Help me understand what's going to happen

Hi CountryHeart and welcome.

What is going on is that there is a mass seen on imaging that corresponds to the lump that is felt and it is recommended that you have a surgical consultation (I agree with dtad in encouraging you see to see a breast specialist and not just a general surgeon if at all possible. For this initial step, removal of the lump, a general surgeon is fine for the biopsy. If it becomes more complicated than just removal, then it's time for a breast specialist) for removal of the lump for a biopsy.

Does this mean you have cancer? No, it does not. What it does mean is that this lump need to be removed and tested. BIRAD 4 means that there is upwards of 80% of it being something other than cancer (Which is GOOD!) it just need to be biopsied to make sure.

You also have very dense breast tissue.

Take a deep breathe. Take several. One step at a time. See the surgeon, make arrangements for the removal. Then we will go from there.

In the meantime, stay away from Dr Google. There is so much out there that has nothing to do with what you are dealing with at this moment and all it will do is increase anxiety. There is a high probability that you are fine.

Is this surgeon a breast specialist? Or a general?

Countryheart there are a few things that are important so I will number them:

1. You need to get to a major hospital, like a University teaching hospital. Better would be a National Cancer Institute comprehensive cancer center. It is time to get serious about getting a good treatment plan. I didn't like that your doctor had to order a piece of equipment. It does not sound like they are used to handling this. This is the link to find a NCI cancer center: http://www.cancer.gov/research/nci-role/cancer-cen...

2. People giving you advice: say "thank you, I am going to follow my doctor's advice. I know you mean well, but it is just confusing to hear about someone else's cancer and their treatment. Everyone is different. Everyone. There are no two cancers exactly alike in the same place that need the exact same treatment."

3. You are on the right website. There is so much knowledge here, and women who have been there before you and will answer your questions.

4. Nothing is going to be the same. but that is ok. things will be different. There will be sorrow and joy and happiness and fear but you will come through this. You are strong. You can do this. and we will help you.

ispy has given you such good advice! I disagree slightly about the hospital. Treatment protocols for breast cancer are pretty standard. I could have gone to a University Cancer Center, but -- as a working mom -- it was far more convenient for me to go to my regional hospital and chemo clinic. Now, if I progressed to Stage IV, I'd be at the University Center for sure.

I just nod along when people tell me "Cancer Stories." They want to say something, but they have no clue how annoying they are. I was at my grandmother's funeral, and one of my Mom's friends talked my ear off about some miracle cure. Ugh!

Countryheart and Angela, Know that this is the community who can emphasize with you! Whatever your choices are, be clear that it is a choice now for your new future. You are brave.

Experience counts. Go to another hospital. Getting a second opinion is your right. If possible hospital can share the pathology lab and biopsy so you won't have to submit one again. The second opinion will help you, take time to process and slow down. Take the opportunity to speak about your real goals.

About the 'helpy-helpertons,' sometimes people just don't know what to say. Most likely they are scared and are scared for you. A few days ago you might have been similar. Forgive them and say "please stop, it is not helping right now". It is not harsh, it is not rude. It is your voice. Use that voice. Speak your goals. Let your love ones know that you will need them, (for what might not be clear now) but you will let them know.

You are in my prayers. r.e.

I am so sorry you're dealing with this, but as others have mentioned....you're in a good place here. I was told over the phone both times I was diagnosed. Honestly was fine with me. The first doctor called on a Friday night because he knew I was going on vacation the next day. I'm glad I didn't have to wait a week. The 2nd time the biopsy was where I work and my surgeon was afraid I would look in my chart before she had a chance to tell me. Again...glad she called.

This is the hardest part. It is for everyone, it will get better. No one can tell you your treatment plan based on someone's they know. But remember that those around you are also suffering and may be offering advice to help themselves cope. It is hard when someone you know is going through cancer. Let them talk, but only when YOU feel like listening. They care about you. Then go to your provider, gather reliable information and start working on a plan. And come here often. Itis such a huge help.

Sorry Elaine but as a health care professional I have to disagree with you about all breast cancer protocols being the same. All you have to do is read all the posts about how different experiences are depending on where you are treated. Also why would you wait until you have Stage 4 bc before you would be treated at a major university hospital? Wouldn't it make sense to be treated at one when its Stage 1 to make sure everything has been done correctly in hopes of preventing Stage 4? I respect all decisions and treatment options. This just happens to be mine. Good luck to all....

dtad,

I realize that many women here take great comfort in going to the absolutely best hospital they can. But the guidelines for someone in my situation -- Stage IIIA, ER+/PR+/HER2+ -- were pretty clear. To be sure, many triple positive women at Stage 1 might wonder about their chemo options, but by the time you're Stage IIIA, you know you're going to get the works -- chemo, targeted therapy, surgery, radiation, and hormonal therapy. There are differences within this regimen (MX or lumpectomy? neoadjuvant or adjuvant chemo?), but not so great that I was going to drive into the city and get my care done there. I work full time, and have twins with autism (one of whom has violent outbursts). I really do have better things to do drive a long distance and sit in a waiting room for hours while my DH tries to manage the twins alone.

And, yes, there is some variation in treating Stage 1 cancer. However, the guidelines for treating it are far clearer than treating Stage IV breast cancer. At that point, treatment is more of an art than a science.

Best wishes to you!

Make sure that if your nodes are negative and your margins are clear, your breast surgeon orders OncotypeDX testing. That will likely determine whether you will be recommended to get chemo and if so, what kind. Again, once your adjuvant (post-surgery) treatment has been planned, you can get your chemo and radiation treatments much closer to home.

Hi again. I agree with ispy.... on all 3 counts!

You are absolutely right, Countryheart -- none but the health care professionals involved in your case can tell you what to expect.

Look again at the third paragraph of Ropes-End's post up there on this thread. I think that is the very answer/response for which you are looking.

Wow that oughta do it!

The other thing is to say in person: "I don't want to talk about it. I am working on a plan with health care professionals. But thank you for your concern." and then literally change the subject. There will be a few people in your life whom you want to share the details and specifics with; everyone else just tell them you don't want to talk about it. This is the time when you learn the difference between "acquaintance" and "friend".

I like that you added all of those questions; it shows how complex breast cancer is, and it will make most people's head spin.