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Mom diagnosed today.

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My dear 77 yo mom was diagnosed today with IDC, nuclear type 2, ER/PR positive, her2 equivocal for over expression. We are seeing the surgeon tomorrow for biopsy path followup, in person. The surgeon, who did the biopsy, has already said mom is not a surgical candidate first....I'm guessing that means other treatment prior to surgical options...or perhaps because of age?

I'm guessing they will need to pin down her2 status to finalize treatment options?

Grateful for the resources here...A lot to learn. Mom is quite hard of hearing and dad's short term memory is not good...so I'm the scribe. Wanting to control my eldest child need to control everything and follow mom's lead. Ironically I was a healthcare chaplain on an oncology unit for several years...its a whole new ballgame when its your own mom.

Sure be grateful for any thoughts about how to best come alongside and support mom...especially from adult kids or moms!

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  • moderators
    moderators Posts: 7,911
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    @bellevue1110 - We're so very sorry to hear of your mom's diagnosis. You know that we are here to support you, offer advice, and give you information. We'd like to suggest you check out also the following discussions:

    Older Than 60 Years Old With Breast Cancer - Here you'll find stories of other women diagnosed around your mom's age who are dealing with age-appropriate matters.

    Caring for someone - Where you might find support for yourself.

    Keep in touch as often as you can and let us know how you and your mom are doing.

    Sending love to you both,

    The Mods

  • maggie15
    maggie15 Member Posts: 855
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    @bellevue1110 I'm sorry about your mom's diagnosis and the stress that comes with it for you and your dad. At 71 I've been both the caregiver daughter and the older mom with breast cancer. It is sometimes difficult to follow your mother's wishes about treatment, especially if they are to take a less aggressive route. At an older age sometimes quality of life takes precedence. Age alone is not the determination of the treatment course to follow. Especially when older, people of the same age have different medical comorbidities and functional levels which can make any given treatment appropriate or not. I have also disappointed my daughter by not opting for the most aggressive treatment offered.

    Your experience as a healthcare chaplain on an oncology unit will be very helpful. My daughter is a PA at a cancer hospital but was viewing me as her mother rather than a patient. When I asked her how she would react to a patient who declined the same treatment for valid personal reasons she told me she would be fine with it and then realized that I had the same right to determine what side effects I would endure. If you ask yourself what advice you would give to an oncology patient in your mom's situation it will be easier to ignore the family ties.

    All the best to you and your mother as she navigates treatment. Your mom is lucky to have you by her side.

  • bellevue1110
    bellevue1110 Member Posts: 18
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    Maggie15 what good advice. I appreciate so much your insights. My mom is a retired LPN...and as all of us related to healthcare providers know, they are not great patients! That said I have found myself reflecting as you suggest...what would I say to someone else's mom? Just grateful we are together, whatever the circumstances. Thank you for replying, I appreciate it very much.

  • bellevue1110
    bellevue1110 Member Posts: 18
    edited July 2023
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    Dear Mods...these links are just what I need. Thank you so much. We are all hanging in this weekend. Mom sees the oncologist monday...which is her birthday...so we are planning to celebrate Sunday with the grands and fortify ourselves for Monday appointment by eating left over birthday cake for breakfast. 😎

  • bellevue1110
    bellevue1110 Member Posts: 18
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    The oncologist scheduled CT scans, us of nodes and a bone scan over the next few days. If nothing shows up mom will have a mastectomy and treatment will depend of course on the path report. I'm amazed at how little providers actually tell you. My brother in law gave my mom some suggested questions (he's a radiologist)...and I had a few to toss in. The doctor seemed surprised. My bil really thought chemo would be first...so did the surgeon. I kinda get the feeling the surgeon and the mo are not exactly buds. They sure rush you right into surgery.

    I'm worried about schedules...we seem to be on track (barring anything on the scans) for surgery in the next 10-12 days....my mom has a ton of questions about reconstruction and recovery...she is diabetic so I don't know how that impacts things. I don't know what options they will suggest. It feels like ping pong right now. I have several work responsibilities that require travel the next two weeks- that are not easily rearranged...I can't stand the idea of mom going thru this surgery and not being there....I know its not about me, but I'm worried my dad will not be able to manage all she'll need in the days following surgery. Am I overracting? I absolutely do not want anything delayed that shouldn't be just because of my schedule, but somehow I need to find a way to work this out.

    My mom is a trooper...but she's said she feels like she is in neutral (which I can only image I would be too). I feel like its rush, rush ..wait..........wait...

    It is what it is.

    And it sucks.

  • maggie15
    maggie15 Member Posts: 855
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    @bellevue1110 , There is no need to rush into surgery. Because of your dad's memory issues it is important that you be there post surgery to help your mom follow the discharge instructions. With your mom's ER+ profile and no evidence of extensive nodal involvement chemo, if recommended, is usually done after surgery. Also, has your mom met with a plastic surgeon about reconstruction? To avoid a third surgery a tissue expander could be placed during the mastectomy. The plastic surgeon would have answers to your mother's questions about healing with diabetes and the best method for her reconstruction.

    The doctors are not providing answers about treatment because they don't yet know. Sometimes surgical pathology presents surprises. There is also lots of waiting involved. If the path report again shows HER2 equivocal there will be a wait of at least a week for a FISH test. If the FISH test is negative there may be another wait for an Oncotype DX genomic test to see if chemo would be recommended. With an ER+ tumor an aromatase inhibitor will most likely be prescribed.

    Breast cancer treatment involves a great deal of hurry up and wait for everyone who goes through it.

  • bellevue1110
    bellevue1110 Member Posts: 18
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    @maggie15, I appreciate you following along with me and my mum. I needed to hear that surgery does not have to be immediate. I talked to the nurse at the surgeon's office today to clarify as much as possible the timeline. Mom has CT scans tomorrow and bone scan monday...we'll follow up with surgeon August 1 for him to explain to mom what options are available. She is not sure about reconstruction at this point. She has been keeping to her routine and only some moments of thoughtful silence. I've been trying to give her space or company as she indicates. Today she told me her biggest fear was leaving my dad with a load of debt and dying anyway....she suspects spread of the cancer. I tried to gently suggest that can't be known till scans/biopsy etc. And I reminded her she and dad have great supplemental insurance (and kids in a position to cover costs beyond). I suspect I would be worrying the same way in her place.

    The MO put in his visit notes that her2 Fish is not amplified...does that mean negative?

    Ok, I'm stopping now. I'm a learner and started my work life as a teacher...now I wish I'd gone to med school. Lol...I'm going to stop trying to do a crash course in all things breast cancer, and go play cards with mom.

    Maggie I hope you are surrounded by good and kind support at home yourself. I'm really moved you'd reach out. Thank you.

  • maggie15
    maggie15 Member Posts: 855
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    @bellevue1110 , Good to hear that the HER2 was not amplified by FISH. That's considered negative and means no chemo for HER2. It will be good to have a follow up with the surgeon when all of the test results are in. If your mom decides against reconstruction she should ask about an aesthetic flat closure which makes the mastectomy side smooth (even though there will still be a scar.)

    My mother always brought up the money issue in spite of good insurance and the possibility of family financial help. I think this topic was more related to her desire not to be a burden. I would remind her of how she had helped her parents when they were older to make her feel better.

    I'm a retired math teacher. All the science courses I took have come in handy when reading medical information and studies. The details of breast cancer and its treatment are not something people generally want to learn about until it affects them. The posters on this website have been very helpful and supportive when I have had problems. We're not medical specialists but our collective experience covers all the unusual things that sometimes happen.

  • bellevue1110
    bellevue1110 Member Posts: 18
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    Maggie, thanks for the tip about closure, that's helpful. Super relieved no chemo. I agree about the money issue...this is the woman who worked crazy hours to send us to college! I'm grateful for the collective wisdom freely shared here.

    Hurray for math teachers!! I taught history and philosophy. One 3 week stint teaching calculus when my colleague practically shanghied me into covering for him. Once was enough..I was one set problems ahead of the students at any given time (and I might have peeked at the odd numbered problems at the back of the book!)