Lumpectomy Lounge....let's talk!
Comments
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springdaisy I agree w Pontiapeggy, you may just need a drug (I know, another pill!) to offset the bone loss. I too was put in a generic fosamax, I took it for about 4 years and was just recently taken off it - completed. Best of luck to you.
Mouthy model - you’re young, I was 58 at dx. I had 5 nodes removed, all clear. I did have LX & rads and yes my rad breast tightened up to be firmer, perkier. I tease it’s my 18 yr old boob, now next to its 63 yr old sister. With your other medical conditions you’ll need to discuss with all what your body can an can not tolerate. Best wishes to you for whatever decision you make.
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springdaisy I agree w Pontiapeggy, you may just need a drug (I know, another pill!) to offset the bone loss. I too was put in a generic fosamax, I took it for about 4 years and was just recently taken off it - completed. Best of luck to you.
Mouthy model - you’re young, I was 58 at dx. I had 5 nodes removed, all clear. I did have LX & rads and yes my rad breast tightened up to be firmer, perkier. I tease it’s my 18 yr old boob, now next to its 63 yr old sister. With your other medical conditions you’ll need to discuss with all what your body can an can not tolerate. Best wishes to you for whatever decision you make.
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Don't freak out, springdaisy: those minus numbers (not the T or Z scores) refer to the percentage your bone density has lowered since your previous scan. Par for the course at our age, especially after taking an aromatase inhibitor (AI) such as letrozole and certainly if you haven't taken any prescribed bone-strengthening drugs such as Fosamax or bone-maintaining ones such as Prolia shots. BTW, know why the reference point for the "Z" score is that of a healthy 30-yr-old woman? Because at age 30, the bones are as strong as they will ever be--bones continue to "remodel" after that, but break down faster than they rebuild. ANY pharmacy--even Amazon--carries 500mg. Ca+D3, on the shelf. Look for "Citracal (Ca citrate) Petites" (or the pharmacy's generic, which label will say "compare to Citracal..."). Talk to your medical team. You are definitely not yet at the point of needing to see an endocrinologist, at least not for your bones.
Mouthy, it may be time to discuss a "surgical menopause" with your MO. You are asking for trouble if you continue to take birth control pills (which contain estrogen) with an ER+ cancer, because those pills will feed the tumor cells. If your chemical menopause caused severe side effects, removing the uterus will also stop the endometriosis in its tracks. If you keep your ovaries, you can still take tamoxifen until they stop functioning, at which point you can switch to an AI. Many younger women with bc who no longer wish to childbear opt for a full hysterectomy (removing the uterus, ovaries & fallopian tubes) and go straight to an AI, skipping tamoxifen (which can cause blood clots if you are already at cardiovascular risk). You might also find that there are other ways beyond oral contraceptives to manage endometriosis (which bugged me till my ovaries gave up the ghost at age 54).
The extent of breast cancer surgery, especially if the tumor is confined to one spot in one breast, is a strictly personal choice. Lumpectomy+radiation is no riskier than mastectomy. But if your breast is very small (even before surgery), cosmesis (appearance) is a consideration. An oncoplastic breast surgeon can work wonders moving tissue around to minimize the appearance of reduction in size. Two of my dear friends opted for bilateral mastectomy, as they were both small-busted; one (whose cup size was "A-minus") had multifocal grade 3 DCIS in the "cancer" breast--and the "normal" breast turned out to have atypical ductal hyperplasia. She opted to stay "flat" as she'd gone braless for decades anyway; my other friend, not yet 60, had unilateral IDC, was a small B cup and chose bilateral reconstruction (to a C cup) for symmetry. Both are doing well and cancer-free.
I was (at almost 65) and still am (at almost 72) very large-busted (G/H in the cancer breast, I/J in the "normal" one), despite a 50-lb. weight loss. I had lumpectomy & radiation. The radiation caused the affected breast to swell a cup size before it went back down. I deal with the discrepancy by wearing underwire bras in the larger cup size, and when I'm clothed you can't really see a difference (no need to "pad" the smaller breast). If I'm lounging around or traveling (when I might have to answer the door), I wear a soft sleep/leisure bra under my nightgown or sweat/T-shirt to "even things out."
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Don't freak out, springdaisy: those minus numbers (not the T or Z scores) refer to the percentage your bone density has lowered since your previous scan. Par for the course at our age, especially after taking an aromatase inhibitor (AI) such as letrozole and certainly if you haven't taken any prescribed bone-strengthening drugs such as Fosamax or bone-maintaining ones such as Prolia shots. BTW, know why the reference point for the "Z" score is that of a healthy 30-yr-old woman? Because at age 30, the bones are as strong as they will ever be--bones continue to "remodel" after that, but break down faster than they rebuild. ANY pharmacy--even Amazon--carries 500mg. Ca+D3, on the shelf. Look for "Citracal (Ca citrate) Petites" (or the pharmacy's generic, which label will say "compare to Citracal..."). Talk to your medical team. You are definitely not yet at the point of needing to see an endocrinologist, at least not for your bones.
Mouthy, it may be time to discuss a "surgical menopause" with your MO. You are asking for trouble if you continue to take birth control pills (which contain estrogen) with an ER+ cancer, because those pills will feed the tumor cells. If your chemical menopause caused severe side effects, removing the uterus will also stop the endometriosis in its tracks. If you keep your ovaries, you can still take tamoxifen until they stop functioning, at which point you can switch to an AI. Many younger women with bc who no longer wish to childbear opt for a full hysterectomy (removing the uterus, ovaries & fallopian tubes) and go straight to an AI, skipping tamoxifen (which can cause blood clots if you are already at cardiovascular risk). You might also find that there are other ways beyond oral contraceptives to manage endometriosis (which bugged me till my ovaries gave up the ghost at age 54).
The extent of breast cancer surgery, especially if the tumor is confined to one spot in one breast, is a strictly personal choice. Lumpectomy+radiation is no riskier than mastectomy. But if your breast is very small (even before surgery), cosmesis (appearance) is a consideration. An oncoplastic breast surgeon can work wonders moving tissue around to minimize the appearance of reduction in size. Two of my dear friends opted for bilateral mastectomy, as they were both small-busted; one (whose cup size was "A-minus") had multifocal grade 3 DCIS in the "cancer" breast--and the "normal" breast turned out to have atypical ductal hyperplasia. She opted to stay "flat" as she'd gone braless for decades anyway; my other friend, not yet 60, had unilateral IDC, was a small B cup and chose bilateral reconstruction (to a C cup) for symmetry. Both are doing well and cancer-free.
I was (at almost 65) and still am (at almost 72) very large-busted (G/H in the cancer breast, I/J in the "normal" one), despite a 50-lb. weight loss. I had lumpectomy & radiation. The radiation caused the affected breast to swell a cup size before it went back down. I deal with the discrepancy by wearing underwire bras in the larger cup size, and when I'm clothed you can't really see a difference (no need to "pad" the smaller breast). If I'm lounging around or traveling (when I might have to answer the door), I wear a soft sleep/leisure bra under my nightgown or sweat/T-shirt to "even things out."
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Zometa. My doctor wants me to take this infusion every six months and still keep taking letrozole. I'm not crazy about doing it, but I guess I will have to. I was not happy with my DEXA scan the other day, so this is what the doctor is suggesting. Whydoes everything have to have so many damn side effects?
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forgot to say, I’m just wondering how other people’s experiences went with Zometa…
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I'm not the best person to ask about Zometa, as I have terribly "squirrelly" veins that tend to roll when tapped. My experience was awful, but most of it was due to that; and to snafus by the cancer center's lab (which "lost" my first blood sample to determine adequate calcium levels and had to re-take it) and pharmacy, which had trouble finding the dose that was ordered. It was not a pleasant experience , as it was pumped (in the chemo suite) rather than dripped and burned with each pulse of the pump (due to my angry little vein). I also had the expected side effects of 3 days of muscle aches & fever, as well as a couple of sharp neuropathies in my foot. Others reported, however, that only the first dose produced those side effects.
The only reasons I was given Zometa were that my GERD made oral Fosamax or Boniva inadvisable; and at the time, my Medicare supplements wouldn't cover Prolia. Part B considered Prolia a "drug" which belonged under Part D (because it is administered by pre-loaded syringe which theoretically can be self-injected), so if Part B doesn't cover something, neither would the supplement. But my Part D (Humana) denied coverage because considered it a "treatment" and tried to turf it back to Part B--and despite prior auth. by my MO, Humana wouldn't budge.
I was all ready to suck it up and fork over $4K twice a year to buy Prolia and self-inject. Fortunately, Medicare had a change of heart and decided it was a "treatment" (administered at a facility) indicated for postmenopausal breast cancer patients taking an aromatase inhibitor, and so it was covered by Part B and my supplement. The nurse injected it at the center's chemo suite. I had no side effects whatsoever from Prolia, ever.
I would push for Prolia.
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thank you for your answer! I decided I’m going to think about it for a bit. My normal appointment is in January anyway. I found a helpful site and it said it would be OK to wait until the T score is below -1.5 and mine is not there yet. i’m going to ask a doctor in January if I can wait a while longer. Trouble is insurance only pays for a DEXA every two years. unless I can pay for one out of pocket myself. One site said as possible to lose 3% per year bone density while taking letrozole. My Onco type said two years ago, that within the next 10 years, so 8 now, I have a 93% chance not having cancer appearing in a distant part of my body. hope that’s true for the breast the original site. I would like to do the five years of letrozol, and then be done.
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What was your Oncotype score? You should know that genomic tests such as that (or MammaPrint) can't predict the risk of new primary tumors appearing either in that breast (ipsilateral) or the other one (contralateral), only metastasis ("distant" spread) of residual cells from the original tumor.
But don't overthink this. Your bone density is not too bad yet (it was better than mine even before starting letrozole), and IMHO you'd derive more benefit from continuing letrozole for at least a total of 5 years--and if you take a bone-preserving medication and do weightbearing exercise, then it would slow down the loss of bone density. (Remember, too, that even if letrozole without bone drugs would cause 3% annual density loss, by the end of 5 years on it the density loss would be 15%, which in the grand scheme of things is not drastic).
I'd bet your MO would advise you to take the letrozole for 5 years, plus some bone-strengthening/preserving regimen (drugs, lifestyle or both).
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- I just remember being told that I had a 93% chance of not getting a distant cancer within 10 years. I do walk on the treadmill at the gym and will continue taking the 500 MG calcium plus D and see how it goes. I do want to do the full five years of Letrozole. I’m trying to find out if Blue Cross Blue Shield Minnesota will pay for Proliatreatment. It’s so hard to find information because there’s pages and pages of it.
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The reason insurance pays for only one DEXA every two years is that you don't need one oftener than that. You don't lose density that fast.
Why does every drug have side effects? Because there is no such thing as a totally focused and "transparent" drug. The body is a delicately-balanced organism--and if a medication works via one mechanism, it will also affect other systems to some extent. Our bodies also change and become more vulnerable as we age. C'est la vie.
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isn’t that the truth? The human body can be miraculous and then again at times….
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spring daisy can you tell me about radiation? I just had 2nd surgery re-excision..lumpectomy to get clear margins of DCIS and papilloma. Pathology came back that there are still foci of caner cells I am shocked. Dr left message saying he is optimistic Hubby thinks that means all is ok. I am struggling...I still have cancer cells after 2 surgeries? But clear margins now .. I guess radiation is the next step? sigh
also surgery was a week ago today the zaps and zings and fireworks are wearing me down any advice????? Thank you so much
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starsnow,
I know it’s hard. The anxiety. Mine was stage 1A and no lymph node involvement and the Dr made sure I had clean margins before I left the operating room. I had no problem with radiation at all. I think I had 30 or 35 treatments. The skin got a little bit tender at the end, but it healed quickly. I am now taking an aromatase inhibitor.
About a year later, my friend also found out she had breast cancer. Here’s is stage 1B with some cells in one lymph node. They started her medication right away and then radiation. Every situation is different, they don’t always do another operation if there aren’t many cells at least that’s what my friend was told. Ask questions though if you’re not happy, ask questions.0 -
I think that josieo has it just right in her response to mouthymodel. You need a medical team that is expert, actually listens to you, and responds to your questions and concerns. I have been very lucky to have a terrific medical team and I think they have steered me well. I had a lumpectomy in late July, started (previously unexpected) chemo in September and have just more one infusion next week. Then radiation and long-term oral medications. This is scary and there is no computer from which you can get answers based on available data. Hang in there, mouthymodel. Thus far, my worst day was the one before the chemo started -- everything was so uncertain.
PS: I strongly recommend writing your questions and giving a copy to someone who will go to appointments with you. You need a second set of ears, someone to take notes and someone who can help you be sure not to skip questions.0 -
Starsnow, DCIS is by its nature non-invasive. A papilloma is a wart (benign), which though usually on the skin can sometimes grow in the duct. I wouldn't be worried.
What grade was your DCIS, and what was the hormonal profile? (I assume it was Grade 1 or 2, as you were advised to have only lumpectomy, not mastectomy). The hormone receptor status would determine whether you need endocrine (anti-estrogen pill) therapy--if ER+, depending on your age and menopausal status, you'd be prescribed either tamoxifen or an aromatase inhibitor (AI) such as letrozole, anastrozole, or exemestane. Because you had a lumpectomy, even with re-excision, radiation is still likely recommended unless your OncotypeDX score indicates you can skip it (the scores & purpose of that genomic analysis differ by whether your cancer was DCIS or invasive: for DCIS, it determines necessity for radiation; for invasive, the need for chemo). Where were the foci of remaining DCIS found? If only in the original tumor bed but not the re-excised margins, you might (especially if you're >60) be a candidate for the kind of radiation I had--16 sessions of higher-strength radiation, aimed only at the tumor bed. If towards the outer edge of the re-excised margins, you'd likely be recommended whole-breast (usually 35 sessions of regular-strength). Chances are that the radiation would also kill whatever of those warts they found, too. (Ah, if only it could kill the plantar wart on my toe, but I digress).
I can only speak to my radiation experience, which was a (relative) breeze. I got only a little reddening of the skin, with some swelling of the breast at the site of the tumor cavity--a seroma (fluid pocket) developed where the tumor & its adjacent tissues were removed. Seromas are very common whenever you have something internal surgically removed, because nature abhors a vacuum and wants to fill it back in. It took about a year for the fluid to resorb and the swelling to subside so that my breast appeared to be the same size it was before surgery. I had no pain, itching, flaking or broken skin. (Right after each session, even before I put my top or bra--yes, I was able to keep wearing a bra, sometimes even underwire--I slathered the site with one of the little tubes of Aquaphor they gave me. I reapplied it, with a little clear aloe &/or calendula cream, at bedtime, and showered it all off in the morning before heading out to each session.
If, BTW, your DCIS was hormone-negative, you would not be prescribed any drug treatment--even if they found it was HER2+. So much DCIS is HER2+ that they often don't test for it, only for hormone receptors, Chemo is never given for DCIS any more, and anti-HER2 "targeted therapy" never was. (By the time they stopped doing chemo for DCIS, they still hadn't discovered "targeted" therapy yet).
Those "zaps" will, alas, stick around for awhile. They are not, however, a sign of anything wrong. Just the opposite--they are the nerves that were cut during surgery reconnecting and signaling to the brain "hey, we woke up." They will lessen as time goes by. Took a couple of years for mine to stop. If they are unbearable, talk to your MO about whether to be prescribed an anti-neuropathy drug like gabapentin. I chose not to take anything for them,
I suggest you buy or download the latest editions of Dr. Susan Love's Breast Book, &/or its counterpart by Dr. Elisa Port. The former, especially, is considered the "breast cancer Bible." They will tell you more--and more accurate--information than you can find online anywhere but here (or possibly Komen). "Dr. Google" will only freak you out.
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Hi everyone! I think that I want to join this group now that I am recovering from a lumpectomy. I am 53, post-menopausal Dx with IDC, stage 1a, 6mm mass in right breast, grade 1, ER/PR+ and HER2-. That's what I know so far and I am 3 weeks post lumpectomy.
I dropped in here to ask about bras because my surgical breast is still quite sore and any sort of movement of the breast hurts. Does anyone have a good recommendation for good support bras without underwires? Someone may have a link to a previous bra discussion that I can read up on too. Unfortunately, I had asymmetric breast sizes before surgery, and my right has always been smaller than my left. Right now I am quite swollen and don't know how it will pan out after things settle and after radiation. I may need to pad the right one after all is said and done. But at this moment I need more support and am not sure how to achieve it with a smaller size on the right surgical breast. Bras have always gapped on the right, but now I need the support there. Thanks in advance!
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concernedaboutresults, There are many companies which specialize in post surgery bras (AnaOno is one.) They make bras for all kinds of situations. Those that are suitable for a UMX might work if there is a major size difference. If you call the customer service number they will provide input on which model might suit your situation. Locally I found a sports bra with hardly any cups which supported my smaller right side and expanded for my larger left breast. This takes trial and error and what fits will change over time so start with one bra and get a second if you like it for when the first is in the laundry.
After the swelling from surgery went down I padded the right with Bravo Double Shapers https://www.amazon.com/stores/BRAVOBraPads/BRAVOBraPads/page/D1A44863-5E89-4C65-AA60-89C0F4A79307 They used to have silicone pads which work for swimsuits but don't seem to carry those any more.
My right breast became even with the left after radiation. The swelling went down some but I developed lymphedema in the breast so its size varies. When I get dressed I have to choose which kind of bra/pad to wear that day as well as my outfit.
Good luck finding something that works!
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concernedaboutresults, our situations are nearly identical (except my tumor was twice as big but still Stage IA). I don't know how well-endowed (mixed blessing) you are, but since I am an H on one side and an I/J on the other my options for wire-free support were limited. At first, I used Leading Lady front hook "leisure" bras that actually come in F/G/H and are pretty stretchy. (Still wear them under nightgowns when I travel). Then I found that Goddess and Glamourise make wire-free versions of some of their underwire bras, in nice colors. Wacoal has an (ugh) "Awareness" collection in a few colors, up to an H cup (their bands run a size tight). At Lane Bryant, I found a wire-free black bra in 40H. Some wire-free sports bras are quite supportive, if you don't mind a "uniboob" effect from the compression. The inexpensive ones (say, the Puma 2-packs at Costco) come in S-XL but there's enough latitude there. You do have to pull them overhead or step into them.
You can find all of these on Figleaves.com, Figleaves.uk. BareNecessities.com and HerRoom.com: the latter even has diagrams showing them under various necklines, and a "universal" cup sizing tool which starts with D and goes up to D8. That's because as the band size goes up, so does the cup volume even if the letter designation's the same: the cup on a 36D is the same volume as on a 34DD or 38C. Some bra sizes vary by mfr. or style--and cup designations differ between the US & UK (a US H is the same as a UK F). You will likely find some styles, colors & sizes on closeout sale--and HerRoom has live chat to answer fit questions, which you can't do with Amazon. (You also know you're not getting counterfeit goods when you use a bra-specific site). These sites also sell accessories like filler pads and strap-anchors. There's another option, ThirdLove.com, which carries cups up to H--their leisure/bralette styles have removable pads.
If you are small enough, some discount-store front-zip (e.g., Fruit of the Loom) or step-in/through (Genie) bras will fit and are much cheaper. I was able to resume wearing underwires a couple of months after my lumpectomy.
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Thanks for the bra recommendations. I think I may have developed a seroma. I had my MO look at it when I saw him on Monday. I moved my follow-up appointment with my surgeon from the 15th to Monday. They wanted to see me today, but we had icy roads and the drive was over 20 minutes. Has anyone had a seroma? If so what was your experience with it, like did it resolve on its own? I am supposed to have the day-one radiation mapping procedure in the morning and I don't even know if they can start radiation with a seroma.
What I am experiencing is a painful sort of hard lump where they did the lumpectomy from the surgical scar inward. It is causing my nipple to invert and the skin to look like the traditional orange peel. My surgery was on 12/22/2022. So I am almost 6 weeks post surgery and this painful lump has been here since about 3 weeks post surgery.
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I had two seromas--mammary (formed in the tumor cavity) and axillary (armpits, where the nodes had been removed for biopsy). The latter was far more troublesome: it hurt and was the size of a large lime. Not just that, but the incision opened up when the radiation onc. removed the remaining Steri-Strips (which failed to fall off after a month). It exploded when I leaned over the sink to floss my teeth, hissing & squirting blood-tinged "serous" fluid everywhere. After close to half an hour I finally reached my surgeon's NP who told me to come up immediately. My housekeeper drove me while I pressed a towel to my chest beneath my ruined sweater. Got to the surgeon's office but she was in the OR. The NP said it had to "heal from the inside out" and that I needed to pack it twice a day for 6 weeks. Nope, not gonna happen--I had to leave for a music conference in IA the next day. I asked to see my surgeon's partner, who took one look and said the weight of my large boob had pulled it open--he agreed with me that it had to be sutured. I didn't even feel the lidocaine needle--and he kept pressing on the seroma as he stitched while it hissed like a cobra. But the sutures held during my trip, and two weeks later they were successfully removed. By then the seroma had shrunk to the size of a date.
The mammary seroma swelled on the outside after radiation, making that breast the same size as the L one. At its largest it was 20cm. Eventually it was resorbed to about 4cm, surrounded by scar tissue, and once again I'm an H/I now--albeit a 36 rather than the pre-diet 38/40. I had planned to get the L one reduced to match it, until the pandemic hit and then I was dx'ed with ocular melanoma. Suddenly, elective discretionary esthetic surgery lost its appeal. They look reasonably even inside a bra, anyway.
(I have to go braless the next couple of days anyway because of a comically-large bandage on my R index finger due to lacerating my fingertip on a cat food can lid way past closing time at urgent care, making it impossible to get it timely sutured--so I can't hook a bra. I can't get the bandage wet, either. It's hard enough trying to work a knife & fork, much less groom myself, pull up my pants and take care of two very old cats--one picky & demanding, the other sick).
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Hi,
I also had two seromas from where the lymph nodes were removed in my armpit during surgery. Even though small they caused some pain. So at my follow up app't with my surgeon he drained them in the office. But they filled up again so I ended getting a referral to interventional radiology where these were again drained 3x (within a year) and the doctor used ultrasound to see the seromas being drained. Finally there was no more fluid to drain and only one sort of hurts because it's right on top of another lymph node. Had to get that checked out because it appeared to be a swollen lymph node. This stuff seems to never end sometimes.
Both my breast surgeon and my melanoma surgeon did tell me that eventually your body will drain the seromas. Nope, not for me. They don't like to put needles in due to the risk of infection. Especially with my upper inside leg lymph nodes removed the seromas were so big and caused nerve and regular pain. Interventional radiology also drained those several times. Unfortunately, the biggest one got infected, caused cellulitis, and I had emergency surgery to drain it, and had portions of the area around the seroma cut out. These leg ones had to be healed from the inside out. So for about three weeks I had to pack the space in my upper leg with medicated stuff. It was gross but eventually they healed and I have no more pain or trouble.
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Should add that I owe my presence on BCO to that axillary seroma. I Googled "exploding seroma," and the first thing that came up was a BCO post "M-M-M-My Seroma." After I picked myself off the floor in a fit of laughter, I clicked on the link and the rest is "herstory."
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Eric - I had to look up STEMI. I forget your MIL's age, but this doesn't sound good. As Wally & Special said - drive safely & we're in your pockets.
Special - sorry your DH is under the weather. Hope it's a short lived spell.
I had the last of the fresh strawberries with heavy cream for brunch. Dinner will be a meatloaf sandwich on Dark Pumpernickel.
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I think grade 1's normally get the lowest oncotype scores so yes, there wouldn't be a lot of risk of recurrence. But does it happen? Sure. Anything can happen in cancer world. Grades are given subjectively with the individual radiologist literally counting and looking at the cells so one laboratory may give a different grade than another. So oncotype is what our oncologists normally look at determining the risk of recurrence since that is less subjective.
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mavericksmom, I am sorry if I misunderstood you. I don't believe that saying has anything to do with cancer since it is not in our control other than going to all doctor appointments with a list of questions
Most of us have the same fear, once we are diagnosed, the sword of Damocles is above our heads. Yesterday, I lost my friend from BC which had spread to her brain. I am very sad today and I also know so many others who are BC survivors for over 20 years. Another BC friend told me that after 3-4 years of the diagnosis, you will look at BC like from the backside mirror of your car.
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2 hours ago, the local hospital called to tell us that MIL was flown to a Phoenix hospital. STEMI.
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Been 7-1/2 years for me. My procedures were all done on the day of surgery--I was "NPO" since midnight the day before, after Kol Nidre service and a big steak dinner & mousse for dessert--didn't start my fast till after that (Talmudic dispensation for illness).
I went into the mammo suite.
First, after I changed into a hospital gown, I had one final standing mammogram to show the "clip" where the biopsy had been. My family was then directed to my roomette, along with my clothes & purse, to await me.
Then I walked into a cubicle--placement of radioactive seed was done lying down, by the same radiologist who did my core needle biopsy and confirmed it with a Geiger counter. No wire insertion. Then I walked to Interventional Radiology for the lymphoscintigraphy--but it was an injection of an isotope, not a blue dye. I was lying down for that too. The injection was into the areola, quite painful like a bee sting but over quickly. Then, while still lying down, I had to massage the part of my breast where the tumor was, as well as my armpit, for 15 minutes. (A good Americana playlist on the headphones helped). Then it was on to the camera table (also lying down), but the imaging wasn't complete yet. So they had a transporter walk me back to my "roomette," where I watched TV for half an hour to give the isotope enough time to reach the nodes; then I was walked back to the camera, where the image showed up clearly. One more walk back to the roomette where my family was waiting.
The surgeon was a bit behind schedule, but the anesthesiologist came in, started an IV, and gave me a push of Versed (like Valium). He then gave me a Zantac to swallow to prevent nausea & heartburn (since Zantac's been withdrawn, you'll probably get Pepcid or Zofran--the latter somewhat costly). Then the surgeon came in, showed us the mammo film--the tumor looked spiculated and larger than I remember from the ultrasound imaging 4 weeks before. I was wheeled into the OR, got a mask and told to count backwards from 100. Next thing I knew I was back in the roomette.
Surgeon came in and said there were "no surprises" and that I had enough tissue to probably ensure clear margins (turns out I did). Was given a mini-bagel & schmear to break my fast (this was Skokie & it was Yom Kippur), OJ & Lorna Doones, then was allowed to walk to the car. I was warned that due to my breast size (38 I) they'd probably have to put me in a giant ACE wrap rather than a surgical bra; but somehow they squeezed me into a size XL surgical bra. (And I do mean "squeezed").
Path report was 2 days later: same histology as the biopsy path; clean margins; and 4 nodes removed, 2 sentinel and 2 "hitchhikers," all negative. Only disquieting surprise was that the tumor was twice as big as the ultrasound showed 4 weeks prior: the ultrasound guesstimate was 7mm; 2 weeks later, the radiologist doing the biopsy said 9mm; but surgical path said 1.3cm. Because of the size (>1cm) it was a "gray area" so they sent a sample for Oncotype DX testing, which revealed no need for chemo.
I did have a sore armpit and a rather large axillary seroma, covered with Steri-Strips which stayed on a few weeks longer than the ones on my breast. Unfortunately, it burst a day after the radiation oncologist removed the strips, so I needed actual sutures. For a few months, even though underwires were fine, I couldn't wear "full coverage" bras because the sides came up too high--I wore "balconnet" bras instead. The axillary seroma had shrunk to the size of a large grape by then and no longer hurt.
And if you get general anesthesia like I did, don't be alarmed if your entire trunk feels stiff & sore (like if you'd started off resistance work at the gym with full-strength weights), beginning a day & a half post-op and lasting for 3 days or so. It's called "scoline syndrome:" they administer succinylcholine, a powerful muscle relaxant, as soon as you're fully "under" so you lie perfectly still on the table. But just before your muscles relax, they contract suddenly and extremely powerfully for just a second--long enough to produce that soreness. Nobody had told me this in advance--I had to Google "why does my trunk hurt after lumpectomy?" At my 1-week followup, the surgeon's NP confirmed that's what it was.
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Thank you, everyone. I was diagnosed on 12/12 and so I've been waiting a bit for this surgery and it's suddenly becoming quite real and I'm nervous. I appreciate you walking me through your experiences.
I think I'll download an audio book if I need some distraction in my roommette and I'll remind myself as someone said that these are the experts and they do this all the time and I can trust that I'm in good hands.
I live alone with my 50lb dog and I'm hoping that recovery is easy enough that after a week I can manage, with some adaptations on my own. My tumor is on my right side and I am right handed. Did any of you have lymphedema after surgery or use a compression sleeve after surgery? I'm going to ask my surgical team but also if you did and there was one you would recommend please, let me know.
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I had some mild (Stage 0) lymphedema that took a couple of months to develop. I'd been warned ahead of time and measured for a compression sleeve & gauntlet. Ugly, but serviceable. At first, wore the sleeve whenever I flew, played guitar (especially outdoors on a hot day), went to the gym, and gardened. I found a site, LympheDivas, that has hundreds of colors, patterns and styles of sleeves, gauntlets & gloves. I couldn't wear a glove because my fingers are too short (they don't make gloves small enough for me), but a gauntlet was fine. (Don't wear a sleeve w/o a gauntlet, lest your hand swell). Eventually, after 6 OT sessions for lymphedema (massage, exercises, learning self-massage), the city's top LE specialist took measurements and declared I no longer had it. It hasn't returned--but I still wear compression during strength training and on flights >3 hrs. At first, when I took an express elevator to the 95th floor of the Hancock downtown for Mother's Day brunch, I prepared by wearing compression--and I could actually sense some swelling for a few minutes once we were seated.
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