October 2018 Surgery Support Group

I am also scheduled for surgery in October. I had neoadjuvant chemo. I am scheduled for a bilateral mastectomy with sentinel node biopsy.

I had scans after my 5th chemo and there were mixed results. The US and mammogram showed the tumor had shrunk from 2.7/2.5 cm to 1.7/1.1 cm. I had an MRI that does not show any signs of a tumor. I am not sure how that can happen.

Hello! I'm joining the group - I am scheduled for BMX and sentinel node biopsy on 10/19/18. Also, TEs will be placed then and I'll have exchange surgery in early 2019.

Sillyoldrabbit, I'm also tnbc with you. I finished neoadjuvant chemo on 9/5/18 (4 AC and 12 T).

Proud_Patriot, did you have a recent mammo/US/MRI (you said you had them after your 5th chemo - not sure if that was recent since I had 16 rounds of chemo). I'm with you on being confused on imaging results, though. I just had my mammo and US on Friday (will have my MRI tomorrow). The radiologist told me I had great results because there was nothing definitive left for her to measure. She also told me there was an area by the biopsy clip that had some "dark and light" areas in it, but it was likely the core biopsy scar and that surgical pathology would clear everything up. Today, I read the radiology report and it says "an area of questionable architectural change is noted" and "the imaging findings are best described as a partial response to chemotherapy." Huh?

This may help clear things up for you: https://pubs.rsna.org/doi/full/10.1148/radiol.2017... "There is overall good agreement between residual tumor size measured on MR images and pathologic tumor size determined after surgical excision. Studies have shown that MR imaging can overestimate or underestimate residual tumor size, with a median correlation coefficient of 0.70 (range, 0.21–0.98) reported in a systematic review by Lobbes et al (33).

There are several factors that have been shown to affect the diagnostic accuracy of MR imaging for therapy response assessment. Tumor molecular subtype is one key factor. Accuracy of MR imaging in determining residual tumor size after neoadjuvant therapy is greatest in ER-negative/HER2-positive and triple-negative tumors and is less accurate in luminal tumors (40,41). The type of chemotherapy regimen can also influence diagnostic accuracy of MR imaging, which can underestimate residual disease in patients treated with taxanes and antiangiogenic drugs, through hypothesized antivascular effects on contrast enhancement."

I've also read many threads here on breastcancer.org where people report that imaging showed the tumor was gone and it was actually still present at surgery OR that imaging showed it was there, but it was totally gone when surgical pathology examined the tissue. I have extremely dense breast tissue and I know that affects imaging's ability to see tumors, too.

Fingers crossed that we all get pCRs!

Thanks for the welcome, sillyoldrabbit! I'm sorry we're all here, but glad to have the support.

I had no imaging after DX until now - that would have shocked me to see the tumor there like yours was! I could also feel it shrinking and no one can feel it now, so I'm confident this is scar tissue. Still, it bugs me to hear "partial response." I know they don't want to jump the gun and say it's gone if it isn't, but we all need some positive news at this point. I guess that's what the radiologist was trying to say when she said it was a very good outcome after chemo. Her report kicked me right off my happy cloud, though. Thanks for saying your surgeon doesn't bother to look at US scans because she can't tell what type of tissue is there - that helps. My BS said something similar when he did a quick and dirty scan in August - "it's probably the biospy scar, but it could be residual tumor. We won't know until we get the pathology report." Yep, living in suspense along with you.

I haven't seen the MO since I finished chemo. I have an appointment on Wed this week and I suspect we'll talk about "what ifs". Another lady in my chemo group (also tnbc. She was stage 2) will start xeloda after her rads (I don't think it's done simultaneously?). She had 10% residual left. I'm ready to do it if I have to. I wonder if that will delay hair growth? I have sprouts and was hoping for hair by Christmas

I am to have UMX on October 25, with sentinel node biopsy. I am hoping they can do the direct to implant, my PS said if my skin looks too traumatized she will put in an expander first. I had said I wanted to try nipple sparing but now question it. My cancer is pretty close to my nipple, and she said she would do a biopsy from the back of the nipple and I would have to go back in if its positive. I had to wait a bit, and go back for more biopsies after my MRI, and then they had had a tumor board about my case. They finally decided my cancer is 4.7 cm. I am curious what the final path will be. All three imaging modes measured it differently, but I have ILC and it is good at hiding on imaging. BethM, I understand very well being scared and overwhelmed. I hope for some moments of peace for you.

Oct 31st is my surgery date for my bilateral mastectomy and lymph node removal as well. They are doing the tissue expanders for now and reconstruction after 6 months. Like every one of you, I am also scared and nervous that my body will be different after that. I went through 4 AC and 3/12 taxol plus carboplatin. The tumor on my left breast has decreased but the tumor on my lymph node around my armpit tends to be stubborn and has not been decreased. It is shown as less active when during the MRI but the size is constant since the beginning while doing the ultrasound, so its confusing to me as well.

Oct 8th is my last day of Chemo . I am looking forward to this date and also getting more scared as surgery date will be approaching. I hope everything goes well for all of us.

Take care ladies.

GAWarrior, I seem to be doing the same! I just got done cleaning out my basement (again!) And I was going to hit the goodwill for shirts as well, I was going to sew a couple of pockets on the inside for my drains. I can say that my house has never been cleaner since my diagnosis, that's how I get out my nervous energy most days. Thank you for your encouraging words. I appreciate everyone so much!

Prayers, hugs and good vibes for everyone's upcoming surgery!

How are you guys planning for comfortable sleep post surgery? I have read on some threads about using a foam wedge maybe. Or maybe just start hoarding pillows? Any other tips that others have? I am a stomach sleeper so this might be rough

I am a true side/stomach sleeper. A bit pricy, but the wedge system aboveworked for me. I needed to sleep on my back 6 weeks after bilateral mastectomy and again after exchange. For me, worth every penny! Good luck!

Well, I’ve been looking for distractions as well. I’m a stay at home mom so I’ve been cleaning like crazy, yard work, and was using my hubby 😉 as a good distraction til they made me remove my birth control. Now we are stating a small kitchen remodel that he chose to do to help me cope (love that man)!

Aside from that just trying to stay busy doing whatever I can. I’ve never been a great cook so would be nice to learn that skill.

Dear Dominos,

Welcome to the BCO community. We are sorry about your cancer and your upcoming surgery but so glad that you reached out to our members. We wish you all the best as you get ready for surgery. Stay active here and keep us posted on how things go for you. We are sure that you will make connections here. Let us know if you need any help with navigating your way around. The Mods

haha, Silly!It’s so true though! Poor guy knows he was used too. Plus may as well while I can. Heard my sex life will likely tank after this and the estrogen blockers. 😉

Hi everyone,

I am scheduled to have lumpectomy and full node removal on right breast on october 18th. I finished 8 rounds of chemo before and according to my doctor, my response is very good to chemo. Thats all i know medically tbh. I am so amazed that all of you have so much knowledge and even know medical words. To me, its like a different language.

My breast cancer was diagnosed after 10 days od c-section. Taking care of newborn and going through chemo therapy has been rough but i am finally done. After surgery, i have atleast 25 rounds of radiation. Then I have 1 year of herceptin every three weeks and 5 year of tamoxifen.

Any tips for lumpectomy? I am getting myself ready but scared

Sillyoldrabbit, thanks for explaining the laser cap. It looks interesting but I think I'll wait for my hair to grow on it's own after I saw the price. <gasp> How weird that your grandfather wasn't told he had colon cancer. I know people often didn't talk about having it, but it's strange that the doctor wouldn't tell the patient. How would you explain why you keep telling this man he has to come in for treatment if you don't tell him what it's for?

SimoneRC, thanks for the wedge sleeping info. I'm a side sleeper so having to sleep on my back after BMX is going to be rough. Plus, I'll have TEs and I hear they're not easy to sleep with either. If nothing else, I will grab the pillows from the various beds in the house and pile them up. I've also heard that for us BMX ladies, it helps to sleep in a recliner for the first couple of weeks, although I hate that idea almost as much as having to sleep on my back.

Kista, I'm sure your hubby was pleased to be used for distraction purposes, lol. I'm still chuckling.

Bubblybubbles and Dominos, I can't imagine going through this with young children. Big hugs to you both. Bubbly, FWIW, a few ladies in my April chemo group have said that surgery is much easier than going through chemo. There will be pain for a couple of days with your lumpectomy, but try to stay with the pain meds and take them on time. In my experience with chemo, if I didn't take my nausea meds on time, it was much harder to stop it once it started, but if I kept the meds in my system, I didn't get nauseous. It's the same with pain meds. Don't chase the pain, keep the meds going so you don't have to catch up. I hope that makes sense (I feel like I'm not explaining it right).

Kat22, my BS said he wanted 6 weeks PFC before doing surgery because I'll heal better, so it's good that you're waiting 5 weeks. Sadly, SEs apparently take a long time to pass. I'm 3 weeks past chemo and still have tender fingers from the T, blurry vision, and am often exhausted. I'd also be happy if I had some hair, although I do have fuzzies and my eyelashes are coming back.

Trishyla, love your onco nurse! Good for you, you're almost done!

Hoping you all have a great weekend.

sillyoldrabbit,

I so hope your ATM VUS never ever amounts to anything at all!!!

Sending you virtual good karma