Canadians in British Columbia
Comments
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moth
Agree with wrenn. There should be a patient record dept. inside of Fraser valley cancer center. You do need to fill a form but can be done right there and they will print the records right away after. Th form will also ask you whether you want to have a designee to pick up the records for you. I.e. spouse.
Amazing thing is they have all records from my GP and Surgeon from MSJ. I picked up all the historical ones the first time, then stop there each time when I go by the center center. Do check the records, some of coordinating doc record could arrive a bit late, so it may not 100% align with the time frame. It happened only on one occasion for me.
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Moth
you can ask The nurse for copies but I found it more of halssle than the records dept, as each doc only release their own records, i.e. MO will not give me a copy of surgeon notes saying he is not authorized to do so.
There is also GP who has almost everything but charge me each time I ask for a copy. bC cancer records are free!
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Hi all;
Met my MO today: was as expected (thank you all for the heads up). Basic info, intro to Dr, sign forms for Oncotype to be sent and study participation. Another 'hurry up and wait' appt. Next appt Jul 3 for results. He booked a chemo day - in case results warrant it he said. At least there's that? If I do need chemo I will be able to w/I a few days as opposed to another month wait.
My ex called his cousin to recco someone for a 2nd opinion should I feel it needed. I'm concerned about the estrogen my ovaries are flooding through my body, and when asked today, MO seemed to brush off. Anyway - after my next set of results are meted out I may seek a 2nd opinion.
Is it just me who looks at other's timelines envious of the quick response in the US? Each day a new level of letting go - or fighting it
thank you for suffering through yet another gripe filled post xo
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Question: I can ask for my records? Where? thank you, xo
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Thinking about you Blue Sky with next steps. It’s good that you are doing your research and thinking this through carefully. It’s true that in the US things seem to happen more quickly. I am glad you are having the oncotype test after the tailorx results so it should be easier to decide about chemo. Keep your zen and know that we are with you
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Happy Tuesday, everyone
Met with a retired oncologist at Inspire Health yesterday, one things stood out what his recommendation on taking baby aspirin, says it will reduce the risk of breast cancer metastasis by 50%. he showed me a paper published in 2010, which was a prospective observational study from Nurse Study. I looked into further, there is 2017 published study from California Teachers study supporting the same belief. That's significant number.
While i am chewing thru the Teacher's study, thought i will pop the question here to ask whether you have any thoughts on this? I have tummy issues when i take Aspirin and general anti-inflam drugs or painkillers, so would like to know more about it before i start popping Aspirin daily.
I feel the type of studies here dont isolate other factors that may have contributed to the outcome. However two studies showing same benefit does make it less an coincidence.
Thoughts, ladies?
some links below
https://breast-cancer-research.biomedcentral.com/a...
http://www.breastcancer.org/research-news/link-bet...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28497...
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Hi everyone, I havnt been on board in a very long time, thankfully!
I need some advice for my daughter. She convinced her family dr. to order a mammogram- she is only 34 but with my history is trying to be proactive. She received her report yesterday and I'm freaking out. Two masses were identified and confirmed with ultrasound. One, 8mm circumscribed parallel hypoechotic and adjacent 1cm from nipple a 5 mm homogenously hypoechotic mass. Recommendation is targeted ultrasound in 6 months to assess interval stability.
I feel she should request a needle biopsy. She will be speaking to her physician today. She lives in west Vancouver, can anyone recommend who she should request? I'm in Ontario and was able to request what hospital I wanted to be treated at is that possible in BC? Her mammogram/ultrasound were done at Mount St. Joseph hospital. Any names would be greatly appreciate
Edited to add that I'm triple negative metaplastic. Ned for 3 wonderful years
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Mount St Joseph's has a specialized breast care center. I'd just do it there if I was her. For needle biopsies it's an interventional radiologist who does them - I'm not sure you can pick who does it (unlike picking a breast surgeon).
(does her report list a BIRADS score?)
best wishes to your daughter0 -
Thank you moth! Yes it says birads 3. I'm hoping that because the report states circumscribed that it means the margins are smooth. Wording on report says 'two probably benign hypoechotic masses were incidentally identified'
It's the 'probably' I'm having issues with. I found my own cancer 6 months after a perfectly clear mammogram and it was 3.2 cm!
Hopefully it will be unneeded but if she needs to see a breast surgeon are there any that stand out?
Shari
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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.
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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!
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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 😘
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Slv58, one thing to keep in mind is that what's NOT in the report is just as important as what is in it. This was explained to me recently. I had a birads three and was freaking out that this mass that 'might be scar tissue or might be cancer' was not being carved out of my chest immediately. My radiation oncologist explained that cautious wording is NOT the same as a suspicious finding. If someone had truly felt I had a lump that might be cancer, I would not have walked out of the hospital that day without a biopsy being done. That no one ran in with a needle and jabbed me says that they are being cautious, watchful, alert, but no one is overly alarmed by what they see. But you sure can't tell that from the language because it sure alarmed me!
So, they have written the report in a way that keeps your daughter on their radar, in a 6 month rotation. But had there been anything truly worrying most likely a biopsy would have been performed or scheduled. If no one did one, or suggested one, put your worry on hold until 6 months from now. Hard to do, I know!
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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.
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Hi slv58, I just wanted to chime in and second wrenn's recommendation of Dr. Davis for a breast surgeon. Not only did she do a great job with my lumpectomy/SNB, but every medical professional I've mentioned her to over the course of my treatment has said very positive things about her as a surgeon. Apparently, she's one of the best. I found her bedside manner to be a bit awkward, but her surgery is top notch, I'm very pleased with her work.
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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
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Shari,
I wonder whether your daughter could ask for a copy of ultrasound and Mammogram and get a 2nd opinion by reviewing the result. They should be able to download it to a CD.
I had experience with two surgeons in Vancouver area.
I done my first surgery at MSJ (Mt. Saint Joseph), by the director of Breast Center, Doc Warburton. She is an skilled surgeon and her specialty is breast surgery. but not ideal if you looking for someone to help you make tough decisions and counter play options etc, she is more of matter of fact type of lady.
I done my 2nd surgery with Doc Noelle Davis, she is much easier to talk to and not afraid to tell you her opinion. If I have to pick something, i would say there is room for error in admin coordination because her office will need to set up things with BC cancer where she performs the surgery. In my case, surgery was delayed by 2 hours as someone between her office or BC cancer got her schedule wrong. Given the BC cancer anesthesiologist is also on a schedule, I was wide awake on the operating table for some time waiting for the anesthesiologist who was preping next patient, Doc Davis reviewed my file when she came in, and again in the operating room on a monitor, which i assumed because she was late so she didnt have time beforehand. But it did make me a little bit uneasy to see the surgeon reviewing the surgery specific mins before surgery.
In Comparison, MSJ was a bit more streamline given everyone in one place, I was wheeled into operating room, they were ready to go with everything memorized.
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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
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Also: Lots of good advice here. I agree w NV Dobie - as well as earlier posts: request a copy of the results for your own records and a 2nd opinion.
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Thank you everyone. Holding positive thoughts in my heart. I will update when we find out more. This group is amazing!
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BlueSky - can you post that study link please? I'm a LIQ as well.
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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.
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Oh good lord - my brain is not working - and I haven't even started further treatment.
The study I linked to and the Korean study are the same. Oi vey...
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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.
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Hi Moujan, I'm really sorry you've been diagnosed. first I'd like to direct you to densebreastscanada.ca. They've done a great job educating people with dense breasts and you'll learn a lot of valuable info there.
Your diagnosis is based on your pathology. I recommend you start a binder now, with tabs for your labs and scans as well as path reports and other documentation you'll pick up along the way. Educate yourself as you go along, and become your own advocate. No one knows your body better than you do.
Looking at your pathology, the cancer is aggressive (Grade 3/3) IDC is interductal carcinoma; hormonal results are estrogen and progesterone positive and HER2 (human epithelial growth factor) negative. This is a common form of breast cancer. I've had this same diagnosis. Usual treatment is surgery, chemotherapy and radiation. However with the new drug classes emerging you may receive a treatment more specific to your Ki67 and radiation can be dependant on tumour location.
A bilateral mastectomy is reasonable, but wait to see what the surgeon says. You'll also find out about reconstruction options when you see the surgeon. It's best to take someone with you, there's a lot of info to absorb so someone taking notes is most helpful.
It isn't a cake walk, but you can do it. This weekend marks 22 years since my first BC diagnosis. This group is an excellent resource and great support. My best to you
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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
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Hello All, hope everyone is coping and healing and having more good days than not. Just wanted to share that i am going for my nipple tattoo tomorrow, so if anyone is curious about it, i can let you know.
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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
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BlueSky - omg, the MO sounds awful!!! Good for you for deciding to switch. I was just hearing from someone else (also in BC) who was really not liking her MO and I thought, this is not ok. This is one off the most important doctors in your life right now. I think you have to have a good rapport and mutual respect with an MO so you can really be on the same page about what you want from treatment. We're not a tumor, we're people - if the MO doesn't get us and respect us as people, then, show them the door.
Good for you for following up with a letter. I suspect some doctors need to pushed to the research side and get out of direct patient care.
I hope your new MO is someone you can have a good (& hopefully very short!) clinical relationship with.0 -
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!
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