Just Diagnosed, Trying to Understand...

Lisa and Sheri -

I'm a BC survivor, but am keeping an eye on this topic for my friend who has just been diagnosed. She'll have surgery later but starts chemo today - tomorrow is her birthday  ;-(   I can't explain everything in your report as it's quite different from mine, but I do know that nuclear grade is not the same as stage. I'm sure some of the more knowledgeable ladies will give you more information soon. There is information elsewhere here about the pathology report, so maybe that would be useful as background information: http://www.breastcancer.org/symptoms/path_report/index.jsp

Best of luck to you, Lisa - and thanks for being such a good friend to one of 'us', Sheri!

Minz 

Hi Sheri and Lisa,

You have come to a great place for info. These ladies know a lot and are the best about helping and sharing. I agree with those who've already said so, this doesn't sound like a lobular, it sounds more like ductal, so it would be important to clear that up. You could actually call the pathologist and ask for them to check for you just to be sure. I also recommend asking about having a sentinel node biopsy, a smaller surgery to look at the lymph nodes, before you begin chemotherapy. Other opinions are very important, as are the staging tests before chemo like MRI, PET/CT scans, etc. The surgeon(s) and/or oncologist(s) you may talk to can tell you more about all this. It looks like you are planning well and asking questions, that's important. It's good that you are working together on this. It helps to have someone else listening.

Good point on the mixed features, Laura. And Gitane's right, it's very important for Sheri to have her scans before chemo.

And even if it's straight IDC, of course you girls can still hang out with us! There is also a board here for HER2+ which would be helpful, as well as an IDC board, a surgery board and a reconstruction board, just to name a few. You can just wander around the boards and post wherever you like. Everyone here is wonderful.

Just wanted to pop in and say: Hope all is on track and you have a plan in motion...best wishes to you!

Jule is right--you need to be hormone positive to have Oncotype Dx done.

With a 5+ cm grade 3 tumor, hormone neg, HER2 positive, I can't imagine the onc not recommending chemo (and Herceptin) regardless of lymph node status.

Lisa & Sherri - Don't want to burst your bubble...but...during my Mast. the surgeon looked at my Sent Lymph Node...went out to the visitors surgical room...and told my dh and my Mom that it looked "clean". They both jumped for joy. THEN...3 DAYS later...she called and said that the path came in that one of my nodes was positive! We were truly devastated at the time. But now...based on what I know now...1 node positive isn't that bad. At the time...we thought that EVEN 1 node positive was a death sentence...So....just remember...there's many sides to this dx...and in time, nothing will surprise you. Hang in there....I wish you the very best...

Hello, ladies. Good news on the nodes!

RE: chemo. The shorthand on the chemo boards for Sheri's chemo will be DD (dose dense) ACx4, followed by 4 Taxol with Herceptin. The Herceptin won't be given with the AC rounds b/c of the potential heart toxicity of the Adriamycin and Herceptin, but once it's started, it's usually given for a year.

Definately post on the chemo boards, but with the AC, Sheri can expect nausea and hair loss, and with the Taxol, bone aches and neuropathy (as general rules). Herceptin is usually well tolerated--mainly headaches and allergy type rhinitis symptoms (my mom used to call it "Herceptin schnoz")

RE: BRCA1 and BRCA2 testing--these BRCA genes are considered the most common "breast cancer" genetic mutations, although if one carries them, one is at risk for other primary cancers, most notably ovarian (BRCA1). There is tons of info on this on-line, but don't worry too much about it unless she comes back positive for a mutation. Only a small fraction of bc are BRCA bc.  

RE: radiation and reconstruction. It might be worth meeting with a PS now, b/c reconstruction options may be limited by radiation. Many PS won't put implants and expanders in on a radiated side b/c of the high fail rate with radiated skin. Worth some consideration and deliberation now, so there are no surprises later. Reconstruction is very involved--there are a lot of gals over on the reconstruction board who are more knowledgable than I on the subject, so you might want to check in with them over there, too.

Glad Sheri has a game plan! Hugs to both of you. 

Hi, Lisa. Yes, reconstruction using one's own tissue is different than implants and/or expanders (unless one is doing a lat flap with implants, but that's not what Sheri's planning).

There are two types of reconstruction using stomach tissue--TRAM and DIEP. TRAM is more common, and they use abdominal muscle in the process. DIEP uses only tissue, not muscle with a blood supply, and therefore is microsurgery and thus more complicated. Not as many surgeons perform DIEP.

Make sure Sheri knows what she's getting into with the TRAM or DIEP--they are very long surgeries (10 hours) with often painful recovery times, and the patient needs to be motivated and committed to the process. So I'd encourage you to do a lot of research on the reconstruction end of things from the get-go, so Sheri is clear on what she'll be going through and what the probable cosmetic result will be. I know the girls on the reconstruction board will be able to give you lots of info.

There's also a private photo section of the board of reconstruction surgery that you can access if you private message TimTam. She's in charge of the passwords for it.