Diagnoses/biopsy results
Comments
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best wishes for your surgery tomorrow.
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seq24, it might be too late to back out of surgery altogether and get a second opinion, and your surgeon's intent on taking a huge chunk out of your axilla and dissecting it only once it's out of you and can't be replaced; but for the love of everything holy DO NOT consent to getting a port installed until you KNOW for sure you will be getting chemo. (And you must INSIST on getting Oncotype DX unless surgical path results show your tumor is so large and high-mitotic-rate, and/or you have so many nodes positive that the test is not appropriate). A port isn't something you should have installed for convenience or “just in case." It is a surgical procedure in itself and is something that needs to be cared for scrupulously to avoid infection. You will feel it. It is the height of irresponsibility to implant one simply because it's “likely" you might need chemo--your doctor needs to have proof that is as objective as possible, not just his “experience" or “assumptions." If you absolutely need it, then the risks and discomfort are worth it. But putting it in now, even before your lumpectomy, even before the need for chemo is established, is just plain reckless on your surgeon's part. If you end up not getting chemo, removing it is yet another surgical procedure.If he refuses to do your surgery unless you have a port implanted, then tell him you will go elsewhere for your surgery and medical advice. It's that simple.
And once again--you are in a small town. Your hospital, if it's as close to home as you say, is a small-town hospital. By whose standard is your surgeon “an expert in his field?" I know I am going to be scolded up one side and down the other by many on this board for scaring you so close to your scheduled surgery (when you should be getting calming reassurances and people “jumping into your pocket"), but I think you are being railroaded into surgery that may be more extensive than is prudent or necessary, as well as into treatment you may well not need and could harm you if it turns out to have been unnecessarily administered. It's never too late to say “no" or at least “not yet--wait." It isn't like you're cancelling a plane ticket or hotel reservation after the deadline. IT'S YOUR BODY.
I only hope you've gotten the chance to read this before you sign anything!!!!!!!!!!!! If it’s too late to avoid the port, DO NOT let yourself be bullied into getting chemo because “you have the port already.” It sounds like your team is intent upon doing chemo no matter what--and that a test result that would show it’s not necessary would, to put it bluntly, be against their own financial interest (the surgeon’s fee for implanting the port and the oncologist’s fee for the cost of chemo).
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ChiSandy, I totally agree with you and have made similar points earlier. seq24, your doctors need to have your written and verbal agreement to go through with any procedures. If you reread the earlier part of this thread, you will see that many members were urging you to find a different surgeon! As it's probably too late for that, I truly hope that you won't consent to having a port installed when the need for it has not in any way been established. Also with the axillary node removal, I had to have it with my second BC but it was difficult to heal from and nothing you've said about your diagnosis makes me think you would need one yet. Sorry to sound bossy, it's just hard to think of someone having far too much invasive surgery and chemo that isn't yet warranted.
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I know I must sound like one of those “all doctors are venal” medic-pharma-conspiracy theorists. But I have been married 45 years to a wonderful guy who has been a doctor for 38 and a cardiologist for 33 of those years. I believe in doctors. I am grateful for advances made by the pharmaceutical industry. But there are bad apples in every barrel, and I fear seq24 may have found two of them. I will add her to my prayer list tonight, that she is able to insist on getting no more intensive surgery and no more treatment than she truly needs.
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Oh I totally agree with everyone when it comes to the port. I refused it, even if I had to go through chemo. I just didn't think that 4 treatments (and even 6 as it was initially proposed to me) warranted more surgeries. My hand is fine and took the IVs great.
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Wow, those are outrageous and, frankly, unethical statements from your doctors, who at this point have no clue if your cancer has metastasized past the lymph nodes! If I were you, I would run, not walk, to a second opinion. You also should demand the Oncotype DX test, if it turns out you have 3 or less positive nodes. SMH.
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Thinking of you seq24. Hugs.
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Thanks for all of your well wishes for surgery today. I apologize I didn't get any of posts from late last night/this morning until awhile ago. Surgery went well according to what surgeon told my family. I did not see him afterwards, but talked to him at length beforehand and got the answers we needed to put our minds at ease about why he recommended what he did. I feel comfortable about it now as does my husband. The tumor had not attached itself to any of the surrounding tissue so it was easily removed. Don't know much about the lymph nodes except that some were removed. Will have to wait for the pathology report later this week. He said that he is 99% sure that chemo will be recommended. Husband, nurses and doctors all highly recommended having the port put in to avoid another trip to the OR. As per all of the advice you all gave me here, I insisted on the OncotypeDX. Surgeon agreed it could prove helpful so he is going to get with Oncologist to get the orders put in for that. The only problem was that they gave me WAY too much pain medication just before I came home. 2 shots and 2 pills of Percocet on a mostly empty stomach. It hit me like a ton of bricks shortly after we got home. Still feeling the effects now. Looking forward to a good nights sleep considering I got a whole 30 minutes last night. Thank you for thinking of me today and for all of your kind words and helpful advice. One more step done. Hugs to all!
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Hi seq24:
Sleep well! Sending good wishes for the best possible pathology results.
BarredOwl
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Glad you got through your surgery okay. Be VERY careful not to lift anything heavier than a half-gallon of milk with that arm for the next several weeks, and do whatever mobility exercises are ordered for you. Be extra nice to your stomach for the next day or so--it’s probably still a bit touchy after that long fast and opioid meds. Work up slowly to your normal food intake volume. But do eat 6 prunes a day, or take Colace, since those pain meds are constipating. If you are small-to-average-busted, Genie and Coobie bras from Wal-Mart or Target (step into them, don’t pull them on) will give you the support you need for now (that surgical bra can get gross after a couple of days). Stuff something soft into the side (micro-fleece is great) and let it hang over so as to cushion that undoubtedly tender armpit. If you are large-busted, Leading Lady makes front-hook wire-free leisure bras in sizes up to 46F/G/H. Amoena camisoles are pricey, but will double as tank top and bra substitute--remember to step into those as well. When you’ve healed enough to swim, they even double as tankini bathing suit tops!
I hope you stood your ground and delayed getting a port installed. If so, I beg you, DON’T get that port unless and until your Oncotype results say you’d need chemo. Yes, it’s another trip to the OR, but it’s yet a third trip to take it out if it’s unnecessary (and regardless what your surgeon says, the odds are even-steven that you won’t need chemo). If it’s too late, don’t let yourself be talked into chemo you may very well not need just because the port is there and “you might as well use it." And follow up to make sure that Oncotype sample gets sent out as soon as path confirms you have 3 or fewer positive nodes and that your tumor is small and indeed ER+/HER2-. Don’t let them drag their feet--too many women found out that their surgeon’s or MO’s office screwed up and didn’t order the test. Hope your path results are favorable--clean margins, low-mitotic-rate, as close to node-negative as it can be! (And if you don’t need chemo, insist they remove the port--it’s not something you want in your body “just in case”).
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seq, did you consider cold capping if you must do chemo? Sounds like you would like to keep your hair. This surgeon sounds scary to me. My breast surgeon did an extensive mri before, he was 90% my nodes would be negative after the MRI. My surgeon was very cautious, he took 2 nodes and did not put in port.
This doctor sounds scary to me that he isn't giving you details and reasons for what he is doing. I would high tail it out of there.
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Are you near a large US city? Your surgery is over, glad it went well. I am hoping you don't have to do chemo.
Best of luck
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Also, don't let your husband drive your health care decisions, especially because of expediency or costs. It's your breast, your body......and your life.
And do your homework--find out how many of your surgeon’s and your MO’s patients get chemo. If it’s a high percentage, that is a HUGE red flag. It would be analogous to my husband ordering an echocardiogram on every patient who walks in with a cold, sprained ankle, needs a flu shot or a work physical because he has that echo machine and needs to recoup the costs. (He doesn’t do that, of course, but you get my drift).
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seq24 - How are you feeling, how's your recovery going? Life settling into a new normal now that all the presurgery stress is over
I hope you'll update us on what all your surgery entailed and what your path report shows.
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I am feeling really good since surgery on Monday. The mass was small and surgeon said it was not attached to any surrounding tissue so I guess that is good. Even though the biopsy showed fragments of cancer in one lymph node, sugeon said that all the ones he removed looked normal. Don't know how many he took though. No word on pathology reports yet. It should be this week sometime. I don't have much pain at all, in fact I only took one pain pill Monday night when I came home. None since, just tylenol a couple times. I actually drove today just to make sure I could do it. I have to be back to work tomorrow and that involves driving kids back and forth to school on their first day back. The biggest relief I have had is that I got to take off the compression bandages just this afternoon. They were so tight and uncomfortable. It's nice to be able to breathe again. I'm tired often and have to take a little nap once in awhile. The only other annoyance is the drain. It's in the way and I'm so worried I am going to catch it on something. Don't have my post op appointment until next Wednesday. Thanks for your concern and support. Will post as soon as I know more. One hurdle down, but the biggest one is ahead. Still terrified at the thought of chemo which I was told there there is only a 1% chance that I will not have to have it.
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Focus on recovering from surgery now and worry about chemo when that time comes. Good to know everything is ok and back on track. Thinking of you
Hugs
Day
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There is lots of hope! I was Stage 2 with 3/12 positive nodes. I had an unsuccessful lumpectomy followed by mastectomy. 4 rounds of chemo and radiation. I am now on tamoxifen and I am CANCER FREE one year later. My doctors never painted a dismal picture. Stage 2 is not a death sentence in any shape or form. I would say if you don't like your doctors, switch! Go with doctors that you trust and feel comfortable with. I had so much encouragement throughout all my treatment that I even trained and ran a marathon while in the midst of it. Try to stay as positive as possible. I know it's hard to do. One year from now this will all be in your rearview mirror and you will have a long life ahead of you!
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Thanks for the well wishes! Suzanne, I hope I am able to have your attitude and motivation. I am hard time realizing that having this surgery behind me is just the beginning of a very long hard road. A year seems so long to be dealing with this! A lot of people say that how you feel during treatment is mind over matter. I need to figure out how to get in that mind set. Not sure how that can be. Chemo puts so many chemicals into your body and your body is going to react no matter what your mind says. Someone told me that they went out and ran for miles whenever they were feeling their worst and they just convinced themselves that they did not feel bad. Not sure how that is even possible.
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Be careful when you are out in the world with the drain . You are at risk of infection until it's out. Also please remember you are recovering from surgery and be kind to yourself.
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seq, it's funny you say you have a long hard road. That is what my doctors told me, I had surgery and AI drugs and practically forgot about the cancer. I was suppose to have chemo but I didn't buy into the treatment. Still here almost 5 years.
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Molly--Thank you. I will definitely be careful. I can't wait until this drain is out. It's driving me crazy!!!
Meow13--I'm just curious, how did you avoid chemo? I really hope I will be able to do that but doctors said there is only a 1% chance I won't have to have it. Waiting on pathology reports yet and that is what will determine it I guess.
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I hope when you get your complete pathology that you will share your results here. So far you haven't posted anything that makes me think it will lead to chemo.
Obviously, your Oncotype will give you lots of info (if it comes back in the gray area then ask for a Mammaprint) Other useful info is your Mitotic Rate. The lower the #, the slower the cell growth. Did they test your KI67. Again, low is better. They must know your Nottingham score if they are saying you are grade 2. Curious what it is.
What is your tumor size? Is there any LVI? What exactly is the pathologist calling the "fragments" in your lymph node. Have they called the node positive or negative. And how many nodes did he take out?
Have you started looking for a second opinion? This diagnosis is scary stuff and none of us wants to be under treated but it can be really hard on you to be over treated for no good reason.
Oh, and by the way - I hated my drains. Thought it was the worst part of the recovery, but thank God it was only temporary. You'll have it out in no time
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There are so many drugs available now that make chemo "bearable". I took Emend for 3 days following chemo which helped. I didn't have awful side effects. I didn't feel great but I wasn't on death's door either. The worst part of chemo for me were the steroids. I couldn't sleep while on them. When I tried to taper them down, I felt worse so it really was a toss up - no sleep and feel better OR sleep and feel sick. But this too shall pass and although none of it was pleasant it is all doable. Just take one day at a time - don't predict you will feel awful...you may not! I only missed 1 1/2 days of work for chemo. One day was to actually receive the treatment and 1/2 I left early because I was feeling not-so-great.
Also - I didn't lose my hair. I used penguin caps and saved my hair which was huge for me. I didn't feel like a sick person because I didn't look like a sick person.
And exercise does help! Even just a walk around the block. Get those toxins moving out.
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The hair loss thing is what is scaring me the most! I looked at wigs and cried the whole time. I have heard mixed reviews on the cold caps. Some say it works and some not. I would be in a lot better mindset about this if I knew I wouldn't lose my hair. That is a terrifying thought. I just hope and pray that if (or should I say when) I have to do this I will not experience horrible side effects as I have some pretty big responsibilities in my job, family and a whole bunch of other stuff. I had to give up one job already because of this. It can't interfere with the other one too. But there's a lot more to it than just work. I'll just say I have a lot of responsibilities in my life, all of equal importance. I was talking to someone the other day and said for her, the side effects were mind over matter. I am not sure I can use my mind to convince myself I'm not feeling side effects when there will be poison pumped into my body. Our bodies are not going to do anything besides to react to that. I am just really, really scared of what comes next. This surgery was a piece of cake compared to what I am picturing for the next 6 months. Thanks for your encouragement Suzanne!
I have spent quite a bit of time reading these posts and everyone's diagnoses that follow. It's kind of scaring me that people who seem to have the same type of cancer as me have mostly all have had a mastectomy. I only had lumpectomy. I'm wondering if that is enough. Doctor's said it was and that a mastectomy absolutely was not necessary, but now I am wondering after reading everyone's stories here.
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You truly are in one of the hardest "phases" of dx and tx, which is dealing with all the "unknowns". A million of us who have been through this, could all tell you that "we get it" and that you will feel less stressed, anxious and more in control once you have all the info and a plan is in place, but until you are "there"....we also understand how impossibly difficult things appear to you right now. Movies, books and tv shows have successfully implanted in our minds, how horrendous cx tx is on someone....but like reality tv.....real life rarely mirrors these portrayals. There are ways to feel more confident however, that you can do this.
Could I make a gentle suggestion regarding your comments about not believing it's possible to use your mind to convince yourself that things are "doable"? If you read back at your messages, you might recognize that at this point....you are using your mind to convince yourself of how horrible things will be for you, how difficult your responsibilities will be to manage, how impossible this all will be to handle. All understandable emotions, but at the same time, not based on your actual experiences, but on your "mind's anticipation" of what things will be like for you. Perhaps you could share your fears with someone (pastor, counselor, compassionate nurse/etc), who might be able to help you refocus and be more open to some "positive, or at least less negative" thoughts? Those who have suggested to you that they were able to do things like exercise, work, do childcare etc., through chemo..... I don't think meant to imply they didn't feel the physical chemo affects, but more likely meant that things weren't as dire as you are anticipating, and that they learned to manage life during chemo. Taking naps when tired, maybe cutting back a bit on some optional activities, accepting help with childcare, meals, housework, etc....there are many paths to help you successfully get through chemo, rads.....whatever lies ahead for you. It is often useful to speak to your doctor, and make use of some anti-anxiety meds if things get to the "overwhelming" stage too. Sometimes, a wee bit of "chemically induced calmness" goes a long way to restoring your ability to handle things.
No one would ever honestly say that any of the various tx's for breast cancer are "fun and enjoyable", but PLEASE, try to hear the voices of those who have been through it, that it is all "doable".
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Nihahi, thank you for the positive thoughts. I'm sorry I seem like a broken record on here. This is all unknown territory for me and I do not know anyone personally who has had to go through this at this level. All of you ladies on here have been a lifesaver to me in the form of all of your advice, recommendations, support and caring. I truly appreciate it.
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I only had a mastectomy because I had no clear margins after my lumpectomy and he couldn't guarantee that another lumpectomy would give me any better results. At that point I just wanted it all to be done. Lumpectomy is WAY easier (I can say that since I had both!) -I wouldn't opt for a mastectomy unless it was recommended.
As for penguin caps - they work 85% of the time. My hair thinned and I have thin hair to begin with so my hair didn't look great for quite awhile. Plus I couldn't color it. But I had hair! And unless you knew me to know that difference in thickness, you wouldn't have known I was a cancer patient. My MO had the Rapunzel freezer (those caps have to be super cold!!!). It was definitely work and painful to do it but very thankful to keep most my hair.
The side effects - everyone is different. Hope for the best. Stay as positive as you can. I think staying busy and staying active helped me. You can let all this stuff swallow you up but don't let it. Expect that you will feel well enough to work. Expect that you will be able to do all the things you want to do.
When the marathon training was upon me I had a choice. Let cancer call the shots are me. I decided that I was not going to let this stop me from doing what I want to do. Running made me feel like a well person. Do the things you love! Don't let cancer stop you.
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nihahi- I absolutely luved your post and your "gentle suggestion". So well-stated and SO hugely helpful. If we all took on this perspective I feel like life would be more joyful and we would more appreciate it for what it affords us. Thank you.
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Seq, my mo wanted me to do chemo. I said no. If you do chemo you should read the cold caps threads. It is very encouraging that you could save your hair.
So far I'm good almost 5 years out.
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Especially being PR and er positive I would do hormone therapy.
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