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May 11, 2018 04:16PM
Hi Walden, I had similar questions about who should be reviewing the results with me. My surgeon did a good job, but I still went through it with my oncologist. I also did neoadjuvant chemo, and had good results, but not a complete response. My tumor was highly ER/PR+: about 80-85% on biopsy and 95%+ in the residual cells. I was node negative also, and yes, it is a huge!
Does your pathology report states residual cancer cellularity (it should be stated in percentage)? If you go to MD Anderson RCB calculator http://www3.mdanderson.org/app/medcalc/index.cfm?p... you will see that this is the main factor that drives the result for the RCB class (yours is stated as 2).
I'm not sure how this would work with you being in Canada, but I requested a second opinion on my pathology just for my peace of mind from here: http://breastconsults.com/about-us/. This is basically a "one woman" shop, and the pathologist is very knowledgeable. She will also discuss results in detail with you over the phone. They were not covered by my insurance but I gladly paid $135 out of pocket. Second opinion had only one disagreement with the original pathology and that had to do with the size of the residual cancer, although she told me the difference was negligible.
From what I'm reading, adjuvant chemo is not very common after neoadjuvant treatment for ER+. Most doctors agree that anti-hormonals are our best defense. Not sure how high RCB should be for them to consider adjuvant Xeloda, although I'm in a FB group with 2 ER+ ladies who got Xeloda after having no response to neoadjuvant chemo. With good response and negative nodes I would doubt Xeloda would be a treatment of choice, although I'm not an oncologist, of course.
8/31/2017, IDC, Right, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2-
9/15/2017, DCIS, Left, 3cm, Stage 0, Grade 1, 0/3 nodes, ER+/PR+, HER2-
9/29/2017 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel)
2/23/2018 Zoladex (goserelin)
2/28/2018 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
2/28/2018 Mastectomy: Left, Right
4/5/2018 Femara (letrozole)
8/21/2018 Prophylactic ovary removal; Reconstruction (left): Saline implant; Reconstruction (right): Saline implant