Lumpectomy Lounge....let's talk!
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Wow, Vargadoll—44 weeks and it’s not a first pregnancy? That’s really rare. Your daughter is gorgeous—may she have a short and tolerable delivery and a robust healthy baby.
Carole, 94 years is a good long run, but watching the last struggle of a parent of any age comes too soon for all of us. Hugs & prayers.
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Congratulations Vargadoll!
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Thanks ladies! Still waiting on the baby! Last check she was at 5cm. This is 3rd baby for her. First was when she was 18 that's why I'm a young grandmother. That labor was 18 hours. Next was 9 years later. That labor was 31 hours. She worked hard for my chubba-chubba. He is a big boy. When the doctor told her Tuesday she was measuring 44 weeks he said why didn't we induce you last week? She said you tell me?!?
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Hi
I am wondering if anyone has ever had a surgical biopsy with no sedative or anesthesia?
Also wondering if anyone is high risk? Last question. I have 6 mammeos and multiple xrays and 2 biopsies. Now I am afriad so many of those plus xrays might put me in a higher cancer risk...Do you guys worry about that too?
Thanks for the advice
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Vargadoll...hope she has or delivers soon! Lovely picture.
Synergy...sorry you have to go through all this. I'm not able to help you with your questions.
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Hi, all,
I had my surgery yesterday, and good news: all margins negative for invasive carcinoma, and two benign lymph nodes negative for metastatic carcinoma. There were 2 sentinel nodes and one tissue sample that had no nodal tissue. Nottingham score is Glandular/Tubular Differentiation 1, Nuclear Pleomorphism 2, Mitotic Rate 1, Overall grade, 1. I think that concurs with the preliminary biopsy, but I'm not sure because I don't have the paper with me. Pathological staging is pT1b.
Now for some questions: what are H&E levels in the sentinel node? focal flat epithelia aptypia?
In one place the report said DCIS identified, and in another, it said DCIS not present, so I'm confused by that.
Can anyone explain these things to me? Thanks!
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8Lb 2 oz 19 1/2 inches long born at 1:08 am . No name yet.
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8Lb 2 oz 19 1/2 inches long born at 1:08 am . No name yet.
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Synergy, I'm sorry that I can't answer your questions but I'm sure someone can. Welcome!
Natsera, perhaps this report here on breastcancer.org can answer some of your questions. Pathology Reports Check out several of them. You'll find lots of great information here - just use the search feature. I know others here will be able to tell you what it all means. My report was not filled with terms I didn't understand like yours seems to be. Glad your margins were clear and the nodes too!
VargaDoll, Aw, she's cutie. But 44 weeks? OMG! Your poor daughter. Sorry you can't help out right now.
Trish and Sandy - Yeah on the cancerversaries!!!
HUGS!
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Not sure what the H&E levels in the node mean; “focal flat epithelial atypia” means an individual spot of atypical but not malignant cells. What’s really important is the very small size, clear margins, hormone-receptor+/HER2- status, Grade 1. Therefore, you are Stage IA, not IB. The “b” in “pT1b” means the size of your tumor is between 5mm and 1cm. "DCIS identified” means that within your IDC tumor, there were also DCIS cells present—which doesn’t change the course of your treatment. Neither does “DCIS not identified.” (You basically won the IDC Lotto—as good as it gets for invasive breast cancer. Congrats!).
I would therefore be extremely surprised if they even suggested ordering an OncotypeDX test—your treatment plan will almost certainly not include chemo (which wouldn’t work on such slow-growing tumor cells). The sequence will probably be to heal from your surgery for >4 wks, then radiation, then long-term anti-hormonal therapy. (If your MO suggests chemo, get a second opinion. Some old-fashioned MOs don’t want to keep up with current protocols, and some want to use the chemo drugs they’ve had to purchase. Beware of those docs). After you’re done with radiation, you will probably be on an every-6-month breast surgeon followup appointment and mammogram schedule; eventually, if nothing changes, you will probably go back to annual mammos recommended, just like for every woman over 55.
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Sandy, it's so nice that you are so knowledgeable and we can pick your brain. Thank you!
HUGS!
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What a beautiful baby! Congratulations all around.
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I had the toodler all day and boy do I feel it! I loved every minute of it to!
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Varga, mazel tov on such a gorgeous little granddaughter!
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Thanks, ChiSandy. Yes, it feels very good to have won the lottery, as you put it! And the explanations are very helpful.
About the focal flat epithelial aptypia, is there a chance they would turn malignant? I know that the docs will be watching me closely but I want to know about what the likelihood is.
I already talked to the surgeon, and while I have an appointment with the medical oncologist, the surgeon assured me that chemo is not necessary and that radiation is my choice, because I turned 69 on my surgery day and studies show that radiation does not improve life expectancy for women over 70. And I'm only one year away from 70. There IS a higher recurrence rate in women who have not had radiation but if caught early, maybe equally as curable? I don't know. But I'm leaning away from radiation unless the oncologist recommends it --chances are that the estrogen suppression will be enough.
I'm still a bit sore but not unbearably so and it reminds me that the surgeon said to favor that arm until she sees me again.
But all in all, this was a much less traumatic experience than I thought it would be!
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Natsera, I was 69 when I had my lx (diagnosed just weeks before that birthday). I did radiation. There really was no discussion of not having it among the tumor board members. Even if given a choice, I would have gone with it. I wanted to do everything to make sure the cancer is gone and hopefully not coming back. I had no problems with radiation and haven't had any with Arimidex. But you definitely need to do (or not do) what you feel is best for you. I did what I thought was best for me. Glad you are feeling good.
HUGS!
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She's beautiful!! 🌸🌻🌼
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Natsera, there are studies that show radiation to be of dubious benefit to women over 70 with Stage IA Luminal A cancers (like you & I had). I would imagine your radiological oncologist being okay with you saying “no, thanks" at 69. My RO had just finished participating in a study that found no survival or disease-free survival difference in Stage IA, Luminal A women over age 65 between 33 whole-breast treatments and 16 stronger treatments targeted to the tumor bed—and I was a couple of months away from my 65th birthday. So I went for the short & targeted option, and pretty much sailed through. I'm now on the second of five years of daily letrozole.
Remember, there is a difference between doing all we can do and doing all we should do—the latter being “all we must do"—to prevent recurrence. The ball is in your court.
As to the atypia, it's moot—they removed it when they took your tumor. Atypia is a risk factor but not a pre-cancer, and the older one is when it’s discovered, the lower the odds it’d mutate into invasive or even in situ cancer.
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I would not have been comfortable skipping radiation. But that's me. As I said, you have to decide what's best for you, just as Sandy did. However, I did not do chemo with my Oncotype of 13 even though my MO thought I should (the tumor board said not necessary). I'm happy and comfortable with my choices, just as you need to be. Sandy does have great information and usually the most cutting edge so listen to her. I was diagnosed a year earlier than she was so the information I had was not the same as she had.
HUGS!
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Vargadoll, congratulations! Beautiful baby.
Natsera, YAY so glad you got good news!
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Peggy, glad you overruled your MO re: chemo with a low oncotype. Tumor boards exist for a reason: to prevent one doctor from calling all the shots, even those which—as in your case—were inappropriate. As I hinted earlier, many MOs who have practiced for a long time (especially in small towns) are way behind the curve and among the last to accept new protocols—especially those that might challenge their financial interests.
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ChiSandy, I don't have a radiation oncologist. I wonder if I should ask for a referral just to have a second opinion. I have an appt with the surgeon on Monday. I'll see the medical oncologist on Wednesday.
What is Luminal A?
Also, what's the tumor board? I've never heard of that before and no one mentioned any supervision of what the docs are recommending.
Peggy, thanks for the hugs! And tbalding for the cheering section!
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Sandy, My MO never pressed me on having chemo, it was more a casual recommendation at least with me. With the tumor board, I don't know. But the BS and RO definitely said no. And yes, he was older (even than me!).
Natsera, a tumor board, at least at my hospital's cancer center, consists of several oncologists from various fields. I know my BS, RO and MO were on it, but not if there were others. They review every single cancer patient's records and recommend a treatment path. If you have radiation, you'll likely have a radiation oncologist. Do ask your BS about this. So much to learn in such a short period of time!
HUGS!
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If you are recommended to have radiation, you will be assigned an RO or given a referral to one. The RO is in charge of the radiation treatments--decides the type, duration, strength, pattern after meeting with you and a couple of planning, mapping and simulation sessions (and a CT scan to see the lay of the land inside).
The hospital's tumor board is usually made up of all its oncologists: medical, surgical and radiation, as well as pathologists (especially the ones who did your pre-and post-surgical biopsies). They draw on their collective expertise to recommend what treatment is appropriate based on the characteristics of your tumor and your age, health and priorities. They deal with all malignancies, not just breast cancers, at that hospital.
Luminal A is the most common type of invasive breast cancer: ER+, PR+, HER2- especially in older women, is always treated with an anti-hormonal pill, and most often doesn't require chemo unless a higher grade with node involvement. It is the least aggressive. It has the longest survival rate. Luminal B is usually ER+,PR-,& HER2-, is more aggressive and so more often requires chemo. There's the "HER2 type," which can be either triple positive or ER & PR-. It always requires chemo, not just because of its aggressiveness but also because the targeted therapies that attack the HER2 protein are not very effective without chemo. Finally, there's the "basal-like type," or triple-negative, which does not have hormone receptors and does not over express HER2. Chemo is the only weapon in the arsenal to fight it, as its fast-dividing cells respond well to it.
As I said, you won the IDC lottery--even more so if you get to skip radiation and go straight to anti-hormonal pills
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Sandy.. thank you for this great explanation!
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Ladies, I went and did it today: I went to my local LA Fitness for my initial fitness evaluation, and signed up for a personal trainer. I picked one who is used to working with older patients with medical and injury issues. He looked at me head to toe and said “your right trapezius must be bothering you.” I hadn’t mentioned shoulder pain at all. He also noticed my scoliosis and that I tend to lean right. I’m a couple of pounds lighter than I’d feared but my body-fat % is much higher than I’d thought. (My BMI is 37.5, which is what I expected). He comes from a physical-rehab background and so will not push me any further than I can tolerate. The main goals are to stretch to keep cording at bay, strengthen my core to protect my back, and most of all strength training to build muscle and make me more able to do cardio. He’s not going to insist I follow a particular diet, only to use common sense & discipline. I had been dead set against training, until I realized I do need the accountability as well as the guidance of specific exercises I would not have thought to devise, designed to address specific problems as well as recognize the medical (LE, asthma) and orthopedic (knee replacement) limitations that would make certain workouts off-limits for me. So I will be going to train twice a week, and take a seniors’ class or two and go to the other facility to swim and maybe do water aerobics at other times.
It’s expensive—but less so than my shopping habit.
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I had a lumpectomy on January 23 I'm about six weeks post op. Stage one tumor removed with three levels of tissue clearance surrounding the tumor all levels were benign two lymph nodes removed both benign. Oncotype score is seven no chemotherapy necessary. feel very blessed. Feel very blessed I noticed under the scar where the lymph nodes were removed around hard bump Is this normal
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Sandy, Good for you!!! A gold star day for you. And it sounds like you found the perfect trainer. I'm so happy for you. I'm sure you'll stick to it because you seem to be someone who finishes what they start. Damn! Way to go, Girl!
HUGS!
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Oahu, Welcome!!! I didn't notice a hard lump under my arm but that incision sure was annoying! You certainly got great results. I assume you are off to radiation and tamoxifen or an AI. BTW, we'd appreciate it if you would fill out your profile and make each and every item PUBLIC. You do that via the SETTINGS tab. I would guess you are in Hawaii (sigh...sounds great). Others will chime in if they have had a bump. If it is bothersome though, please do talk to your surgeon about it.
HUGS!
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Congrats on such a favorable result, Oahu! What you're feeling beneath the SNB scar is a seroma (fluid-filled space where the nodes had been), which is not only normal but darn near universal. It'll reduce over time and eventually disappear. Most of us here have been more bothered by our SNB incisions than our lumpectomy ones, because so many things rub up against the armpit or axillary tail and irritate it. Watch out for stuff like tight armholes, scratchy lace trim, etc. You can keep a small pillow between your armpit and the underside of your upper arm to minimize it—some have sewn a handle or strap on the pillow to hold it over your shoulder to keep your hands free.
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