texas there are good options, such as MD Anderson or something. You could seek a second opinion about your imaging, pathology and treatment plan, but still have recommended treatment(s) (if any) locally. If that is of interest, you may wish to start that now. Let us know if you have any questions about the second opinion process.

BarredOwl