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Topic: Anxious about my surgery/reconstruction decision

Forum: Older Than 60 Years Old With Breast Cancer —

Meet other women who are similar in age and dealing with age-appropriate issues.

Posted on: Oct 7, 2020 02:45PM

suzopedia wrote:

This is my second time around for cancer. I had two lumpectomies (left) in 2005 and was diagnosed in 2020 on the right side. It looked like it was DCIS. The first lumpectomy didn't have big enough margins and the second lumpectomy found a micro invasion, more DCIS and atypical ductal and lobular hyperplasia. I panicked. I'm wondering what else is in my right breast. The second lumpectomy was to clear margins and they found all this instead. After being at peace around BC for the last 10 years, I'm finding it difficult to live with the anxiety. My MO agrees it might be better for me to have the UMX rather than deal with constant monitoring. So here I am. Really scared but trying to move forward.

My surgeon said she did not recommend more surgery, partly because of my age. I'm 70. That's the reason I want the MX. I want to reduce my chances of having to deal with this again in the future. I have orthopedic/spinal issues I also have to keep an eye on. I am leaning away from reconstruction right now. I don't want anymore complications or surgeries than I have to have. But I'm still scared. How will I feel being lopsided? How will I feel looking at that scar?

I'm feeling alone and disconnected. The social worker and nurse navigator don't return calls. My husband is supportive but it's along the line of "I'll support whatever you want to do". I want my mommy :-) and/or someone to make my decisions for me. I know that isn't going to happen. I just needed to vent. I have a call into the psychologist at my MO's office. And then I'll keep coming in here and pestering you all until my surgery and maybe even after. <hugs>

susan

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Oct 7, 2020 04:27PM abigailj wrote:

hi Susan - sorry you’re having to deal with this difficult situation. Although I’m a few years younger (63) I had a BMX and opted for pretty involved recon (see my signature for details). However a much older relative by marriage had a UMX and opted for no recon. The lopsided thing bothers her more from a balance perspective than anything else, she uses a good quality custom fit prosthesis (Medicare covers that) when going places and is fine with it for appearance.

Maybe you don’t need to decide immediately- perhaps the surgeon can leave skin and maybe nipple if that’s feasible when doing the UMX if it’s your preference of course while you consider if you want anything more done. Then you can weigh recon options and if you decide against, a PS can instead remove the excess skin for a smooth closure. Again, it’s for you to decide in consultation with your care team, I’m just hoping you’ll be able to reach a decision you’re comfortable with and can get through this with as easily as possible.

Dx 1/2020, ILC/IDC, Both breasts, 2cm, Stage IB, 0/4 nodes, ER+/PR+, HER2- Surgery 6/23/2020 Mastectomy: Left, Right; Reconstruction (left): DIEP flap, SIEA flap; Reconstruction (right): DIEP flap, SIEA flap
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Oct 7, 2020 04:28PM Betrayal wrote:

Susan: Sorry you are back for a second time and experiencing difficulty with surgical outcomes. Have you talked to a RO about what they would recommend as far as treatment? I would not just use age as a criterion because I am not sure why your surgeon/MO feel this way? As far as monitoring, what is your MO saying?

You did not mention breast size but this may be a consideration for the UMX if you need to use a prosthesis. If you have spinal issues the weight could be something you want to consider. I don't have personal experience but some have reported the weight is an issue on neck and spine alignment. Knitted Knockers makes and provides for free a replacement that can be used to fill out a bra. They are made according to bra and cup size and are adjustable so that may be an alternative to being lopsided.

I am hoping someone will have the answers I am unable to provide due to lack of personal experience. However, you are not alone and as long as you come here you will be connected to others that can identify with your issues. So vent away and in the meanwhile I am sending you an enveloping pre-Covid hug.

Surgery 1/31/2016 Lumpectomy: Left Surgery 1/31/2016 Lymph node removal: Sentinel Surgery 3/3/2016 Lumpectomy: Left Radiation Therapy 3/30/2016 Whole-breast: Breast Hormonal Therapy 6/24/2016 Arimidex (anastrozole) Hormonal Therapy 5/18/2017 Femara (letrozole) Hormonal Therapy 6/15/2020 Aromasin (exemestane)
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Oct 7, 2020 05:26PM - edited Oct 7, 2020 05:30PM by Cowgirl13

Hi Susan, I don't have experience with this myself, but I did want to say that my best friend had a recurrence 20 years later. She was 73 when she had a unimastectomy and she did just fine healing from it. She did have reconstruction and it was just too many surgeries. Until someone else posts here I will also share that there is a section here on going flat and a subsection on Aesthetic Flat Closure.

Here is the link for Aesthetic Flat Closure:

https://community.breastcancer.org/forum/82/topics/876915?page=1#idx_19


Be the kind of woman that when your feet hit the floor each morning the Devil says: 'Oh crap! She's up! Dx 5/28/2009, IDC, Left, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/17/2009 Chemotherapy 8/3/2009 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/21/2009 Hormonal Therapy 2/23/2010 Arimidex (anastrozole)
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Oct 7, 2020 05:56PM MinusTwo wrote:

Suze - you have started 4 or 5 new threads in the last week or so, and many of us have been trying to answer your questions and concerns. It makes more sense if you pick one thread and let people get to know you & follow along. Others who have been diligently responding to your posts and interested in your answers will rightly get frustrated that you're asking many of the same questions over & over. And leaving those who are responding on your other threads just hanging.

I'm not going to repeat what I've said on your other threads, but you should go back & read answers from people like Beesie who posted very thorough & detailed responses. And try to pick one thread and stick with it.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 7, 2020 06:14PM suzopedia wrote:

Minus Two,I'm sorry I am violating your norms for how I am supposed to post. I am looking for a group of like minded people who have similar experiences. I've read everything Bessie has ever posted to me and I appreciate and value her input. I have told her that a couple of times. I am sorry if someone feels like I have left them hanging. That was not my intention.


Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Oct 7, 2020 10:46PM suzopedia wrote:

Thanks abigailj. Your right. I don't need to decide right away. That's kinda my nature. I'm so stressed about this and I'll feel better when my plan is in place. As uncomfortable as I am, right now, I guess this just can't be rushed.

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Oct 7, 2020 10:56PM suzopedia wrote:

Betrayal, the RO is ready to go and says I'm good with just radiation. That was after the first lumpectomy. If I would have followed his advice, I would have gone right to radiation and not had the 2nd lumpectomy. That's where they found the microinvasion. The surgeon says I don't need anymore surgery (even to look at SNB) because of my age. I was not comfortable with that. The MO says she understands that but she wanted to know how I would feel about the constant monitoring. Since I'm already jumpy as a cat, we both agreed that the MX would be easier on me.

As far as breast size, I'm small on the left side after two lumpectomies. So I'll be lopsided but the balance probably won't be bad. I'll look into Knitted Knockers. thanks

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Oct 7, 2020 11:02PM suzopedia wrote:

cowgirl13, thanks for telling me about your friend. I can use the encouragement that I'll be fine. I'm also leaning toward no additional surgery. I don't need the stress. I read a bit about Aesthetic Flat Closure. It seemed like most of those women who were really happy with that had BMX. That's not what I'm looking at. I wanted to hear from more women who had a uni. thanks.

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Oct 8, 2020 11:34AM MinusTwo wrote:

Suze - not really any rules. It's just that it's frustrating for people who are trying to help to see the same post in 4 or 5 different threads.

Take a look at the October surgery thread. Or read September surgery for input. The women there are all going through similar things and I found the support to be great. I am still friends with women I met in my chemo group when I was in that stage.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Nov 2, 2020 04:33AM abc54321 wrote:

Had my right breast removed March 13, 2020.

And it's fine! I am small, so I don't even bother with a falsie. I've found no one really looks at me, haha.

I actually love my scar! To me it's a battle wound. Maybe shocking at first sight, but now I'm proud of it.

I looked into reconstruction, thinking (at first) that I wanted my breast back. After consultations as to what all would be involved, I said, "No thanks - schedule my surgery asap." There had already been delays getting all my tests done

And as I've posted elsewhere, please ask your anesthesiologist about doing a block. They did an arm block on me, then only had to use very light anesthesia. I woke up alert, refreshed, and didn't even feel like I had surgery. That was on a Friday - I went in early and left that day. I didn't really feel any pain or discomfort until the following Sunday, then it came on gradually, allowing me to get used to it.

Dx 1/12/2020, IDC: Mucinous, Right, 4cm, Stage IIA, ER+/PR+, HER2-
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Nov 2, 2020 04:55AM marie914 wrote:

Suze - I am 60 and I had the choice of a lumpectomy or an unilateral mastectomy or a bilateral mastectomy. I did not want radiation but I did want to keep my one breast until I saw how things worked. I did have an expander put in and will be getting an implant. I'm okay with it but I can see where just sewing me up would have been fine and I could have worn a prothesis or knitted knocker. I wear a prothesis that I got off Amazon for $40 or something. It works great now until my expander gets enough saline in it to match my other breast. When I am home I just go without. I haven't noticed balance issues but I think the prothesis I got makes me feel fine in public. You could probably get a better one if you are staying flat.

Dx 7/31/2020, DCIS/IDC, Left, 2cm, Stage IIA, Grade 2, 0/8 nodes, ER+/PR+, HER2- (FISH) Surgery 9/14/2020 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Chemotherapy 11/6/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 1/31/2021 Reconstruction (left): Silicone implant Hormonal Therapy 2/8/2021 Femara (letrozole)
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Nov 2, 2020 11:29AM suzopedia wrote:

abc54321

thanks so much for the tip about the block. I met with my breast surgeon this morning and asked about that and she said yes, we could ask the anesthesiologist to do that. I was concerned because I wouldn't be spending the night in the hospital. I wondered how bad the pain would be.

You love your scar. Good to know. I remember the first time around in 2005 I wouldn't even consider a mastectomy. Not sure exactly where that came from. The thought terrified me. Heh-heh. I'm sure I will have scars that I will get to love also.

I found a good website for bras that work for mastectomies especially singles. Handful.com I bought one of their bras. You can put thin forms in each side so you can even out. They were super nice and bc survivors get a big discount.

thanks for your response.



Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Nov 2, 2020 11:48AM suzopedia wrote:

marie914,

I have decided to try an implant. When I met with the plastic surgeon, he thought he could use the direct implant procedure and I would go home with the implant. I'm already small on the left side from my surgeries 15 years ago so a small implant on the right would be just ducky. Added benefit, I won't have to wear a bra most of the time. They put the implant in and check you out, blood flow, etc. If it doesn't work they take it out and put in an expander. And I'll go through the fill/exchange procedure.

I guess in a few months I'll be on here saying "yeah, no big deal". It seemed like a really big deal to me, but now that the plans are made and I've talked with both surgeons, my MO and the psychologist from her office, I'm starting to relax a little. I wasn't ready to just see a scar but if that's how it works out, I'm sure I'll adjust. So, hoping for the easiest case but I'll take whatever I get. Thanks for your input.

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Nov 2, 2020 12:25PM Beesie wrote:

I'm glad you are feeling more comfortable with your decision. If your only surgical option is not what you would willingly choose (not that any of us would choose to have any surgery!), it's natural that it takes a while to get used to the idea - I know that was certainly the case with me.

Do you have your surgery date?


Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole
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Nov 2, 2020 01:02PM suzopedia wrote:

sent you a PM

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Nov 12, 2020 10:21AM suzopedia wrote:

Well the deed has been done. I had surgery on Tuesday and it's Thursday and I'm doing good. I have pain, but its tolerable. I think I'm with you Marie914, I would have done just as well without an implant. The direct implant didn't work and I have a tissue expander. I have these awful antibiotics I have to take. I don't do well with them. I have had c-diff in the past. So another adventure for me. I'll get though it. Now if I just get a good pathology report. Fingers crossed.

Dx 1/5/2005, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+, HER2- Surgery 2/24/2005 Lumpectomy Chemotherapy 2/28/2005 TAC Radiation Therapy 6/1/2005 Whole-breast: Breast Hormonal Therapy 7/31/2005 Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 7/23/2020 Lumpectomy: Right Dx 7/27/2020, DCIS, Right, 3cm, Stage 0, Grade 2, ER+/PR+ Surgery 9/21/2020 Lumpectomy: Right Dx 9/27/2020, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+
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Jan 1, 2021 11:09AM - edited Jan 1, 2021 05:49PM by luv2walk2

This Post was deleted by luv2walk2.
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Jan 1, 2021 11:53AM Beesie wrote:

luv2walk2, to get the attention to your own situation, can I suggest that your start your own discussion thread, rather than tag onto suzopedia's thread?

To get the most people to see your post and offer their support, the Just Diagnosed forum is probably best - here's a link: https://community.breastcancer.org/forum/5

Near the top of the page you can see where to click to "Start a new Topic". The easiest thing to do is just highlight & copy your post from here and then paste it into the new post - that way you don't have to rewrite everything. Then you could delete this post, so that all your information and responses are in your new thread.

One thing you could clarify is your diagnosis. You say "My cancer is papillary and in the milk duct. It is supposedly 1 x .7 x 1 cm, with an invasive spot measuring. 15 cm." What it sounds like is that you have a small invasive cancer that is .15cm in size, along with a larger area of DCIS (which is in the duct). If that is correct, is it the DCIS that is papillary? Because if so, this is quite common and very different than papillary invasive breast cancer, which is rare. The DCIS portion of the diagnosis a non-invasive condition; the more serious condition is the invasive cancer, and if yours is .15cm (1.5mm), that is extremely small, just a tiny bit larger than what's called a microinvasion. But I'm just guessing here, which is why clarification would help. Perhaps you can copy exactly what's in the biopsy pathology report.





Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole
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Jan 1, 2021 05:49PM - edited Jan 1, 2021 06:11PM by luv2walk2

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Jan 1, 2021 08:40PM MinusTwo wrote:

Sorry to report that we were apparently unable to connect with Luv2Walk. She has deleted all her posts from all the threads she joined.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014

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