I am scared

Ashley, I'm so sorry that you've gotten this bad news. It's certainly news on one wants to get, but you're in the right place to discuss "what now." First of all, cancel the mastectomy if you don't feel ready yet. And it doesn't sound like you do. Tell them you want a second pathology opinion before surgery. Unless it was inflamatory BC, you have time. (What does your pathology report say?) There is no reason to rush to have surgery.

And yes, a biopsy can be wrong,but it's unlikely. However there is no reason that you can't get a second pathology opinion. The specimens & slides taken from your biopsy can be sent to another pathologist. You'll need to identify a specialist pathology practice. Presumably at a specialist breast center/NCIC-designated cancer center or something like that. Your doctor should be able to help you to identify a good place for a second opinion.

You probably don't need a second biopsy. But if the second pathology group wants to see more, then that would be something to consider.

Most of us don't feel sick when diagnosed. It's part of what makes this whole breast cancer "thing" seem so unreal. And in fact, we feel fine until we have surgery or treatments. They're what make us feel "ill."

Finally, you may want to meet with a medical oncologist before you have surgery. Increasingly they're suggesting neo-adjuvent chemo to shrink the existing cancer.

So slow down the train. Get copies of your procedure reports, pathology reports and imaging reports. Get a second path opinion, meet with a medical oncologist and make a considered, deliberate plan. You have time, and you should get to make the decisions.

Come back and tell us more...

HTH,

LisaAlissa

The ct scan should be able to tell more. You can slow it down for even a week maybe to get more info. The dr should be advising you more. 

Slow down and take a deep breath, Ashley. Most of us have had the paradox of feeling stronger and better than at any time in our lives yet simultaneously being the sickest we’ve ever been. That’s one of the things that’s so maddening about this disease. It’s okay to set a surgery date, but this soon after diagnosis you really shouldn’t have surgery until you have a better idea of what your treatment plan would be. At the very least, you should have the option of choosing a surgeon and knowing what his or her approach to the mastectomy will be. And LisaAlissa is correct, in that more and more these days chemo is done before surgery for tumors that would otherwise be too big to make lumpectomy practical.

If you know anything about your tumor(s) (side, size, grade--i.e., Nottingham score, hormone-receptor and HER2 status), please put that in your profile under diagnosis and check “make public” so we can see what you’re dealing with and advise you more accurately.

Welcome here. It’s a club nobody wants to join, but with the most caring and helpful fellow members you’ll ever meet. We’ve got your back, and we’re in your pocket.

Hi Ashley, can totally relate. I am newly diagnosed and am leaving no stone unturned. Personally. My pathology slides are being unbiasedly reviewed by an independent breast pathologist  Trust your gut. If you're panicking. Please ask for the rationale for such a drastic first step from your surgeon. Are there lymph nodes involved? It's crazy to be here. Ask if there is harm in waiting a week. Ask. Ask. Ask. So sorry you're going through this. It's harrowing. God speed on whatever you decide.

Ashley, get those scans---but cancel that mastectomy, at least for now, until you know exactly WHY they’re recommending it and WHY they think it should be done so soon (hate to be paranoid, but maybe they’re afraid you might change your mind or even go to a competitor)! You have the right to know every detail about your tumor that they know (and have it explained)--and if they are so patronizing that they refuse to comply, you need to find a care team who respects you! You can’t undo a mastectomy.

Hi Ashley:

I understand that you were just diagnosed this Monday, December 28 with IDC, also known as "invasive ductal carcinoma." It is "high grade", so presumably grade 3. There are 3 tumors ("multifocal"), with the biggest estimated as about 1.5 cm. That is not very big, which is good.

You are scheduled for a mastectomy tomorrow on Wednesday, December 30. This is extremely fast. Naturally, you feel you are not ready and are being pushed. From the information you provided, there does not seem to be any medical necessity for such a hurry.

I would call them first thing in the morning, and cancel the surgery. Explain that you are not ready to proceed with such a major surgery only two days after diagnosis, and you would like time to obtain a second opinion regarding your diagnosis and treatment plan, unless there is a medical basis for the urgency (which has not been communicated to you). You can reschedule for a few weeks from now if you wish.

While I do not think you should wait months, it is very common for people to take a few weeks to obtain a second opinion with a diagnosis of IDC.

When you arrange for a second opinion, the opinion will include a review of copies of all imaging (e.g., mammogram, ultrasound, MRI), a pathologist will review the actual slides of tissue from your biopsy (slides are sent overnight), and you can obtain another opinion regarding treatment, including whether a mastectomy is appropriate. Sometimes, additional images may be recommended. You can ask for a breast surgeon, radiologist and medical oncologist to consult with you.

Sometimes, people receive chemotherapy type treatments before surgery, which is why a person might consult a medical oncologist before surgery. This is done most often with triple negative (ER negative, PR negative, HER2 negative) disease or with HER2+ disease. Do you know your estrogen receptor, progesterone receptor, and HER2 status? If not, that would be another reason for a second opinion: to get a better understanding of your diagnosis and understand the available treatment options.

BarredOwl

Hi Ashley:

Here is a quote from an excellent book by a breast surgeon, Carolyn M. Kaelin ("Living Through Breast Cancer"):

"Obtaining a second or even a third opinion from different breast specialists can be very important. Don't be too shy or feel too rushed to do so. This is common practice and no insult. If a doctor rushes you—perhaps by saying he or she can fit you into the surgery schedule very quickly—it may be wiser to continue your search for advice rather than giving in to fear or pressure. The cancerous cells in your breast have been there for several years, perhaps even a decade. Usually, it is safe and sensible to take a few weeks to thoroughly evaluate these very important decisions."

Keep us posted.

BarredOwl

Ashley, there's nothing I can say that hasn't already been said. I am just as shocked as everyone here at how fast this is going. I went 3 months and had time not only to decide and agree on a mastectomy, but to research and feel confident in my decision. I also was able to consult with a plastic surgeon who operated on me the same time as the doctor doing the mastectomy. He started the reconstruction process, eliminating another surgery later. I am not saying wait 3 months like I did, but please take more time to at least figure out what exactly is going on. I can't imagine any surgeon recommending having such a huge surgery 3 days after diagnosis.

No matter what happens, it's obvious we are all concerned and will keep you in our thoughts and prayers. Please keep us updated.

Dear Ashley.....Sending you big Hugs

I don't understand how a diagnosis on a Monday can end up with mastectomy 2 days later unless there there is such a big urgency.

I was DX August 21st and decided to have a lumpectomy which was on September 10.

Since I wasn't comfortable with my first choice I asked for Double Mastectomy which the BS wanted me to wait at least 7 days to see if I was sure.

And on October 14th I had my BMX.

Again if it's not urgent please do not rush with any decision making....

You don't need a Mastectomy to test SNB...

Please keep us updated..

Sheila

Ashley, I was on a similar compressed schedule after diagnosis, simply because my surgeon had an opening. At that time, my whole medical team including the surgeon said it was fine to wait a few weeks and research things. I chose to go for it, because I was sure of what I wanted, but no one should ever make you feel rushed into such a vital and life changing decision. Hugs, sweetie. You will be fine.

I met with my general surgeon on a Thursday and was booked in for a mascretomy the following Wednesday. The general surgeon should have explained your biopsy results and the up coming surgery. Maybe delay the surgery by a few days and meet with your surgeon again and take someone with you, as it can often be a surreal meeting the first time around, esp as most people are in shock. Obviously you don't want to delay surgery too long (more than a week), but you need to be happy with what you're agreeing too. Having someone else attend is also helpful for anything you may have missed and asking questions. I went in with a list of questions and just read them out 😀 Good luck

sounds like they need to ultrasound your nodes just to check it off, that can dictate the stage of bc. High grade means it's fast growing and that would explain the two tumours at 2 and 10 o clock, so that might be why the oncologist was quick to book you in for surgery. I would make sure you don't delay surgery too long

Request a CD from the facility that did your mammo/us to take to a second opinion at a different facility than the Surgeon who is pushing for immediate mast. You can request the facility to send a copy to the Dr you will bw seeing. It is your right to have copies of all scans/tests/etc. and should be filed away for future use (if ever necessary). Hang onto your copy.

"A reference letter" - none of my Drs would have 'gone with' that -had to have copies of 'everything'. Most Drs will want to see the actual 'films'/pictures and the actual path. report to make their own decisions, not someone else's opinion - not all Drs 'see' everything the same way or interpret the findings the same. Do not be surprised if the 2nd (or 3rd) Drs want to do their own scans/tests to confirm the previous ones. Do not be surprised either if they want full body CT/MRI (with contrast), Bone, or PET Scans to confirm that there has been no metastis (areas out of the breast/axillary/clavicle areas) to be 'safe' with TX plan.

There are few (if any) absolutes for all or our BC type when it comes to the best TX plan for us, individually. My TX plan was different than most with my DX (I did 1 neoadjuvant and 1 adjuvant Chemo while most do 2 different Chemo neoadjuvant) - BUT for me, it was 'the way to go' as I'm still here and still NED 6+ yrs post DX.

See a Chemo Dr and Rads Dr - the TX plan is not jalways just 'cutting out' (Surgeon) but a complete TX plan which also encompasses all your TX.

Stage can be guess-timated from the films and path. reports but it takes the path. report from surgery to make an accurate Stage diagnosis.

Oh yeah - I felt great - not 'sick' at all and felt fine.

Please get a 2nd opinion (not at the same facility as they may be in 'cahoots') and see the rest of your team for the entire TX plan.

I may have missed it, but, did you have an MRI?  If you were just diagnosed on Monday, then it is doubtful that you have your ER/PR/Her 2 status back yet or your Ki67 score.  You said that you were having a CAT scan.  Did you have this?  I think that I read that there did not seem to be any lymph node involvement.  That and the fact that the tumors are less than 2cm is a good sign.  Multifocal tumors are scary, none-the-less. I am glad that you are getting a second opinion. A surgeon does surgery, especially, a general surgeon.  Please see a medical oncologist, a breast surgeon, and a plastic surgeon.  This way, you can create a plan for reconstruction, should you need to have a mastectomy.  Do you want reconstruction, do you want a DIEP flap?  Your cancer seems to be multifocal, however, some of the other areas may be benign and not malignant.  You do not know because nothing was tested yet.  You do not have pathology on these areas.  I am glad that you are going for a second opinion.  Good luck.  This is a very scary time but don't let anyone pressure you.  Unless you have IBC, you have time.  Don't wait too long though.  I agree with everyone else who has posted.  I cannot imagine why you would be rushed to have a mastectomy so soon.  I am sending you hugs and prayers. 

In my case, I was told that I needed to have a double mastectomy at the time that I was dx'ed.  This was even before I knew that I had two primary bc's.  The two primary bc's were only discovered after my double lumpectomy surgery.  At the time of my surgery, I knew that I had ILC and LCIS but I did not know that the cancer was pleomorhpic or that I had invasive tubular carcinoma.  The invasive tubular carcinoma, the pleomorphic status, and the second LCIS area was discovered in my pathology report after my surgery.  Even after my lumpectomies, I was told for a second time, that I needed to have a double mastectomy by doctors in Florida.  My doctors at M.D. Anderson Cancer Center told me that mastectomy surgery would be draconian and that I did not need to have that drastic of a surgery unless my genetic testing showed that I needed to have the mastecomies.   It did not, thankfully.  (I had already had my double lumpectomy surgery.) I followed the advice of my doctors at M.D. Anderson Cancer Center rather than the advice of doctors in Florida.  My original MO told me that I needed to have chemotherapy.  I went for a second opinion and I changed my MO.  My new MO in Florida as well as my doctors in TX told me that I did not need to have chemotherapy.  My original MO never discussed oncotype testing when she recommended chemotherapy, even prior to my surgery, and even before knowing about the second malignancy.  I am amazed by that and, thank God that I went for a second opinion.

Years ago, I went to a bs for a palpable lump that was not seen on imaging.  The radiologist told me that nothing needed to be done for this lump as it wasn't seen on imaging (mammo and us).  Three other lumps were actually found at that time and 2 were biopsied.  Benign.  The third was a lymph node and nothing needed to be done about the lymph node according to the radiologist.  The bs insisted on surgery, against the advice of the radiologist, because he is a surgeon. A general surgeon.  I was terrified because my father had lymphoma.  I followed the advice of the bs rather than the advice of the radiologist.  I had needless surgery as a result.  I have fibrocystic breasts which I was aware of.  Fibrocystic tissue was what was found after my needless surgery.  My bs removed the palpable lump rather than the lymph node, as was discussed.  He did this because general surgeons perform surgery.  I did not know any better at that time in my life.  I was furious because I would never have agreed to remove fibrocystic tissue.  Please don't rush to surgery.  You definitely need tx and surgery, but please speak with an MO who will create a realistic plan for you, before rushing to have a MX.

I am glad that you are getting a second opinion.  Second opinions dramatically changed my tx plan and I am so happy for that.

Good luck.  It is a terrifying and anxious time.  I wish you the best.

Please listen to all of the ladies who have already posted.