Does this sound right?

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schmooth
schmooth Member Posts: 4
edited November 2018 in Just Diagnosed

Hi There. I have been reading the forum for a week or so now and got my diagnosis on Wednesday. I am 40 and went in for my first mammogram and they found a suspicious mass. They immediately did an ultrasound and said they wanted me back asap for a needle biopsy. It came back as IDC. The mass is 1cm. I met with a surgeon on Friday and it sounds like she wants me straight into surgery once we get the result of the genetic test back to determine if I should go lumpectomy or double mastectomy.

What I am wondering though, is that there hasn't been any talk of any other testing like an MRI that I see others mention. I think she mentioned that they would biopsy some lymph nodes during surgery. Does that seem right to you? It seems like most people are having more testing than just the initial needle biopsy before they go to surgery?

Thanks for any feedback. <3

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  • 70charger
    70charger Member Posts: 963
    edited September 2018

    That's all I had, biopsy with ultrasound then surgery.


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  • bella2013
    bella2013 Member Posts: 489
    edited September 2018

    Schmoot, she will probably order the MRI before going into surgery. The MRI gives more accurate information and also will indicate if there is anything suspicious in the other breast.


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  • schmooth
    schmooth Member Posts: 4
    edited September 2018

    Thanks for the reply. I don't think that is her plan, but maybe I am wrong. She basically just wanted to get the surgery scheduled once the genetic test comes back and said she would see me once before surgery to explain everything.

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  • Georgia1
    Georgia1 Member Posts: 1,321
    edited September 2018

    Hi there and so sorry you are joining our little club. That actually sounds right to me. IDC is pretty straightforward; it is DCIS and ILC that are sometimes surprising in their eventual size. And 1 cm is so small the usual recommendation is lumpectomy. But if you have a family history of breast cancer I'd ask for an MRI.

    The sentinel node biopsy is usually done during surgery.

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  • JoE777
    JoE777 Member Posts: 628
    edited September 2018

    After my biopsy, I had a lumpectomy. On the day of my surgery , dye was injected in about 5 different areas of my breast to trace where my sentinel lymph node was. They imaged then with a cat scan to record where the nodes were. I was then taken into surgery and they did the lumpectomy and removed the sentinel to get the pathology report to see if it had spread into the lymph system. I told the doc if I had bad nodes or bad margins to go with the Mastectomy in that surgery ,but I was lucky and woke up to hear just a lumpectomy with good margins and no node involvement. Your case sounds like the standard procedures. Ask doc everything you want to know. They're use to it. Hugs and a peaceful night. Jo
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  • Sara536
    Sara536 Member Posts: 7,032
    edited September 2018

    If at all possible, get a second opinion. It seems that your questions have not all been answered and they should be... and before the last minute. A second opinion may re-enforce the first or it may offer an alternative and the need for a more in depth conversation. Your fellow BCO members are wonderful at sharing their experiences as well as offering support but we are not doctors and what is “standard" changes over time and according to location. Continue to ask questions until you are comfortable with the plan. (edited for spelling)

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  • Sjacobs146
    Sjacobs146 Member Posts: 770
    edited September 2018

    I did not have an MRI. Just mammogram, ultrasound, biopsy. Not everyone has them, and my understanding is that it's fairly rare to have BC in both breasts

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  • Ingerp
    Ingerp Member Posts: 2,624
    edited September 2018

    I had an MRI when I had DCIS, but not with IDC. (My BS referred to DCIS as "squirrelly"--can't feel it, can't see it--maybe that's why they tend to do MRIs with it?)

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  • DATNY
    DATNY Member Posts: 358
    edited September 2018

    Do you have the hormone and HER2 status? If it is HER2, standard of care is chemo and neo adjuvant first. I think second opinion is a great idea.

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  • WC3
    WC3 Member Posts: 1,540
    edited September 2018

    schmooth:

    My tumor was 2.54cm on the mammogram when it was spotted. All of the surgeons I saw wanted the receptor typing back and for me to meet with an oncologist before they would do surgery. I consulted with a general surgeon who did mostly breast stuff, two breast surgeons at breast cancer centers and two oncologists at breast cancer centers. The place I went with held off on a treatment plan until my cancer was confirmed to be HER2 positive by a FISH test. It was previously confirmed by IHC but that can yield false positives. My center does chemo before surgery as standard for HER2 positive breast cancer, however the reasons for that may have a bit of a shakey premise. In any case though, all surgeons I saw wanted me to see an MO before surgery and have an MRI and bone scan.

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  • schmooth
    schmooth Member Posts: 4
    edited September 2018

    thanks all for your input. This all makes a little more sense with the different types being evaluated different. I will ask my dr about it and think about a second opinion.

    I should have hormone receptor and genetic test results back today or tomorrow which will provide more direction. I hate all of this waiting and worrying.

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  • dtad
    dtad Member Posts: 2,323
    edited September 2018

    schmooth....So sorry you have to be here but welcome. I don't want to confuse you but IMO you should insist on a preoperative MRI. Its the best screening tool for dense breasts which you probably have due to your age. You want to know the whole picture before you make any surgery decisions. Get a second opinion if you have to. Good luck and keep us posted.

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  • gb2115
    gb2115 Member Posts: 1,894
    edited September 2018

    Some surgeons do a pre-operative MRI before surgery just to make sure nothing else is being missed (for example, if you have a lumpectomy and then find another area later one, it would have been advantageous to have a mastectomy. However, I had read that not all doctors do it because of the high rate of false positives. For example, I had the pre-op MRI, that lead to an additional biopsy during which I failed to stop bleeding for a long time. It ended up being negative, but I had a massive hematoma and a whole lot of pain leading into surgery. They put me into a mammogram machine (squishing my excruciatingly painful hematoma) to do the pre-op wire placement.

    So....in hindsight all of that was pretty darn unnecessary (and extremely unpleasant) for me. But I understand why my surgeon wanted the MRI, and if put in that same scenario again I would still do the MRI. To be sure. But I think that's why they don't always do it...to avoid unnecessary things.

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  • ksusan
    ksusan Member Posts: 4,505
    edited September 2018

    My left breast showed DCIS on the mammogram. My right didn't. A pre-op MRI showed IDC, DCIS, and a positive lymph node on the right, which I wouldn't have had removed without that info. Insist on more imaging.

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  • schmooth
    schmooth Member Posts: 4
    edited October 2018

    Well, I ended up getting a second opinion which I am so glad I did. This surgeon was so great at explaining everything and really walking me through options. She did think I should have an MRI given my age. It came back with a big positive area on the opposite breast. I have a biopsy scheduled for next Thursday to confirm but she sounded pretty certain that it was DCIS. So grateful to have had this found before going through with a lumpectomy and then who knows when this would have been caught.

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  • bevin
    bevin Member Posts: 1,902
    edited October 2018

    hi, I had an breast MRI before surgery. I did get 3 surgical consults. I chose the surgeon I felt was most qualified and from a top cancer research hospital. Good luck with your choice. As long as you see someone from an nci designated hospital you will be in good hands.

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  • Asaka
    Asaka Member Posts: 13
    edited November 2018

    I was diagnosed 6 weeks ago after I felt a lump on my right breast. Did Mammogram and Ultrasoud at the same time and they found another mass on left breast. Right tumor 1.4 cm, left tumors 1.3cm. Had surgery 3 weeks ago, double mastectomy. Surgeon is adamant that no scans are needed because I’m stage 1. I go to one of the best cancer centers in the US. Their rationale is scans do more harm than good for stage 1. Lots of false positives which lead to unnecessary biopsies. He says “it puts patients through hell, no scans”

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  • Cowgirl13
    Cowgirl13 Member Posts: 1,936
    edited November 2018

    Schmooth, I wouldn't be comfortable being rushed and it sounds you are bring rushed. I'd definitely get a second opinion. And I was scheduled for an MRI before surgery happened but couldn't have it because of a small piece of metal in my ear. Good luck.

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