Lumpectomy Lounge....let's talk!
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PontiacPeggy - you are not alone. It does nothing for my children either. My son is on 3 different meds - poor guy. I took Benadryl as well during Taxol to help me sleep. That is what MO said to do. I felt so wired on Taxol and I am sure being thrown into menopause doesn't help either. I was surprised they said I could take both, but thankful they did.
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PontiacPeggy - you are not alone. It does nothing for my children either. My son is on 3 different meds - poor guy. I took Benadryl as well during Taxol to help me sleep. That is what MO said to do. I felt so wired on Taxol and I am sure being thrown into menopause doesn't help either. I was surprised they said I could take both, but thankful they did. Guess I should have taken some benadryl tonight
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For my allergies, Zyrtec (OTC) & the montelukast I take for asthma prevention work very well and are non-sedating. Also two squirts of Nasacort a day in each nostril. Benadryl is the active ingredient in almost every OTC sleep aid (except the Unisom tabs, which are docusate sodium—the gels are Benadryl). It’s the “PM” in every “PM” pain reliever. When I was a kid in NYC, I took Teldrin Spansules, and then Chlortrimeton—talk about sleepy, and short-acting! Had ragweed shots from age 13-20. My entire 7 yrs. in Seattle, I had no allergies; but the first summer I moved here, oy vey! My PCP back then had me rotate four different antihistamines so I wouldn’t develop resistance. When the first non-drowsy antihistamine, Tavist, came out, I was overjoyed…but it didn’t work well for me. Seldane was better, but they took it off the market when it killed some folks who took it with grapefruit juice. They reformulated it as Allegra, which is still made. I was on Claritin for years until Zyrtec went OTC—it’s broader-spectrum. As a cat-owner, I appreciate that. But when I get a bone treatment, I switch from Zyrtec to Claritin for a few days before & after. When I had a Zometa I.V., I thought I wouldn’t be among those who would get all the awful side effects (faux-flu, foot neuropathy, bone pain). I was wrong. But Claritin after the fact did help. I took it before and after my Prolia shot and got no bone pain.
So I had my bilateral mammo today. “The kids are all right,” to steal a phrase from Pete Townshend. No abnormalities except very large size. Thelma (my L healthy breast) is BIRADS 1 (normal). Louise (my R lumpectomy breast) is now 2 (benign) because the seroma has shrunk so much. (Had been a 3—probably benign—back in Dec.). X-Rays on spine & ribs show no lesions or fractures, and lungs are clear too. But there is “wedging” in the space between T7-T8, which explains my kyphosis. Bone spurs too—but why should my T-spine be any different from my C-spine and lumbar? (Tell me something I didn’t know). So the upper back/rib pain is a deep muscle pull from overdoing the strength training 6/10. Treatment is just to keep training, a bit more gently, till it goes away. No time this week for another training session, but at least I can duck in a couple of times to do cardio, and do my stretches at home.
My bloodwork is also great…except for a slowly declining hemoglobin. Everything that would explain it (RBC, ferritin, iron, folate) is dead-bang normal. So it’s adios again, NSAIDs (even Celebrex & baby aspirin), for a month, and then we re-test in case those drugs were causing a GI bleed. Otherwise, if it keeps declining, we’d have to start looking (smear, maybe even bone marrow biopsy) for something more ominous. MO is more worried than PCP—she might order a smear this week. As if I didn’t have enough to deal with (friend’s memorial Thurs., long drive Fri, for a gig up near Duluth Sat. morning). I am cleared to drive up to Rice Lake (6-7 hrs., a distance I’ve driven solo many times downstate) WI, solo—actually, taking 2 days (leaving after friend’s memorial Thurs.) would be worse, because I’d have an extra night of shlepping stuff from the car to my hotel room & back to avoid theft or heat damage. So I’ll leave early Fri. morning, arriving dinnertime (there’s an old-school WI “supper club” across the street from the hotel). Then another hr. Sat. morning to get to Hayward in time for our 10 am-1pm gig. (Everything in Hayward was already booked by fishermen—we are playing “Musky Fest”—before we even got the gig. Rice Lake is the closest we could get).
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I was just given a treatment plan for my lumpectomy. I have a very small .7mm invasive mammary ductal cancer. My doctor is planning to do a sentinel biopsy on my lymph nodes. Has anyone had the cancer removed without having the lymph nodes taken out? The radiologist did a sonogram of my lymph nodes last week and said no cancer had spread due to the early diagnosis. Thanks for everyone' input.
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Had Savi inserted yesterday by BS for brachytheapy, and I posted on the radiation group site about that; however I have a question. I see MO today for a second visit. As far as I know due to clean margins and nodes- I've been told no chemo- just radiation. What should I be finding out from the MO today? What questions should I ask? I'm not totally sure why I'm going at this point.
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Hi Donnalf - I am/was in the same boat as you. Had small 9mm invasive ductal carcinoma. Had my lumpectomy on May 8 and had 2 sentinel nodes removed. My docs didn't suspect any spreading to nodes after ultrasound and MRI however not having sentinel nodes removed was not a option offered by my docs. Also it was not an option for me. I wanted to make sure from pathology that there was nothing there. I don't know if you're concerned about the removal, but just to let you know I had absolutely no problem whatsoever from having those 2 nodes removed. For me the entire surgery process created no problems at all. I had no real pain, took Tylenol the first night only and had total range of motion immediately. Surgery was at 11 and I was home by 2:30. I felt much better knowing pathology on nodes was clean. Other than a small scar I can't tell I ever had surgery. Let me know if I can help. Good luck!
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Nancy, I was stating what "I" would do. Just as "I" opted to get a prophylactic mx on my non cancer breast because "I" have a genetic mutation. I can give her my point of view. runnermum, whatever you decide do it because YOU are comfortable with YOUR decision. You do not have to do what your team tells you to do. If I had pushed harder for an MRI prior to my lx I would have saved myself an unnecessary surgery. Instead I let them tell me it was just a small tumor and that my concerns about my swollen lymph node was "just due to the biopsy". I ended up needing a mastectomy anyway.
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donnalf,
Welcome! There are some doctors that now will do just radiation instead of sentinel node biopsy. Standard of care is still snb with lumpectomy. A scan won't show micro cells in the nodes.
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Runnermum, I apologize for being short on words when I posted to you. I have a very busy job and your post called out to me. Unfortunately I don't have much time to post long explanations. Your re-excision is this Friday, correct? As long as you are comfortable with your surgeon's recommendation for re-excision instead of MX that is your decision. I just wanted you to think about what you would want. I have had enough time to know what I would do but I have the benefit of hind site. You are in the midst of a very stressful time. Best wishes and good luck on your surgery. Make sure you get your surgeon to go over the final pathology report in detail with you.
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RunnerMom - Congrats on the BRAC test. We're with you on Friday and pray for clear margins. I think you will find after Friday, once treatment plan is lined out you will be able to concentrate on yourself. The unknowns and waiting are in some ways the hard part.
Donnalf - Welcome to this forum. I'm rather new to all the variations of treatment and analysis of BC but I have the impression that scans (US,Mamms,MRI's) can identify location but not what it is (cancerous or benign). In my case, I had to have a second biopsy as a second lesion which was identified by an MRI. Prior to the biopsy, the radiologist leaned toward it being removed even if benign. It turned out it was benign from that path report. And I still had it removed. The best I know is no one can tell from scans definitively that you have a cancerous lesion or node, although there may be some flags.
I'm like llamalady in that it was not an option for me not to have SN's removed. I did not bounce back as quick as she did as I had two lumpectomies on same breast, along with brachytherapy and SN's removed but recovery even for me was fairly quick. One pain pill surgery night and the rest of the time Tylenol. Full range of motion. By three weeks was done with surgery and radiation and back to work. I would have been back to work sooner but the incision from radiation needed to heal as my work is physical.
Barbmak - Your MO will be your doc after you complete your brachytherapy. He'll be the one to prescribe your preventive medication. Mine ordered the OncoDX, which gives a predictive measure of reoccurrence and if chemo is warranted. I was a bit lost about this at first but must admit I'm glad after the fact that I had the test done as I too was led to believe up front that no chemo would be needed. I think once you get past the radiation treatment you will be so pleased you were able to have this option(brachytherapy). I just did my month follow-up with my Radiologist. If it weren't for my incisions (which are healing nicely) I don't think you would know I had a lumpectomy. Radiologist was very pleased and could only share how fortunate I was to be able to do the brachytherapy as he said very solemnly that my results would have been very different if I had to go with external radiation.
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Thank you everyone for the support, kind words and prayers. I wish I could thank you each individual. Today was a better day. And i just need to keep moving forward as that's the only way we get thru this right!
Molly50 No need to apologize, I was not offended at all and you brought up good up points and expressed some of my worries and questions I have already discussed with my breast surgeon. You are right it is not an easy decision by any means. And I feel I am making the best one with the info we have. I did have MRI already back in May. My lumpectomy was delayed a little as I had to have a MRI biopsy after and developed a humongous hematoma. I trust my surgeon and medical team. I am at a very good facility...one of the top in our country, my surgeon comes from one of the top 2 cancer centers in our country. I also have a sister in law who is in an OB/GYN physician and is able to accompany me to some of my appointments and is also able to do research for me to make sure what I am being told and the decisions I am making are the best for me and my plan. Everyone is different and these decisions are so agonizing to each of us. Like someone on this thread said earlier trusting strangers is difficult but I feel I have a good team and good support and I have to be comfortable with my decision. At this point I am. But thank you I appreciate your advice...it is hard and I do look for info and advice on this board as well.
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donnalf- I have never known of anyone not having a SNB. Sometimes the lymph nodes appear to be clear on ultrasound and MRI, but then found to have cancer cells when biopsied. I have met several ladies who had that happen. Prayers for clear margins and clear lymph nodes!
Sandy - happy to hear that your test results were good. Hope the pulled muscle settles down. My son takes allegra, montelukast, and flonase for his allergies. Zyrtec made him sleepy he felt. Safe travels on your busy weekend.
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donnalf, When my BS completed my LX and SNB, she told my DH I did great and my "lymph nodes looked fine." See my stats. I think they can feel to them a certain way, but when my pathology came back, my experience was 6/7 cancerous nodes. Totally changed my plans from expected radation only to a higher stage, chemo and now more lymph node surgery later plus RADS. Pathology was key for me. Thankfully, my CT scan and bone scan revealed no cancer elsewhere in the body. Weeks later, I guess I still am in disbelief, in a way, this is happening. Feel like I am living outside my own self at times, but I am living!
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I agree with you, KimPossible that nothing beats pathology.
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Got my revised 6-month mammo report today: the seroma is now smaller than the chunk removed in my lumpectomy. And they are recommending a 6-month followup with my surgeon, and no more mammos till July 2018! They are authorizing an oncoplastics consult to determine if reduction(s) are advisable for both symmetry and to minimize upper back strain. Think I'll do the consult, but wait on the surgery till I've lost more weight so that my gut won't stick out as much if my breasts get smaller--proportion is key.
Barbmak, at first blush it doesn't look as if you'd need to see your MO, as your DCIS was double-negative (which, also Grade 3, is fairly common for DCIS). Therefore, no need for hormonal therapy, and they don't do chemo or targeted therapy for pure node-negative DCIS regardless of grade, hormonal or HER2 status (HER2+ is also extremely common in DCIS, so much so that as long as you don't develop invasive cancer they don't even bother to test for it any more). My guess is that the MO will want to explain that to you before (s)he "sets you free." I'd be very surprised if your MO would continue to be your primary medical care doc, given your very favorable circumstances. Heck, I see my MO twice a year and she still insists I see my PCP for anything not cancer-related. She prefers to stay in her own "wheelhouse."
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Sandy, All sounds VERY good for you! No mammos for more than a year sounds like a real gift!
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I read this on a different site and am very confused.
- Excisional biopsy and lumpectomy should not be confused with one another. Lumpectomy is performed when there is a known diagnosis of breast cancer and the mission is to remove all of the cancer with a health margin of tissue around the tumor. An excisional biopsy is not a surgical treatment, it is diagnostic procedure
I was informed at my biopsy of a spiculated mass. Pathology determined ADH-atypical ductal hyperplasia with no cancer cells present in the removed tissue. I will be meeting with a surgeon on Monday. The surgeon's office informed me that I will need a lumpectomy. Should I "sweat" the difference in terms- lumpectomy/excisional biopsy.I know I was told 2/3 cm of tissue surrounding the 8 mm mass will be removed as well to determine clear margins. I wonder if I should ask about a sentinal lymph node biopsy to rule out the spread of cancer since I read that .
- The sentinel lymph node is the lymph node in the arm pit that is the first place cancerous breast tumors can spread. It is identified during surgery using a special blue dye or radioactive isotope that is injected before the surgery.
It makes sense to me to be as thorough as possible at this point.0 -
On my way home after 4 weeks away--2 weeks caring for my mom and 2 weeks funeralizing & cleaning out her house. Its been utterly exhausting. I don't know how people do this for years on end. And when I get home I'm going to walk right back into the fray--DH has been supervising renovations at the house all this time. I fully expect to take at least 1/3 of our stuff to thrift or trash.
So, I'm sitting in an airport waiting on my plane, which has been delayed twice already. Thank you, Tropical Storm Cindy! Good thing I have 2 books and my phone is charged up.
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Poodles, I'm glad you are finally coming home! It has been an awful time for you. And I'll tell you how people do it: They just do it because there is no other choice. After 4 straight years of 24/7 caring for DH, I had BC descend. When I had my LX the boys came in (tag-teaming) to actually care for their dad. First sleep I'd had in years. They hadn't realized how exhausting it had been for me. Neither did I since you just do it. That's why I put him in a nursing home after his kidney cancer surgery. I couldn't do it anymore. It's terrible when you count the days until DH is going to the hospital for surgery because you're totally wiped out and going through rads.
I'm not sure I'd be looking forward to seeing what DH has done to the house. I hope it is all good! Maybe you can move forward with your life now. Sending lots of love to you.
HUGS!
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Kaso, your confusion is understandable and that's why the preferred term for "lumpectomy" is "partial mastectomy." I had four excisional biopsies done over the course of about 35 years. They were simple procedures, done under local anesthetic (except one where the lump was pretty deep). Recovery was simple, pain was minimal, my scars were tiny, all were benign.
A lumpectomy is a more complex procedure and is, as one wise woman here reminded me, major surgery. While I only had surgical glue externally, I had multiple internal stitches. My mass was at the 6 o'clock position so my scar - about three inches long - is on the lower part of my breast. While the pain was tolerable, I was uncomfortable.
I've had one women tell me three times about her three procedures, all of which were benign. She was confusing an excisional biopsy with what I had done. I didn't bother correcting her; sometimes it's just not worth it.
I also had a sentinel node biopsy done; I think it's pretty standard with a lumpectomy. I did have nuclear isotopes injected as well as a blue dye (turns your urine a gorgeous shade of aqua for a day or two!). That incision, in my armpit, was more troublesome than the one on my breast. It's a really tender area. What I found helpful was keeping a small pillow under my arm so skin did not rub on skin.
So I guess the question for you is, what does the surgeon have planned for you? Are they confusing the two terms?
Best of luck as you meet with the surgeon. Take someone with you, if you can, as all the information is overwhelming. It's hard to take it all in.
MJ
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Kaso: It is all overwhelming in the beginning...so much to take in and learn. I found it helpful to not only take a notebook with me to scribble things down, but to have someone else with me to hear what I didn't hear or to validate what I thought I heard. Good luck as you start this journey none of us chose to take!
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tappermom383 I agree with the SNB incision....that hurt me more than the other incision. I had the SAVI put in this week and had scans yesterday. Radiation starts on Monday 2x a day. I am tolerating the SAVI although it is a bit uncomfortable. My other dilemma is that when I went to see the MO she said that the pathology showed I am now ER+ (weakly positive). Originally pathology from of the biopsy said ER-. MO wants me to start on Anastrazole (sp?) for 5 years but side effect is loss of bone...I already have osteoporosis- so she said I could have the 2x a year shots. I've stayed away from things like actonel, etc because of side effects....There is so much to think about. Right now my husband and I are thinking that if the anastrazole helps me not to get another cancer...that is more important than the other medications and side effects. Anyone else face these worries??
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Barbmak: Unfortunately, most of the AIs have the side effect of bone loss. But I do think the oncologist follows that closely with blood tests and bone density scans. That's another question for you to ask when you go. I'm not fond of the SEs but if helps to not have a recurrence, I'm willing to work with the meds and the onocologist is willing to work with me to find one that I tolerate best.
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Hi, Barb I also had internal radiation. It was uncomfy but not painful. I missed bathing the most. Good luck! As for side effects of your meds- There is 3 that they prefer for post menopausal women, they all can cause bone loss but not everyone gets that side effect. I did when I was on them along with a few other side effects so I was switched to Tamoxifen. This med used to be the norm for post or pre menaupasal but now its used mainly for pre-menopausal. So just know there is things that can be tried. My MO told me that no ones body reacts to these meds the same way, each one is different. I wanted to know my chance of reoccurrence if it was increased because I was now on Tamoxifen instead of an Ai. My MO said she could not give me that number as no one really knows how each person will react.
Anatrazole, Femara and Armidex are the 3 Ai's.
Good Luck, Radiation will go quickly for you!!
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BarbMak, I am osteopenic. My MO put me on Fosamax to prevent bone loss and it also helps prevent bone mets. Some of the gals do Prolia and have had good luck with it. Other than perhaps dry eye and a bit of hair loss, I've done well on Arimidex (generic is anastrozole). Good luck!
HUGS!
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Peggy, I am doing infusions of Zometa as a precaution to prevent bone mets, though I do not have osteoporosis. You are one of the few that has had their MO say that these type drugs can stop mets. My new MO told me it is up to me if I want to continue the infusions every 6 months. There was a study that looked promising when my former MO suggested the infusions. My new MO is not as adamant as he was that it works. I just wish MO's agreed on things! I am so up in the air if I should continue
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Ndgrrl, if I recall correctly there are several studies supporting the use of bisphosphonates to prevent bone mets. I'm sure there's no guarantee on that but it is still worth considering. My new MO here in Spokane seems to be much more up on current studies and thinking than the one I had in Michigan. If you tolerate the shots, I'd keep them up - but that's me. What works for you may be different.
HUGS!
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Thanks Peggy, the first infusion was nasty. It was like having the flu. My 2nd one I took Benedryl and they infused wilt saline solution before and after and it was not bad. Starting the IV was the worst part. Did your MO say anything about jaw bone break down from these meds to you? I had to get dental clearance as they say in the 3 yrs I will get the infusions( every 6 months) that I will not be able to have major dental work done. The jaw bone necrosis is what scares me. I was told it is rare though
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Ndgrrl. No mention was made of jaw problems. I have dentures so that may make a difference. In fact neither MO has mentioned them.
HUGS!
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Kaso, I would wait to see what your breast surgeon recommends. I was I diagnosed with DCIS, which is non invasive, stage zero. Since it was contained, I did not have the sentinel node biopsy when I had the lumpectomy. However, the pathology from the lumpectomy revealed a very small, 3mm, spot of invasive, plus she did not get clean margins. Since I had to have 2nd surgery for clean margins, I then elected to have the SNB to make sure it hadn't spread. My BS have me the choice since the 2nd spot was so small, but I wanted peace of mind so I had them checked. Try not to worry too much, you have to take it a step at a time. Also be careful researching on the internet, it's a scary place and not always accurate. I stay on this site to be safe. Also if you could fill it your profile and make it public for your diagnosis and treatments, it'll help us help you. Keep us posted. Sending positive thoughts to you.
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