2nd time breast cancer. Need new BS. Dallas, Texas

@shelley74 I am registered for the Presbyterian retreat on 3/26. Looking forward to it

Hi Balthus--thanks so much for the additional rec.

I just wanted to update everyone on my experiences. Selecting a doctor is such a personal matter, and everyone has to pick the doctor that is right for them. That said, I do think it is helpful to get insight from others who are looking for the same kinds of providers.

I guess it's good to provide my diagnosis first--6cm of grade 3 DCIS; I found the mass about 6-8 weeks ago, and decided to look into it when it didn't go away and seemed to get larger. I'm 39. No significant history of BC in my family that I'm aware of. ER+/PR+. For many complicated reasons, I didn't have a doctor I could consult regarding the mass, so the two interviews I had today were my first opportunity to speak with an expert. My background is in research, so I did a lot myself, and came to the conclusion that I would probably need a mastectomy on at least one breast. I was braced for this and was really more interested in the POA that each provider would recommend.

My first appointment was with DR. Grant, and he had a nice beside manner--was personable--seemed sufficiently concerned. He recommended a mastectomy---obviously no need for radiation, hormone therapy, or chemo with no breast. He suggested genetic testing and offered several options regarding reconstruction. After I left his office (with my team in tow). we were pleased with the visit.

Fast forward two hours later, and we meet with Dr. Ganaraj. Let me just say that Presby was not my preferred facility, but Dr. Ganaraj was nothing short of AMAZING. Great bedside manner (important, but not at the top of my list), incredibly informative (by, for example, explaining that the measurements on the mammogram might underestimate the calcification/mass/tumor, but will not not overestimate. Or that a mammogram can pick up DCIS, but not usually invasive cancer.) She suggested an MRI on both breasts to try to determine whether any of the DCIS is invasive. She also suggested some methods that might save the breast (not likely, but it was nice to hear options). I'll also add that I had a question for her medical assistant on Friday regarding some previous genetic testing I previously had done and whether it would be sufficient, and she responded immediately.

I have my appointment with Rao today, and will keep everyone posted.

Anyway, just thought you would like to hear an update. Sending good thoughts and well wishes to you all.

how about sat 5/14 or sun 5/15?

I'm going to try to make it- surgery is on the 17th, so it will depend upon his much I can get done in advance

The High Risk program at UT Southwestern is very good

Team based comprehensive clinic, and they are the only NCI Designated Cancer Center in our area.

http://www.utswmedicine.org/hospitals-clinics/seay...

Melissa and Lunderwood - thank you so very much for your helpful input. I really appreciate it, as does my sister. And thank you for your kind thoughts.

Lunderwood, I did neoadjuvant AIs, also (Femara) and am very glad to have had that demonstration of how well it worked on my particular cancer. I wish more women could have that experience. Good luck with your sx on the 15th - I'll be thinking of you.

Thanks again.

Lunderwood, I hope your surgery went well, pathology contained no unpleasant surprises, and that your recovery is going smoothly. Stay cool!

Lunderwood - I am hoping to be. My office wis not very far form the hotel so I am planning to head to the expo early and go into work late that morning. I will know for sure sometime that week depending on what's going on at work. Maybe we can meet in the lobby and say. Glad your surgery went well. Who did you end up using at UTSW if you don't mind my asking? I am amazed you are on the treadmill with your drain! It does get better! Thanks.

Balthus - My BS is Dr. Marilyn Leitch, PS is Dr. Nicholas Haddock, and MO is Thomas Froehlich. Very pleased with each of them - all very different in personality and perspective but work well as a team.

Hopeful82014 - I will be thinking of your sister. I self diagnosed my tumor about 12 mos before going to Dr. (long story - both parents died of cancer and I was not a fan of conventional medicine) My sister and husband basically had an intervention and I agreed to seek medical help but at my terms thus I came to be a part of the research program at UTSW. It seems to have worked out in the end. oh path reports were good - clean margins no node involvement. Drain out next week.

Lunderwood - I am so glad to hear that your margins and nodes were clear. Thanks for the update. Thanks for sharing the info about your 'Intervention,' too. When you have time, I'd be interested in how you chose UTSW, etc. Hang in there with the drain!

Have a good weekend everyone.

DebHen - I had SNB at UTSW before my BMX - the morning of not the day before. I did not want to be at Clements 2 days in a row. I sent a message via my chart requesting prescription for the "Emla" cream to use before the procedure and Dr. Rao or her nurse called it into my pharmacy. Things are a bit foggy now 6 months later but I remember that I applied it when I woke up that morning and wrapped my chest with saran wrap. I recall that Nuclear Medicine was not thrilled about it but it's not like they wouldn't do the SNB. I know I have read on various posts on NCO pro's & con's of using the cream. I don't recall the procedure being painful so hard to know if that was due to the cream or not and since i was going into surgery shortly thereafter I was already freaked out. Not sure if I helped or not but wanted to pass along.

Balthus and Lunderwood:

I can't thank you enough for your quick responses, especially since my pre-op visit for SLNB with Dr. Leitch is today!

I really can't say at this point what I am going to do. I know I need to have this procedure, but I am terrified of the pain involved with it. I found a study that compares the pain between two different types of injections: Technetium Sulfur Colloid and Technetium Timanocept. The Sulfur Colloid is the most painful of the two and is, of course, the the product that UTSW uses.

I had a terrible time with stereotactic biopsy, so much so that I had to stop the procedure after only 2 samples instead of the usual 5-6 (this was not done at UTSW, but at Baylor Plano). Thank goodness UTSW uses the radioactive seeds instead the wire for localization and after the initial pain of the lidocaine injection, I was able to tolerate this procedure, but not without tears. My lumpectomy went well and I never took a pain pill. I have a VERY low pain threshold and just do not understand why on top of the stress of having cancer, I have to deal with pain that I think can be lessened.

I am going to take all my research with me today and drop a copy off at Nuclear Medicine, but I doubt much will change. I am going to ask Dr. Leitch about a PET/CT scan and having the procedure with just the blue dye only - which is given under anesthesia, but again, I doubt she will be comfortable with these options.

Again, thanks for your replies.

Debbie

DenHen - Dr Phil Evans did all my biopsies at UTSW - 2x stereotactic & 1x MRI - and he was the best. Of all the doctors I saw related to my diagnosis, tests surgery, follow-up, etc he is the only one who gets a A+. He was kind, gentle, eloquent, responsive, etc as were the techs who assisted him. In retrospect, I should send him a thank you note.

I hope your appt with Dr. Leitch went well today. I started at UTSW in the mid-90's when I had a benign fibroadenoma removed and at the time saw Dr. George Peters who was the head doctor. He too was excellent - brilliant, skilled with a wonderful bedside manner. He had a stroke and retired and Dr. Leitch replaced him some years later.

I continued to get mammograms there for many years and would see Dr. Leitch but after years of all clear I changed to a facility closer to my office but when I had my bad mammogram last October I immediately contacted UTSW for my biopsy. Dr. Rao had operated on 3 friends in past few years and her beside manner is slightly better than Dr. Leitch so that is why I went with her.

But I think you are in the best place with best resources.

I thunk you will do fine with the SNB. Keep us posted.