Timeline questions from DX on

Hmmm.... Your DW's timeline, order of treatment, etc. may depend on two things: 1) her HER2+ results; and 2) where you live.

In the U.S., HER2+ cancer is often treated with chemo and targeted therapy (e.g. Herceptin) neoadjuvantly (before surgery). However, in other countries like Canada, neoadjuvant treatment is less common.

If your DW is HER2-, she may get surgery first. Then, her oncologist might order an Oncotype test to see whether the benefits of chemo outweigh its risks for her particular lesion.

Depending on the surgery chosen by DW and other factors, she might get radiation either after surgery or after chemo. Many women who choose a mastectomy can skip radiation completely.

Hope this helps!

My referral was to a surgeon initially but many folks are doing chemo prior to an operation these days. An MRI would provide helpful information so perhaps you could push to get that scheduled. Waiting for results is the worst part. The tumor has probably been growing for some time which means an extra week or two should not make a big difference in terms of ultimate outcome. Are you in the US or at a comprehensive cancer center?

I'm sure your wife knows that you are a great guy to be stepping up and doing this research on her behalf!

Hmm, if your wife's doctors were really concerned about mets, they would order a PET scan not an MRI. A breast MRI (which is done face down) focuses primarily on the breast region. It might show nodal involvement and chest wall involvement, but it wouldn't show whether or not the cancer had spread elsewhere.

Most early stage women do not get a PET scan unless there is some chance of mets (it's an expensive scan). I got one before surgery because 1) my tumor was big (5 cm+), and 2) one node had already tested positive for cancer (fine needle biopsy). Plus, my cancer was Grade 3 and "growing like kudzu in the lab," according to my oncologist. I did have to get pre-authorization from the insurance company to get a PET, but given my situation, it was easily approved.

Sorry you're feeling so antsy -- the waiting really truly sucks.

My team ordered the MRI right after my biopsy and before I met with the breast surgeon and I'm grateful they did because they found an aggressive DCIS in the other breast (which then led to another biopsy and more waiting for results)

My first mammo was end of Jan and surgery was in early April. (so, 2 1/2 months start to finish) Part of the delay was because of my personal commitments and partly to schedule a time when both the breast surgeon and the PS has openings in their schedules, so you can expect this early phase of treatment to take 2 months (if no chemo before surgery). Then the Drs like to let you heal up a bit (maybe a month) before starting any chemo, radiation.

I know, it drags on forever when you are desperate for quick answers. Just keep studying the info on this site and you will be well informed when meeting with your Drs and making decisions.

Best of luck to you both. I'm hoping for only good news from here on out