I didn't have my surgery at MSJ and am only a bit familiar with some of the surgeons there. I know in the past few months there has been discussion of MSJ surgeons on this thread. If you have time to scroll back through the pages you will probably find it. Otherwise I hope some of the women who had surgery there will chime in. Baby steps though - she's nowhere near needing a surgeon yet, and hopefully she won't need one at all. Fingers crossed.

Thankyou everyone, very sound advice. I guess I'm leery of the six month wait because of the nature of metaplastic, grows extremely quickly and I have seen that to be the case twice. There is so little known about it as it only counts for .02 of all breast cancers and they don't know if there is a hereditary factor.

Very interesting information wrenn about biopsies, I wonder if that occurs with needle biopsies or just punch.

I will read through the more recent posts on here and see if any names get mentioned positively. My daughter made a follow up appointment with family dr to go over results- she is thinking biopsy as well to put her mind at ease.

Everyone's comments are appreciated, it's so hard worrying about our daughters- especially when she is so far away.

Positive thoughts!

Oh wrenn, a true bc sister! I see we joined the same year as well. Thank you for sharing that with me, I'm sorry you had that diagnosis, there are so few of us, but thrilled we are both here and feel less alone because I'm sure you understand my worry.

Thank you for that name, I'll keep it in my back pocket and hopefully won't need to give it to her. And yes, I have learned to be my own advocate and like to be prepared as I know how difficult it can be to switch doctors, so I'd rather go with a recommended one right off the bat.

Thank you 😘

runor, thank you- I am going to copy your post and send it to my daughter. Your way of explaining is comforting and reassuring. Having gone through this twice, I pray my daughter never has to. I still would encourage her to have a biopsy because I am an example of things being worse than predicted but I will try not to let that spill over to her.

Dr. Dingee. Her colleague who was also highly respected, has recently retired. She did my lumpectomy and SNB at MSJH in 2012 and mastery in 2013. Her bedside manner is different but she is highly skilled. Dr. Lee was head of radiology then and he did my core biopsy.

Marian

Hi;

I had an Mx on May 1, 18 at Mount St Joe's. Warburton did the surgery and Maxwell performed the 1st stage recon. After initial anxiety I realized they are both excellent and I'm pleased w both: confident in their surgical skills and team. The anesthesiologist agreed to give me a lidocaine plus magnesium block based on research I had done and scientific papers I read that stated a lower incidence of chronic breast pain after surgery w block on top of a general. I was relieved that I was listened to and she (forget her name - anesthesiologist) happily agreed.

Thanks Moth and all for your earlier support re; chemo. My brain is so empty - and not in a "I've attained nothingness & enlightenment way". Very distracted - go see a Dr for a 2nd opinion referral and forget to ask for it, can't remember basic info kind-of-way.

I find out about chemo or not on Tues. I'm scared and grouchy and fed up and feeling sorry for myself at the moment - I have succumbed today. I'll get back to plowing through this experience tomorrow and make it to Tues, but it's been gruelling. My boys are frustrated and want to know summer plans, same for me.

Read a paper on prognosis based on a Korean 2017 study that analyzed what quadrant the BC was found in - mine was LIQ (lower inner quadrant). Only 6% of BC's found there, outcomes are worse for stage one, pre menopausal node neg patients. The paper posits under treatment as a cause, and possible mets vis inner lymph nodes. I'll copy a link and post it if anyone is interested...

Thanks for holding space and reading. Harumph. Am desperate to know which way my treatment is going - and to get it over with.

xo

Thank you everyone. Holding positive thoughts in my heart. I will update when we find out more. This group is amazing!

Hi Moth;

Here it is...I hope I'm not super tech savvy. If the link doesn't work I'll ask someone (my boys) to assist. There is another recent Korean study w similar results.

https://www.ncbi.nlm.nih.gov/pubmed/28169145

(I'm node neg, premenopausal, under 50, er/pr+)

Clin Breast Cancer. 2017 Jul;17(4):e169-e184. doi: 10.1016/j.clbc.2016.12.011. Epub 2017 Jan 10.

Poor Prognosis of Lower Inner Quadrant in Lymph Node-negative Breast Cancer Patients Who Received No Chemotherapy: A Study Based on Nationwide Korean Breast Cancer Registry Database.

Hwang KT1, Kim J2, Kim EK3, Jung SH4, Sohn G5, Kim SI6, Jeong J7, Lee HJ8, Park JH9, Oh S10; Korean Breast Cancer Society.

Collaborators (72)

Author information

Abstract

BACKGROUND:

We aimed to investigate the prognostic influence of primary tumor site on the survival of patients with breast cancer.

PATIENTS AND METHODS:

Data of 63,388 patients with primary breast cancer from the Korean Breast Cancer Registry were analyzed. Primary tumor sites were classified into 5 groups: upper outer quadrant, lower outer quadrant, upper inner quadrant, lower inner quadrant (LIQ), and central portion. We analyzed overall survival (OS) and breast cancer-specific survival (BCSS) according to primary tumor site.

RESULTS:

Central portion and LIQ showed lower survival rates regarding both OS and BCSS compared with the other 3 quadrants (all P < .05) and hazard ratios were 1.267 (95% CI, 1.180-1.360, P < .001) and 1.215 (95% CI, 1.097-1.345, P < .001), respectively. Although central portion showed more unfavorable clinicopathologic features, LIQ showed more favorable features than the other 3 quadrants. Primary tumor site was a significant factor in univariate and multivariate analyses for OS and BCSS (all P < .001). For lymph node-negative patients, LIQ showed a worse OS than the other primary tumor sites in the subgroup with no chemotherapy (P < .001), but that effect disappeared in the subgroup with chemotherapy (P = .058).

CONCLUSION:

LIQ showed a worse prognosis despite having more favorable clinicopathologic features than other tumor locations and it was more prominent for lymph node-negative patients who received no chemotherapy. The hypothesis of possible hidden internal mammary node metastasis could be suggested to play a key role in LIQ lesions.

Hello ladies,

I was just referred from another post to here. I am really grateful for this site. Here is what I had posted:

Since the beginning of May my life has been a roller coaster. A little background info which may help other particularly those in BC, Canada.

I thought I had felt a little lump back in Dec / Jan and went for a mammogram and mentioned this to the technician, She said that it will show on the mammogram if there was anything. In January the result came back normal and come back in 2 year so I put this out of my mind. Early May I found a large lump in my right breast and off to the Dr.... Long story short, ultrasound showed the lump about 2 cm at about 12 o'clock position and the radiologist sent me immediately for a biopsy. Biopsy showed negative for neoplasm but discordant. Therefore, either had to repeat the biopsy or take it out for proper analysis. I was sent to the Breast Center in Vancouver- horrible experience there for me.

The lady doctor that I saw there wanted to repeat the mammogram, do MRI and another biopsy. Even though I have small breasts, apparently they are very dense. I did not know this till the day I saw this lady, yet knowing this, she ordered another mammogram. I asked her lets take it out for analysis immediately instead of poking it again as it may come back discordant again. But this doctor thought this was an old fashion way of doing things.... so off to my family doctor, he arranged with another surgeon at a different hospital to take it out for analysis.

Meanwhile, I had the 2nd mammogram which missed it again and the radiologist basically told me that mammogram is pretty useless for me. The MRI indicated an unusual enhancing lesion at 12 o'clock that does not demonstrate malignant type enhancement but rather plateau kinetics in a lobulated ring like fashion involving the periphery of the mass and a small adjacent nodule. The MRI report recommended to do either biopsy or do an excision. Three additional tiny lesions were found in the MRI as well.

A few days later the surgeon performed excisional biopsy of the tumor, no lymph nodes were taken and last Friday I got the horrific news form my family Dr.

Breast tissue taken out 3.3 x 4.2 x 2.3 and the size of cancer was 3.3 x 2.9 x 2.8.

Positive for IDC with greatest linear tumor dimension of 3.3 cm. Minor component of high grade ductal carcinoma in situ with comedonecrosis, histologic grade of invasive carcinoma grade 3/3 poorly differentiated (tubule formation 3, nuclear grade 3, mitotic rate 2 compatible with 8/9 points SBR) - Est /Prog + HER2 - Negative and Ki-67 proliferation rate high over 15%.

AJCC stage: pT2NX

I will see the surgeon again on Tuesday. My family Dr. recommended to remove both breasts.

So as you can see I am very confused how the MRI could not give a better diagnosis?

Can anyone help me understand the above analysis better? chances? how bad is it? etc...

Anyone had similar results? Any recommendations?

Thank you for your help.

Popping in after a very long time to say hi to old friends and new. As I just posted to Moujan, this weekend marks my 22nd year with BC, the last 5.5 with MBC. I hope everyone is enjoying Canada Day! My best to all

Hi all;

Moujan: I'm sorry to read about your struggle for clear results and information. I found the system moves at a glacial pace and have ben very frustrated. I hope you have more information at this point to think through your options. I'm glad you are on this site - and thread. I'm a newbie here but thanks to the ladies who came up along side me during the process, I've learnt tonne, felt more confident asking medical questions and felt less alone. It has been a life line for me. I hope someday to re-pay the grace others have shown me.

Quick update: Met w my MO today - good news for me - finally - no chemo. Start Tamox in the next few days. Relived, and feel like I've just gotten off a tilt-a-whirl.

Have decided not to return to MO. For the second time I found him dimissive, aggressive, patronizing and...I could go on. Had a friend w me both times: 1st a female RN friend, 2nd my ex-husband PhD Bio Chem scientist. Both were appalled for me, both agreed. Today the MO barely looked at me, barely spoke to me - focused on my ex - the man. Last appt MO made a 'joke' about missing his prostate patients b/c they nodded and smiled and asked no questions. Ugh. I made sure both times to be polite and was aware that I might be anxious, etc and over compensated both times w open mind, no judgement. I believe his medical information to be accurate, but my life is wayyyy to short to have to take that level of aggression, etc. I gave him second chance, I brought a different set of ears, I tried my best. But - I'm going to write a letter - which I never do - he was that awful, that condescending, that dismissive - I'll stop now : ). I know all relationships are chemistry - including medical Dr's - and he and I are not a fit at all.

That said: happy with the news he gave me, look forward to future care w a new MO.

Hoping for best outcomes for you Moujan, and all

With thanks

Hi BlueSky

Yay on dodging chemo! What was your Oncotype score? I didn't get the test and wish I had. When I asked the GP at the Cancer Centre who was supervising radiation why I didn't get it, he said I “didn't deserve it." Trying to make a dumb joke I guess, because my tumour was low grade. It bothered me and I will ask the RO about it at my follow up appointment in a couple of weeks. I think they are trying to save health care costs, though truly I don't think I would opt for chemo anyway at my age (69). I never saw an MO - too old? too low grade? But so far, no problems with AI or healing from rads.

No more excuses for your MO. You did everything possible to give him another chance and he actually sounds misogynistic to me. You will be helping other women by writing a letter.

Although we have good technical cancer care in BC, there are huge gaps in patient support, and that is part of healing. These docs may be stressed, but they still should control their comments to patients.

Good luck with a new MO and with the tamoxifen!

Just waving hello to everyone! I've got 3 more weekly taxols to go & then radiation. Supposed to be starting school in September and now I'm getting cold feet ....

Also, I'm starting to get neuropathy so it's not just cold feet but sore feet (ha, couldn't resist the lame joke; oh look, lame...another joke LOL)

My blood counts are still on barely above what they need to be. I hope I can make it to the end of the set with my bone marrow intact & some feeling in my hands and feet. I'm feeling a bit tired and I don't know - kind of bored of all of this, kwim? I hate having everything be about my health & cancer & being well & staying well. Ugh, b.o.r.i.n.g.

Other than me being a grump, all is well here. Hugs everyone.

I feel like it is been ages since I've written and sorry to not have jumped in where I could've. I love it that this thread is so active these days and there's so much help being offered. The discussions about changing doctors has been interesting and I for one agree that sometimes it is important to make a change. Not sure if I mentioned some time ago that I did just that. I changed my pain doctor at BCCA Victoria and it has made such a difference. She works only one day a week at BCCA and her main job is the Victoria hospice at the Jubilee. That hospice has seven acute care palliative beds and 10 beds for those nearing end of life. My pain doctor got me admitted in June and over two weeks I saw a different doctors and also did what is called a methadone conversion. I was switched from all of my Oxy drugs to methadone. Tomorrow I see her again and we will increase the dosage. I also saw up a specialist on nerve blocks and will likely have one in August. Being an inpatient allowed me to have tests done easier as I was readily available when cancellations happened. I had a CT with contrast, a full bone scan and an MRI. The chest CT shows my tumor as being stable in the bone scan has a couple spots nothing major but the tests will be redone in three months. Back to doctors and changes. I think most of you know that I asked to change to a different MO and that also has made a world of difference. I feel like she treats me as a regular breast cancer patient as opposed to one who is Metatastic and thus less important. At least that is how I felt with my old MO.

For those of you who did the virtual reality study I am curious to know how you feel now. I enjoyed some parts of it and did feel that there was a distraction but in the end I do not feel that is helped me with my pain. Perhaps the one thing that came from it is getting back to some form of meditation even for short times. I joined a newly created support group at BCCA for metatastic patients and not just breast-cancer. I think there will be 10 of us and we will meet once a month. With the second month coming up there maybe one or two people who could not come the first meeting but after that there will be no admissions until 4 to 6 months so that we can create bonds and make goals together. I'm really excited for this and found the first meeting to be helpful.

Happy summer to all of you and I look forward to being present on the thread again.

Cheers, Marian

wrenn - it's not your memory. I've been cagey about telling what I'm doing - partly because saying it makes it seem so frigging real and I'm getting scared, and partly because IRL I've gotten some weird reactions to this plan. So here - I'll tell you guys & then I might delete it because I don't know if I want it out there for posterity.

This plan was hatched before I got sick & has been coming for a long time. I've been accepted to a 36 months continuous program to get a BSN and become a registered nurse. I'm a board certified lactation consultant but I've been mostly a sahm for 20 years & my previous degree is in PoliSci. I wanted to go back to work for 10-15 years in health care, in a unionized setting, in a job which would allow me to travel and which I could also move into health care policy research if I wanted to move from bedside.
This seemed sort of a crazy plan as a healthy 51yo, but now as a recovering bc patient, it seems even more crazy My alternate was a Master in Public Health but I always felt that was more risky in terms of job opportunities & not guarantee of employment so .. here we are.