New primary (or, here we go again!)

You are all so kind - thank you for the support and generosity of spirit. It sucks, no doubt about it. But I'm counting on catching it early, and hoping for node-negative status. It's so interesting how different this cancer is from my first ER+/PR-, Ki-67 of 50%, this one is ER- and Ki-67 of 10%. Just - very different. And yet, almost in the same spot as my first, so hit with whole breast radiation as well as targeted boosts. And survived. And thrived. And.......I don't know enough yet to be helpful, just enough to be dangerous.

Meow, I hit upon metaplastic because of the odd description of the cytoplasm and nuclei. As Isaid, it's just a guess; I'll know more on Monday (I hope), and perhaps it's nothing. These were core biopsy samples, I expect I may have to wait until lumpectomy to know final path details.

Farmerlucy, my hormone status was weird before (apparently, I'm just special in lots of ways). Original path was ER 50%, PR 10%, Her2 was equivocal so FSH determined Her2-. The Oncotype test changed my PR to negative, and gave me a scant ER positivity. My Oncologist NP said my tumor was likely heterogenous and that might have been a better picture of the overall makeup of the tumor.

So this path is ER 0% and PR 0%. My surgeon says there's no way it's the same cancer as before because there isn't any ER, but those were core samples, so I wonder what it would look like if they removed the entire tumor and retested it? (I'm grasping at straws here). Might mention that to Onc today.

The other thing that makes me sad right now is the surgeon indicated that they can try, but will probably fail, to be able to do an SNB given previous radiation (I guess the auxillary rads damages the ability for SNB). So they'll be doing a complete node dissection. Crap.

Thanks for the information on recovery, Meow. Yes, right now I just can't be un-abled or down with surgey and not able to move/lift anything, needing to help my parents. It's a terribly challenging situation with (and for) them, and while I have two sisters who are also helping, one lives in Alaska and won't be here for long, and the other is on the verge of getting married and moving away. Mom and dad can't really afford much outside help, so it falls to us to ensure their health and safety. Plus - I'm training for my first half marathon in May and I'd really like to do it (if possible) before surgery. And I teach yoga; I want to finish the winter/spring session, and maybe take the summer session off.

Thank you all for your kind words. One of the reasons I keep coming back to BCO is the support and understanding for the curveballs life throws us.

Quinn, we're doing an excisional biopsy rather than a lumpectomy because we don't have the Her2 status yet. If positive the standard of care would be Perjeta pre-surgery - so a "lumpectomy" would negate the ability to use Perjeta. Additionally, everyone's opinion is there's no need to remove any more tissue than necessary at this point, when mx is the ultimate plan down the line.

University of Michigan called me and will work on setting up a day-long second opinion after the biopsy (so they have Her2 information), including new tests and consults with the BS and PS to discuss reconstuction (I will only consider DIEP at this point, otherwise I'll go flat). By the end of the day I would have a new plan in place. It's nice to have options - I like options.

I already have a hip-to-hip incision from a surgery when I was 18 (very large teratoma on one ovary). It's really quite beautiful and almost invisible now. But - kids and age have provided me with a perfect boob on my belly. :-) I don't want to lose any underlying muscle - yoga and running. I already know i don't want implants. I'd be happy (reasonably so, I guess) going flat, if necessary. Looking forward to talking with a PS so I know my options.

I know I'm lucky to have a great facility just down the road. I grew up in Ann Arbor and have much respect for the health system. My son is on the transplant list with UM and they're wonderful to work with.

Whoo-hoo! Treatment plan! Met with surgeon and oncologist yesterday. Bone scan is clean (yea!); CT found an enlarged mediastinal lymph node. Everyone's "thoughtful" about it but it's not in an easy place to biopsy so we're just going to watch it for three months. I'll be doing neoadjuvant chemo so I'll be curious to see what happens.

Chemo starts in about three weeks (time to heal after Monday's surgery). Having an excisional biopsy to retest hormone receptors and get the Her2 status. Everyone wants to ensure they get the right area this time (my surgeon is going in from a really distant, odd angle so as to leave the scar in a place that will later be removed during mastectomy) so they've scheduled me for an US-guided wire placement. The radiologist (who did the previous biopsy) wants to be so certain that after the US placement, we're going to walk over to the mammogram machine and he may insert a second wire while I'm there. Seems like a lot of work to get this thing out but I'd rather be safe than sorry.

Once I have the Her2 status we'll know whether Perjeta and Herceptin are on the table. MX this summer, possibly BMX depending on results of genetic testing.

It feels good to be moving forward, even if just ever so slowly......