Still figuring it all out....My story
Hello everyone,
Last month I had a radial scar identified per multiple mammograms, but a negative ultrasound. Excisional biopsy/lumpectomy was done 8/3, showed unifocal IDC 0.6cm, Grade 2. DCIS component 0.2cm low grade without comedo necrosis. Margins negative. No lymph vascular invasion seen. ER+ strong 67; PR+ strong 94, HER -, Ki67 2%. Follow-up MRI negative. Had sentinel node biopsy 8/17 and will get the results tomorrow. Treatment options will depend on final staging, but I'm leaning toward brachytherapy, pending insurance and other "stuff." Luckily I have lots of contacts in the medical field, including a daughter who works in radiation oncology as a dosimetrist.
This is quite strange after being a nurse for so long, to becoming a patient. The whole thing still seems quite surreal. Although know clinically my prognosis is very good, I'm still dealing with having the "cancer" label affixed to me.
Just thought I'd start a thread to make notes of my journey.
PS: Thanks to everyone who has shared their stories - I have learned so much from other's experiences!
Comments
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Well I had good news this morning, my nodes were negative! (0/3) so it's on to planning radiation. Might travel to Phoenix, AZ to get radiation done there.
So now to research the estrogen meds, which I hear are not fun.
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hi Fridayyet,
Great news! Welcome here. I'm not used to the Dx either. Not sure you ever do get used it. Glad you have so many knowledgable to turn to plus being a nurse yourself.
Do you live in Az or is there a reason you would go there for treatment rather than where you are
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Hi Beach2beach,
Thanks for the welcome!
I live in New Mexico and they don't do the partial breast irradiation here. My surgeon recommended the SAVI localized radiation due to how early my IDC was caught, and the short course of treatment. It's about a 6 1/2 drive from me, so if my insurance will cover it, I'm seriously considering going. If not, I can get whole breast irradiation here if for some reason it doesn't work out.
~Friday
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I just read up on it. Outside of you having to drive to Az for it, it sounds like a great option instead of having to do radiation on the whole breast.
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Hi FridayYet, welcome to the club that no one wants to join.
I also had a radial scar but I think because mine was larger they also called it a complex sclerosing lesion. Statistically, you and I are almost non-existent. The number of radial scars that turn out to be cancerous are infinitesimally small. And yet here we are. All along I was told 'this doesn't look like cancer, it doesn't have any of the typical markers.." Well, boo on that. It was cancer.
I had a surgical biopsy followed a few weeks later by a lumpectomy and just finished whole breast radiation a month ago (July 26 was last nuke blast). I only had one node removed (all the surgeon could find despite digging) and part way through radiation I started getting weird sensations in that arm, like the skin was too small, tight, which they say is a sign of impending lymphedema. I have been trying to keep it at bay since then but think I am losing the fight. For the first time ever I almost could not get my wedding ring off tonight!!
Recovering from burnt skin and under boob grossness took a while. My boob is still mottled pink and brown and slowly peeling. I hope that pinto look goes away. I hate it. But the INSIDE of my boob is still changing as now sleeping on my stomach hurts as there are hard, knobby chunks (?) in there. Internal bits and pieces are getting thick and miserable it seems.
Oncotype 11 so Onc said no chemo, but I am 100% ER and PR positive, so Tamoxifen for sure. I have posted about my resentment and fear of this drug in other threads. I have also posted that I have decided to take a 10mg dose instead of the 20mg dose. Reason being that the 20mg dose seems to be the most widely tolerated, but was never investigated as to whether or not it was the optimal dose. Just the most tolerated dose. Some small studies have shown that lower dosages keep a steady level of the drug in your system, with lower side effects, leading to woman more likely to take it the full 5 years instead of toss it due to utter physical and mental misery.
I hope you find your way. I am still struggling how to live a life where I plan to be 80 and also plan to not be here 5 years from now. I am messed up. Others here are much more together. I hope to get there. You will find lots to read and consider here. Good luck and hugs to you.
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Well, I have an appointment 9/11 with the radiation oncologist in Arizona, and treatment should start a few days later and end 9/20. It's close enough that I can spend the weekend with friends in Sedona, even though I'll have a catheter sticking out of me. (They're cool, they won't mind.) And it will save me a few nights of hotel stay.
Still waiting for insurance auth, and financials, since my surgery claims haven't even been processed by insurance so it's not showing I've met my deductible and out of pocket $$ (Frustrating!!)
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Interestingly enough mine all started with a radial scar in my left breast that I was going to get excisionally removed then found out by sheer accident of my suregons team looking at my son that I had something on my right that was not noted on my report. Turned out to be breast cancer. After I had mastectomy found out my left breast had no cancer. Meanwhile for a month I was so worried about if they would find cancer with the radial scar and it was my right boob out to get me.
Outside of waiting for insurance, glad the ball is rolling for you and you have your appointments set.
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Better news on the insurance front - my auth came through for brachytherapy, and enough claims have cycled through that it at least shows I've met my deductible and half of my out-of-pocket expenses for the year. Hope more come through before I leave, so there will be less to pay up front. I said to DH: you save up for a rainy day-- and it's definitely raining! Just praying that we don't lose insurance since we buy on the marketplace and now I definitely have a pre-existing condition.
Runor - thanks for sharing. Weird to be in the small group where the complex sclerosing lesion really was something to worry about! Even my ultrasound was negative. My ER+ score was 67, PR+ 94 so I'm not sure how that figures into possible therapy. I also didn't have an oncotype done. Wonder of the MO will order one and if it can still be done from the tissue stored in the lab?
So many things to learn. Worked in a hospital for 20 years but never in oncology. So grateful for everyone sharing their stories so others can learn!
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You are hormone receptor positive so makes you a candidate for hormonal therapy. Was chemo ever discussed? Onco test would be helpful in determining the need if it is questionable that you need it at this point.
My surgeon sent out my tissue for the Oncotype test and took over a week to come back. I believe I read somewhere that they hold the tissue for quite some time. Can't hurt to ask if they can send it out pending Insurance approval.
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I actually haven't seen anyone besides my breast surgeon yet. who recommended the brachytherapy. (Since the lumpectomy was already complete before we knew about the cancer.) I see her again on Thursday, so I'll ask her about it.
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With your pathology I’d be extremely surprised if your OncotypeDX (if even tested) would be high enough to warrant chemo. Are you perimenopausal yet? If you don’t want the more dangerous SEs of Tamoxifen (risks of both blood clots and endometrial cancer) you might want to ask about ovarian suppression or removal so you could take an AI (which increases mets-free survival 1-2% over Tamoxifen).
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Hi Sandy,
I was perimenopausal for a while, but when I lost weight it seemed like my symptoms went away - no more hot flashes, less PMS, etc. My cycles are now more regular after being slightly irregular most of my life. Really though they'd be gone by now since I'm 54!!
When I get to my appointment with the MO, I'll definitely bring up surgery. I had one ovary removed long ago for a dermoid cyst, guess the remaining one decided to work overtime!
My Ki-67 %positive score was 2.2, so definitely not dividing rapidly according to what I was told. Breast surgeon said I wouldn't need chemo, but would like to hear it again from the MO eventually.
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When all you ladies had the original biopsy and it came back as a radial scar/complex sclerosing lesion did it show atypical cells? I am a little confused by a radial sclerosing lesion (diagnosed with one amongst IDC in the other breast). It showed no atypia or malignancy; but it is rather large at 2.4 CM x 3.2 CM. The surgical oncologist told me that this can be monitored instead of being removed. I am confused as i assumed because it was such a large lesion; excisional biopsy is the recommended treatment. In my biopsy it showed calcifications; and usual ductal hyperplasia as well.
All the imaging is showing distortion with spiculation; which is why they biopsied.
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"Still figuring it out" feels totally "my" topic as well... I'm new to this forum and website. Have been diagnosed with ILC in mid-July and had lumpectomy +sentinel node removal on 31st of August. Tomorrow have an appointment for the results... very anxious about it. I'm reading diagnosis of other people (trying to figure out new reality) and have question - why did some people undergo mastectomy with relatively small tumor sizes? I was told that mastectomy is much more severe surgery than lumpectomy.
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KatjaNL,
The reason I chose a double mastectomy was twofold. First, I had more than one tumor, more than one type of cancer, and both breasts were involved. I figured if I didn't deal with it now, I'd probably have to deal with it again in the future. Secondly, I did not want radiation. The best way to avoid radiation is to remove all of the breast tissue. For me, it was an easy decision.
Trish
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SHelby85, I'm not sure if this is answering your question or not. BUt my radial scar was named such BEFORE any biopsy ever took place. The mammogram results said radial scar / complex sclerosing lesion.
I researched this and read over and over that needle biopsies, no matter the type they use, give poor results with a suspected radial scar and they prefer to do a surgical biopsy to get a good, solid chunk of the thing to look at. So I refused the needle sticking biopsy and went straight to the surgical biopsy.
MOST radial scars are NOT cancer. If yours does not have suspicious cells, then watchful waiting is maybe a prudent approach to take.
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Friday_Yet - Are you aware of the Editha House in central Phoenix? 16 apartments available to cancer patients for modest donation. google it. Also, can I ask who the Oncologist is that you've chosen to see? I live in North Scottsdale and am still collecting information.
Thanks!
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Shelby, the radiologist saw the radial scar / complex sclerosing lesion and told me that needle biopsies of these lesions often don't capture the right place since they are very hard to target, and referred me to a breast surgeon. So I never had a biopsy, just the excision/lumpectomy which (surprise!) had a small cancer in it, thankfully clear margins. There was no lump, nothing showed on ultrasound.
Katja - There is SO MUCH to figure out at the beginning. Thankfully there are so many others who are willing to share their stories! Trishyla gave an excellent answer, and the lumpectomy vs mastectomy decision is influenced by many factors - aggressiveness of the cancer, one type or more, one spot or more, nodal involvement, etc. The decision was made for me this time, but if it ever comes back, I'll have a mastectomy. This is such a great place to ask questions!
jjAriz - I was referred to Dr. Robert Kuske by my breast surgeon. He has extensive training and developed accelerated partial breast irradiation, and I've been told (by my breast surgeon) he is top in his field. I also met the qualifications for brachytherapy, which they don't do here in New Mexico. It is done in 5 treatment days with two treatments a day. (Not on the weekend, plus the consult day, catheter insertion day, planning day, so I'll actually be gone from home 10 days.) I did read about the Editha house, but read that they require a caregiver to stay with the patient and I'm traveling to AZ alone. Did find a fairly inexpensive hotel a few blocks from the Cancer Center though, and will stay with friends in Sedona for the weekend, which will save a few $$.
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Shelby , I had a radial scar upon biopsy because I had 2 tiny 4mm mass on sono. Everything was benign with it but because radial scars can sometimes have cancer by it they remove it. I wound up finding out I had cancer in other breast so did the double mx because I just couldn't do the 6mth surveillance,. The anxiety I had was bad. Add. that to the mix forget it for me. Plus my sister had breast cancer. I knew right away I'd do a bmx.
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Today's update: I'm cleaning, packing, and picking up the last needed supplies for my trip to AZ for brachytherapy. Had another mammogram on Thursday, then saw the breast surgeon. The Mammaprint test was back, and things look good. Luminal A, no real benefit from chemo, so that's good news. On a side note, I may have a couple stitches trying to work themselves out of my armpit incision, it burns a bit. If they are still inflamed when I return, the doc will open them up and remove the stitches that are refusing to dissolve.
Getting more nervous about things. Not necessarily the procedure, but just the logistics of hotel, picking my daughter up from a strange (to me) airport, traffic, getting to the right place at the right time, etc. I'm usually the navigator while DH drives. Not really "scared" just uncomfortable.
Also hit me that I'm no longer an organ donor, and can't give blood at this point. Makes me sad.
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Hello everyone, I'm now in Arizona and had 20 interstitial catheters placed through my breast yesterday. Lots of tugging, but the MD used a ton of local prior to placement and I had pain meds on board, so it wasn't too bad. DD was with me, and the MD was great teaching her and explaining everything to us. (They don't do brachytherapy at her center, so it was a good learning experience for her.)
Radiation therapy starts tomorrow, twice a day.
Got a call from my insurance today asking why I was sent out of state. Now I'm nervous about denial of payment. So frustrating since I wouldn't have come if the cancer center hadn't told me that they had already received the auth. Can't stop treatment now, the catheters are already in me. Really hoping I can get this cleared up tomorrow.
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Dear Friday, I'm sorry to read that insurance is creating worry. You have enough to focus on without that part of it. I hope it's resolved quickly so you can focus on healing.
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My blood bank told me that if I'm still NED 5 years after finishing treatment (in my case, letrozole), my blood would once again be accepted if it meets the usual parameters (hepatitis and HIV-negative and sufficiently high hemoglobin & hematocrit). And even if still not yet out of treatment, or Stage IV, a cancer patient can still donate corneas upon death
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