Lumpectomy Lounge....let's talk!
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I'm taking notes! I have a list of questions for the surgeon which may help me get things straight (or straighter). I am confused indeed about DCIS and "microinvasion," versus IDC. The diagnosis was indeed specifically DCIS but "early stage 1 cancer." Presumably because of the microinvasion (in my mind I see tiny invading warriors creeping out of the duct....
) I am possibly too hung up on the terms. I do plan to ask about chemo timing--I will be having it anyway sometime in the coming year because of my lymphoma. Last time it was Cytoxan, which I think is also used for breast cancer. I do think it makes sense to press ahead with a lumpectomy--it doesn't seem like I would lose anything by it. 18 years ago or so a lump (that I could feel, unlike what I have now) was removed from my right breast --they didn't call it a lumpectomy, but it was under general anesthesia (if I am remembering correctly). It was benign and required no treatment. That healed nicely and I can hardly find the scar now. Anyway, thanks all of you for your supportive and informative comments--it makes me feel a lot better about all this, and better able to keep a clear head.
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Isabel1865 agree with the LX first if at all possible but did want to say you very well may have numbness from an LX. I do and it's not surprising. Nerves get cut during surgery; sometimes they regenerate and sometimes they don't.
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Thanks, that is good to know, too!
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Isabel, DCIS is Stage 0. "Early Stage I" would be IDC. Need to pin down your MO as to which it is. Sometimes Stage IA IDC has "associated DCIS" (though mine didn't). It's the more advanced-stage diagnosis that drives treatment--and if the IDC cells are hormone-receptor-positive and HER2-negative, a sample would be sent out for an OncotypeDX or MammaPrint test to see if you should skip chemo and get endocrine therapy.
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I did have minimal low grade DCIS with the IDC, 1A, but no OncotypeDX or MammaPrint. PCP was surprised that I didn't but I guess it was because of age. Well, for the time being, on to other things. Today, on to MOHS procedure for 2 tiny Squamous Cell Cancers on, unfortunately, opposite sides of my forehead. After that gruesome procedure at 8 AM, go to Plastic Surgeon, 9 miles away for wounds to be closed. Have horrible pictures in my mind of bleeding to death on the way, but have been assured this won't happen. Will be extensively stitched by PS once I get there. DH test drove the route yesterday. What bothers me most about this are the weeks of disfigurement, til the scars fade. Forehead and mask are not a pleasing aspect and that I will have to stop walking 5 miles a day for awhile.The MOHS support page on Facebook is gruesome, but reassuring. People have been through far worse and, after a while, look just fine and Plastic Surgeons hide things between natural lines. So, after this hurdle, second mammo next week since Feb '19 diagnosis and BS checkup, then in Oct, PCP and Derm for full body check..All this makes me nervous. In early November, back to Evanston Retirement Home from lovely Glencoe. Always go to Key West in January for 2 weeks for Literary Festival there, but will just this time, load up the Kindle. And so it goes.
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I was just diagnosed last week with ILC ER positive HER2 negative. I will be having a lumpectomy on October 9, 2020. I have no idea what to expect.
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May your scars heal quickly and invisibly, Judy. And may your mammo & checkups be boringly uneventful. (I'm still reeling now over RBG's passing tonight).
Welcome aboard, Bren49. I don't have much knowledge about ILC (I had IDC, as did most here), but ER+/HER2- is a favorable sign.
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Oh to have everthing from now on for all of us be “boringly uneventful.” It would be bliss, but as unlikely as that there would ever be another RBG.
Mohs surgery for SCC microinvasive skin cancer not nearly as difficult as I feared it would be. And, after the surgery, I had the wounds closed by a young woman, Plastic Surgeon. So wonderful the many young women today who balance such important work with family
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Glad it went well, Judy. We're all going to need as much hopeful news as possible going forward. Shana Tovah.
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My first inclination was to say "there goes my will to live." But then I realized that my will to live is more important than ever---it must make me gather and energize my will to fight.
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And RBG as our model
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RIP RBG
Last night I ordered my RBG fight tee shirt. Tonight is a rally.
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Hello!! My surgery is 10/9 I’ll be having a lumpectomy and sentinel node biopsy. Does anyone have a recommendation for a good post lumpectomy bra? I’m a 42DDD so front closure bras aren’t easy for me to find! Thanks!
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Bren49 - I had my lumpectomy yesterday and I Am feeling great! A little sore but as long as I don’t move my arm much in that side, next to zero pain, and no painkillers. Such a relief to get it done. I was very anxious beforehand and it’s like an amazing weight has been lifted now.
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I looked at my RBG "action figure" (part of a set with Bernie, Warren & Obama) and fought back the tears this morning.
Bren, after my lumpectomy I was a 38 I cup. Leading Lady (you can find it on HerRoom.com, BareNecessities.com, and the FullBeauty/Roaman's website) makes a wire-free front-closure "leisure" bra in sizes from 36-48, with cups that run A/B, C/D/E, or F/G/H in a wide variety of colors. Back then I got 40 F/G/H; now I wear a 36 F/G/H in it. HerRoom.com has invented a "universal" wire-free bra called the "Robin," in black or beige--it is very supportive, with easy-adjust straps and is front-close. It comes in sizes from 34-42, and cup sizes that correspond to HerRoom's "Universal Cup Size" guidelines, which run from D through D6 (H or I). (In underwire bras, which I currently wear, I'm either a 36 I or 34 J).
Just make sure, before you order, that 42DDD is your true size. I thought it was mine, too--because I had to go up to a 42 or even 44 to find cups I didn't spill out of--I couldn't understand why the center "gore" pooched out and gave me a "uniboob" and the back kept riding up. Turns out most women wear bands that are either 1 or 2 inches too big and cups 1, 2 or even 3 sizes too small. Hope you can get properly fitted, pandemic notwithstanding, before your surgery. The center gore should lie flat against your sternum (giving you good separation), and the back should not ride up. You'll know you have good support if in profile, the most "projected" part of your bustline is between your shoulders & elbows.
An alternative is a camisole with a shelf bra built in. I wore Amoena in size 18 or 20 (I was much heavier back then because I ate whatever I wanted). Step into it, rather than trying to pull it on overhead.
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hello all, I am new to this forum. Just diagnosed 8/27/20 with IDC, grade 2. I am Est +,Pro +, HER2-. Tumor appears to be about 3cm and does appear to include the nipple. I wish I had contacted my doc in May when I first felt something. I have a lumpectomy scheduled for Oct 2. Lymph nodes appear to be ok, and left breast is fine. Radiation will follow in November. They will take the sentinel node for biopsy just to make sure nothing has spread. I am 54 and one year into menopause. No immediate family history of BC. I've had 3 C-sections, so surgery isn't new to me, but not sure what to expect with this. I wear a 36C bra and wonder how lopsided I could be after? My husband is very supportive. Thanks for any insight! Juli
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Welcome Juju. You need to ask your surgeon whether (s)he is an oncoplastic breast surgeon or will work with one in the O.R. to get a good result in a lumpectomy. They may be able to go beneath the nipple and leave it intact on the surface. A 3 cm tumor is somewhat challenging, given how much tissue will be removed to ensure clear margins. If you are "lopsided," Federal law mandates that insurance cover either a partial reconstruction (implant, fat transfer) in the surgical breast or reduction on the other breast to achieve synmetry, I was a 38 I beforehand (with the R breast a cup size smaller than the other). After radiation temporarily swelled the R breast, and I've dieted for over a year to lose about 70 lbs., I'm back to my R breast being a cup or two smaller than the L. (Currently between a 36 I and 34J). But the R one looks rounder and perkier, while the L one sags like a hound's ear. When wearing a bra or swimsuit, however, you really can't tell the difference.
The prep for the sentinel node biopsy is actually longer and more involved than the actual lumpectomy. You'll be awake for the former but most likely under general anesthesia for the latter. These days it's a same-day surgery: in at zero-dark-thirty, home before dinner. But prepare to take it easy for at least a week. Make sure you have enough tops and nightwear that button or zip in front because you might have trouble for a few days pulling stuff over your head. (I didn't, but it was nice to be prepared). Get a couple of stretchy front-close or step-into "leisure" bras because reaching behind your back might be problematic. They will send you home in a front-velcro "surgical" bra--ugly but functional. Mine was two sizes two small, so I rejoiced when I was allowed to shed it after 48 hrs. Surprisingly, you shouldn't have much pain--they didn't even give me an opioid prescription to fill. After the one painkiller "push" into my I.V. when I woke up, all they gave me was Tylenol--and regular strength at that. I did pop one leftover Norco at bedtime, but from then on plain Tylenol Extra Strength was all I needed, and only for a few days.
For a 1.3 cm tumor, they took out a chunk about the size of a ping-pong ball and thickness of a "Double Stuf" Oreo to get clean margins. My 2 sentinel nodes were clear, but there were 2 non-sentinels (also clear) stuck to them so I lost 4 nodes in all. A cushion between your arm and armpit should make that area more comfortable. Some patients are lucky enough that their sentinel nodes were so close to the tumor that only one incision was necessary.
Your mileage may vary, of course, but what I had was pretty typical.
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I am three years post lumpectomy. Occasionally I still have pain in that breast. I was told to wear a sports bra at night as I could be sleeping on that side. Has anyone still had pain this far out?
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I did for several years until the radiation-swollen tumor cavity seroma finally shrunk down to a knor of scar tissue. I still sleep in a leisure bra when wearing body-hugging knit PJ tops or nightgowns. (Woven scrubs hide everything, though). If I go braless under knits, you can definitely see my L boob "Thelma" dangling nearly to my waist while my R one "Louise" sits where she oughta (for an old gal, at least). Resembles one of those old "Horny Granny" Buck Brown cartoons in Playboy back in the day. (Don't ask me how I know that).
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Thanks!!!
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thank you! I appreciate your insight so very much. Taking into consideration margins, I kind of expect the amount for her to take will be larger than a golf ball.
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Juju, I'll bet that you may be a candidate for immediate partial reconstruction during your lumpectomy.
If you could do us all here a favor, please go to your Dashboard and update your profile with diagnostic info, which would appear at the bottom of your posts. The more we know, the better we can guide you. (And no, you needn't post your location).
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crsharper, you're welcome! Wear them in good health, as my grandma used to say.
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keywestfan
I haven't checked this thread in months, but I decided to look in tonight and I saw your post about Mohs surgery. I had a rather large, messy basal cell that had gotten past the easy removal stage, and had to have Mohs surgery. It was on my cheek, right next to the lower half of my nose. Luckily, the doctor had explained the procedure very thoroughly at the initial consultation, or I'd have freaked out afterwards. My incision ran from the top of the bridge of my nose to almost even with the corner of my mouth. He cut a reverse D out of my cheek, then pulled the skin together. I had about 25 stitches, I think with an inner layer of dissolving ones. I was sure I'd have a dreadful scar, but he did a beautiful job of hiding the incision in my laugh line and the rest right against the nose. I had it done in early September four years ago, and it was invisible by the end of that month. I didn't have to go to a separate plastic surgeon; the Mohs specialist did the surgery and the repair, with just time for pathology results in between. I hope your healing is going well.
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Hi everyone, I had my lumpectomy on 9/18 and I’m doing great but I have some questions about my final pathology and I’m wondering if others had more cancer than expected?
By ultrasound end of July the mass was 6mm, by MRI a month later it was 11mm. Final pathology said 1.7cm of IDC and 2.2cm of DCIS.
I will be asking my MO next week about the size differences, but I’m curious if other have ended up having more taken out than expected? I’m lowrisk mammaprint and my Ki67 is 5% so I did not expect much change in growth.
Thank you!
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Not at all unusual. 8/18/15, the "focal asymmetry" noted on my routine annual mammo was guesstimated at 4-5mm. On ultrasound 8/24, it was 7mm. Biopsy (core needle) 9/8 was 9mm "at its longest sample" and the next day confirmed to be IDC. Surgical path from 9/23/15? 1.3cm. My surgeon explained that doesn't mean it more than doubled in size in a month and a half (though it wasn't even visible on the previous year's routine mammo); rather, that until the tumor is excised it's not possible to definitively ascertain its size. Even a "3D" mammo isn't precise enough to rotate the image so you see the tumor in all its dimensions (like in those cancer clinic or immunotherapy commercials). And to put things in perspective, they removed about 8cm to ensure clean margins and check for stuff like lymphovascular invasion and "associated DCIS," neither of which I had.
From your profile, you had a rather "indolent" cancer. (Which is a good thing). Not only was it Luminal A IDC (ER+/PR+/HER2-), which is as good as invasive breast cancer gets, it was Grade 1--the least aggressive. And the 2cm of DCIS was also Grade 1 (it's fairly common for DCIS to be even Grade 3). Almost certainly, your IDC was close to 1.7 cm all along; and the DCIS probably didn't even show up in the earlier imaging. Remember, by definition, DCIS is confined to the ducts--and its histology is different from invasive cancers, indicating that unless it mutates, it is unlikely to become invasive (and the lower the grade, the lower the likelihood of breaking out of the duct).
Good luck--you will likely have smooth sailing as far as treatment goes. And welcome to the sorority nobody wants to pledge.
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Alice, Thank you for your encouragement about Mohs and I’m so glad your cheek- nose procedure turned out well. I had stitches removed yesterday after one week, and was, if one can be, delighted with the result, since they are on two different sides of my forehead. Was told I could use makeup so I put a little concealer from a stick over and they were basically invisible last night. Next week I begin scar strips so that should help even more. Silly to worry about my face when we’ve been through so much more, but the Mohs Facebook page is scary indeed. This month is quite a month for me PTSD wise, though maybe I’m getting desensitized. Monday will be mammo and ultrasound in one hospital, Evanston. Adorable breast surgeon canceled having to deal with more urgent cases, so I see his PA Friday at another hospital, Skokie, then the next week , my PCP, then the Plastic Surgeon for a look at the healing, then the Derm on Oct 30 for a full body check and maybe more skin blights. Oh, just to be back in regular life, the quotidian, where nothing happens.
jud
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Key west fan and Alice: Interesting as in the middle of my breast cancer journey this year I also had to have MOHS surgery on my ear. It was basal but with roots? Not much tissue on my outer ear but the surgeon did a wonderful job and it is fully healed and not deformed like I thought it would be. It only took 2 swipes of tissue. I am done with this year for sure. At least I hope so.
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Chisandy - thanks so much for your reply! My biopsy on 8/4 showed a 6x5x4 mm mass.... I guess I assumed that was accurate. And yes no DCIS was picked up during imaging. I definitely have some questions still, but am more focused on radiation to come and hormone therapy... and how to mitigate side effects, including supplement to use or not to use. It’s funny, I was super happy after surgery and now the gravity of the situation has set in, hard a few nights of just feeling damn sad.
Thankfully I am connected to local cancer resources and will be doing zoom yoga and counseling. How was radiation for you??
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