Respectfully asking for help

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hoping42
hoping42 Member Posts: 117

Hello everyone. First and foremost this site is one of great comfort and sanity. To give a little bit of background-first, I am the sister of a beautiful soul that was just diagnosed with IDC grade 3 yesterday-ER+PR+Her2borderline-will be looked at it again. Our mother had ILC back in 2009. Hers was stage IIIb and in 11/22 nodes. Our mom survived! (Unfortunately, she received a new primary dx that she did not survive in 2015. Our mother passed away within a year of our father passing away from AML leukemia--heartbreak. I posted on this very site back when that happened in 2014). I posted here as I also had breast cancer. I had DCIS and Pagets disease. ER-PR-Her2+++ So out of us two daughters and our mom, all three with breast cancer and not only that-all different. Very confusing. I had BRACA testing after my diagnosis which came back negative. After my sister, the same and only sister I have was diagnosed with Melanoma-nodular, stage 3, 2/22 nodes-also in 2015- we had extensive genetic testing to cross reference known mutations for melanoma and breast cancer. No mutations. The medical field calls us "sporadically unlucky"--we call it something a little different. $#@*....................... I bring all of this up as it may add to what we should ask tomorrow.

My sister is fortunate in the respect that since she already is being seen by her oncologist tomorrow, she is etting in two days following a diagnosis. She will be seeing a surgeon-but she is debating with going with the oncology surgeon that did her surgeries for melanoma (which is his specialty) or to go with the breast health surgeon. As you know, those relationships are so important! However, the surgeon at the breast health surgeon mentioned here did my and mom's surgeries) Okay now that I have given a bit of the background, can you please help think of specific questions we should be asking. (luckily we live in the same city so I will be able to be right by her side--every step. she has a great little family too) You would think with everything, I would know what to ask. All of a sudden, I feel like a truck ran me over and not able to think clearly even though this isn't all new to me. However, is new as it is a different diagnosis. We will get a copy of the report tomorrow but this is what I do know-apologize for the repeat of a few thnings)

ER+, PR+ (85%) Her2 borderline, grade 3 lymphatic invasion absent, 25% (my sis could not remember what the nurse said about the 25% except that it appears contradictory to the grade 3--maybe growth rate ?) Nottingham 8/9 ( I don't even know what that is)

One of the first questions of course will be what kind--medullary, papillary, etc. Just want to make sure we are asking the right things for those precious face to face moments with the doctor. Thank you in advance, so very much!!!!!!


Danielle

Comments

  • moth
    moth Member Posts: 4,800
    edited July 2018

    Nottingham 8/9 is how they assess the Grade. That's where the Grade 3 comes from.

    25% might be referring to how much ER+ or PR+ staining there is. That's the only percentage number on my pathology reports anyway.

    Ask for a copy of the pathology reports so you have it for later.

    I think the main questions for the oncologist are: surgery first or chemo first? Will she be getting the Oncotype or Mammaprint genomic test?

    Re the surgeon appointment, seems to me the big Q is lumpectomy + rads or mastectomy? My surgeon is an oncology surgeon and honestly that would be my preference - whoever is most skilled and experienced in removing cancerous masses. However, if your sis might be recommended a mastectomy, then she'll need to consider if she wants to go flat or reconstruct and then I suspect having a breast surgery specialist might be more important. My interest in cosmetic outcomes is almost nil so I really didn't care. That said, most surgeons pride themselves on doing neat nice surgeries and having good cosmetic results.

  • hoping42
    hoping42 Member Posts: 117
    edited July 2018

    Thank you for your time in responding! I am confused by the 25% too. Her ER+ and PR+ are 85%. I guess just something we will have to wait and ask.

    Positive thoughts to you!!!!


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