Recently Diagnosed IDC and confused

hi I’m new to the forum and I am still in a daze I was involved in a car accident last September which left me with deep scar tissue in my upper abdomen. I went through physical heat therapy but the mass in my left breast would not diminish I had x-rays ultrasounds CT scan mammogram and MRI‘s none of them detected the cancer my doctor decided to do an aspiration biopsy to remove the fluid once we did that the papilloma popped up like a finger I immediately did a core biopsy it did not pick up the cancer another mammogram again still no cancer so my doctors and I decided to remove the mass altogether with my pathology report I was told I have invasive ductal carcinoma rising in association with encapsulated papillary carcinoma The focus of the invasive carcinoma measures .5 cm I also have ductile carcinoma in situ with high nuclear grade with lobular cancerization with solid growth pattern invasive carcinoma is present so 7 mm from the deep margin in 8 mm from anterior margin and a encapsulated pappillary carcinoma which resulted in type 1/a grade triple negative cancer I’ve been told to do radiation although everything I read says chemotherapy for triple negative breast cancer my question is could the car I accident have caused the cancer from blocking the blood flow and are there any new studies a triple negative being treated with Just radiation and being successful

Moujan: Hi. I am sorry that we're meeting over your new diagnosis. I hope you will begin your education here at the site.

The MRI reading you received has conditional wording -- it is about as far as the Radiologist could go because without a biopsy or removal, there could, possibly, be a reason other than cancer for certain spots to "glow".

You have biopsy results and that's what is important now.

Hi Moujan. If you would like more information before deciding about chemo you should ask your doctor about an Oncotype DX test. That gives you a low, medium or high score which advises on how helpful chemo would be. On whether or not to push for a bilateral masectomy, genetic testing may be helpful. But I'm in the U.S. so defer to our Canadian sisters who will undoubtedly give better advice.

All best wishes to you.

Moth, just to point out.. The myth that Lumpectomy+Rads is as good as Mastectomy is FALSE for younger women, ESPECIALLY WITH DENSE BREASTS.  BCO has an article on this as well.  Here it is: https://www.breastcancer.org/research-news/best-surgery-for-early-stage-may-depend-on-age 

Please don't push people into lumpectomies if they'd prefer BMX.  I certainly would much rather have the boobs GONE than risk another tumor that they just didn't see.   In addition, many women find there are additional tumors when they demand a BMX rather than Lumpectomy.  - oh and with Dense breasts, a woman is 8 times more likely to get BC... why in the hell would you want to keep boobs like that on your body if they've already developed 1 tumor already?  You may only be concerned with mets.. but I was concerned about a new primary developing in the other boob and it being missed by the mammogram and creating a bigger issue. 

Oncotype qualifications in BC are covered in that document I linked above. All of the BC Cancer agency guidelines are in there.
You can use Ctrl-F to find the word in the document & eventually you'll get to a table which explains the eligibility criteria for the province to pay for the test.

http://www.bccancer.bc.ca/books/breast/management/...

re the lymph nodes - sentinel lymph node biopsy is evidence based treatment. It's a big risk benefit analysis - removing all the lymph nodes puts you at much greater risk of lymphedema which is a serious complication. I had SNB and they ended up removing 5. Lymph nodes are small. Even with radioactive tracer dye, it's hard for surgeons to find them so they sometimes end up taking more than they really wanted to.

Chemo is additional hedging of bets to prevent metastatic recurrence. When you look at those probability stats in the calculators I linked above, when they list the risk of dying of breast when chemo is not chosen, it's metastatic (stage IV) disease they're talking about.

Anyway - your surgeon is not the one who will make recommendations about chemo. Your medical oncologist will do that ... I'm guessing your bs was just warning you what the provincial guidelines suggest given your tumor characteristics. Once your surgery is done & the pathology finished, you will be referred to a medical oncologist who will take over the rest of your care.

Can I ask what specifically scares you about chemo? Not saying you have to choose it - everyone needs to make an informed choice that's right for them & their circumstances. But sometimes our perceptions of what it's like are not quite accurate. Some people work almost full time through their chemo. Side effects are usually well managed with various interventions. Obviously it's not something you want to do if you don't have to, but I'm not regretting it (& I'm not done yet - started in Feb, will end in hopefully just under 3 weeks).

Do take your time to think all this stuff through. It's a lot to process, I know. I hope you're surrounded by supportive friends & family.

best wishes -

I had my surgery at Surrey Memorial. I didn't pick based on hospital - I picked based on surgeon. I met my surgeon and really liked him & just went wherever he had OR time available. I was very fortunate as he slotted me in very quickly.

I know what you mean about the risks from chemo. I sometimes read through the side effects (& some of them are possibly lifelong issues like heart problems or neuropathy) and do get worried. But fwiw, the breast cancer which I already had scared me more than the potential of a cancer or other illness down the line. If it happens, we'll deal with it then (& every year treatments get better so odds improve every year you can kick the can down the road). I just wanted to hit it as hard as we needed to, to reduce the odds of it coming back. Because I'm essentially triple negative, I can't use hormone therapy to try to keep it at bay... But otoh those hormone meds can have side effects as well so even for hormone receptor positive patients, there are decisions to be made about endocrine therapy and whether they can handle the side effects. It's a lot of tough decisions.

I hope you don't have to wait long for surgery. Faster you get it done, the faster you get your sample to the pathologist (& if it's going to be Oncotyped that takes time as they need to send it to the US & there's additional permission forms etc) and then you'll get a treatment proposal that you can finally decide on. This part is so stressful, I know. I felt a lot better once I had a detailed plan in hand. It will all come together eventually & you'll make the decision which is right for you.

Just for anyone wondering: things are different in BC. We have universal health care & provincial standards of care which mean essentially everyone gets evidence-based treatment (for free). The entire provincial cancer agency is also a research facility, affiliated with major universities.

Any complicated or grey area cases are discussed by tumor boards on weekly conference calls - so 2nd, 3rd and 4th etc opinions are built into the system because the system is based on team care.

I think op's lymph nodes weren't tested because technically she had an excisional biopsy. They didn't know what they were looking at yet. They do sentinel nodes when they already have confirmation that it's malignant.