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Topic: Path Report, Just diagnosed, Metastic Carcinoma in Lymph Node

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Nov 3, 2018 10:13AM

duncmelsmom wrote:

Hi all-

I'm hoping to hear that someone has a very similar experience as I have, and can tell me what to expect. Here are the chain of events:

Oct 11 - Found lump while putting on deodorant, went to Primary dr, sent to mammogram, then ultrasound

Oct 16 - Sent to Breast Specialist

Oct 19 - 5 tissue samples Biopsy

Oct 25 - the "call"; Breast Cancer...will schedule MRI and Oncology visit

Nov 1 - go to Breast Specialist to see if Biopsy was healing, he goes over pathology with me:

Final Diagnosis: Metastatic Carcinoma, Compatible with breast primary within lymph node tissue

ER - Weak Positive 20% Staining

PR - 0% Staining Negative

HER2 Score 1+ Negative 0% Staining

Breast Specialist doctor says that this will probably be treated as a Triple Negative by the Oncologist. He says that I'll probably begin the 6-8 rounds of Chemo within the next 2 weeks (2 weeks between each treatment), next have surgery to remove the lymph node, then start quite a few radiation treatments.

This seems really scary. Thoughts? Am I going to be able to teach while being treated? I see online that Metastatic Breast Cancer is Stage IV and only 22% live after 5 years. I really have positive thoughts about all of this. I haven't shed a tear. I just want to hear the good, bad, and ugly, so I am prepared.

What's next:

Nov 6 - MRI to look for the source (there's no sign in either breast)

Nov 7 - Meet with oncologist to discuss the start of treatment

Thanks y'all!!


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Nov 3, 2018 10:25AM - edited Nov 3, 2018 10:28AM by MoonGirlJess

I might have chemo brain and missed something, but you think you're a stage IV? If you haven't had the bone scans or CT chest/abdomen I'm unsure if they can stage you. My BC was in my nodes and I'm a stage 2b.

Sorry for the diagnosis! And yes this is really scary. You’re in good company here.

Jess

Pleomorphic Dx 6/6/2018, ILC, Left, Stage IIB, Grade 2, 3/9 nodes, ER+/PR+, HER2- Surgery 6/21/2018 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left Chemotherapy 7/29/2018 AC + T (Taxol)
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Nov 3, 2018 10:35AM CaliKelly wrote:

Hi, just want send you some love and encouraging words. I don't really know about the primary b.c. being in lymph nodes, but I do know that my cancer was in my lymph nodes, that how I found it, couldn't feel lumps in my breast, they were always lumpy But I knew that jelly bean in my armpit wasn't right. Its metastatic to the lymph nodes, but i was considered stage 3C . Not stage 4 if its in the axillary nodes. Ultrasound, biopsy mri found large tumor in my breast and lots of affected axillary nodes. Had all the recommended treatments, finally finished last year, doing great, so dont panic, you dont seem the panicky type, Confirm the stage with your Dr. I thought , not stage 4 if in the lymph nodes! Treatments all do-able. Youll take days off for recovery from surgery, and couple of days off after chemo infusions, its tiring, you'll feel flu like, few days. Radiation you can totally work, just schedule it early a.m. I went right to the gym after. Get all your info from Dr's, then come back here for help and encouragement!

Dx 6/17/2015, IDC, Left, 6cm+, Stage IIIC, Grade 2, 8/20 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 8/10/2015 TAC Surgery 1/19/2016 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/29/2016 Arimidex (anastrozole) Surgery 6/28/2016 Reconstruction (left): Silicone implant Chemotherapy 11/2/2016 Xeloda (capecitabine) Surgery 10/6/2017 Reconstruction (left): Latissimus dorsi flap Surgery Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Nov 3, 2018 10:36AM duncmelsmom wrote:

Well, I must admit, I thought maybe a Stage IV due to Dr. "Google". When I googled Metastatic Breast Cancer, it said "Stage IV". The breast specialist said it's definitely at least a 2. Thank you, MoonGirlJess for clearing that up! That's why I'm here. I hope to clear up some of my fears and self-diagnosis-es.

LOL....

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Nov 3, 2018 10:40AM duncmelsmom wrote:

Thank you, CaliKelly. It's so good to hear how others handle(d) their treatments. I guess I should explain my lymph node. It's 4.5cm and the other Lymph Nodes look fine. In the mammograms, there is nothing concerning in either breast. Tuesday's MRI is to look at the breast and see if something "lights up" as cancer. I think I'm supposed to hope that it's there. I had a mammogram in Jan. '18 that had normal looking Nodes. I think this is quickly growing.

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Nov 3, 2018 11:15AM Dani444 wrote:

duncmelsmom- I have ILC so very different from TN, but I have positive nodes and I am stage 1b. I didn't get my pathological stage until after my surgery and final path. So sorry for your diagnosis,and Dr. Google is not your friend! There are great articles on this site, and these folks are a wealth of knowledge for sure. Keep us posted and ask away with any other questions. I have just started down the treatment road as I am healing from my mastectomy. It all seems so overwhelming in the beginning and does get a little better when you have a treatment plan in place.

DX @ 46, premenopausal, mammaprint low risk Dx 8/21/2018, LCIS/ILC, Right, 4cm, Stage IB, Grade 2, 2/3 nodes, ER+/PR+, HER2- (IHC) Surgery 10/24/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Silicone implant
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Nov 3, 2018 12:23PM duncmelsmom wrote:

Thanks for your story, Dani444. I'm so surprised that you didn't learn your stage until after your surgery! Don't worry, I am totally stepping away from Dr. Google and will rely on this website for info. Hang in there with your treatments as I have read that they can be yucky. I'm looking forward to learning my treatment, just as you said. Keep staying so positive! ;)


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Nov 3, 2018 01:07PM Trishyla wrote:

Duncnelsmom,

No one gets their final staging until after surgery. They may think you are a stage 2, but if your breast tumor is large, you may end up as a stage 3. Conversely, if your tumor is tiny, and the axillary nodes are the only ones with cancer, you could be restated as a 1B. Since you will be treated as a TN (triple negative) you probably won't know your final staging until about May of next year, after neoadjuvant chemo and surgery.

As far as the chemo goes, it's very doable. As a TN I had the standard 4 rounds of bi-weekly Adriamycin/Cytoxan followed by 8 weekly rounds of Taxol. You will lose your hair, but that's doable as well. Wigs aren't so bad in wintertime🙂.

Good luck to you. We're here for you..

Trish


Dx 8/30/2016, IDC, Left, 1cm, Stage IIA, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 8/30/2016, IDC, Right, 1cm, Stage IA, Grade 3, 0/1 nodes, ER-/PR-, HER2- Dx 9/6/2016, IDC, Left, 1cm, Stage IIA, Grade 2, 1/2 nodes, ER+/PR+, HER2- Chemotherapy 9/28/2016 AC + T (Taxol) Surgery 4/4/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Nov 3, 2018 01:26PM duncmelsmom wrote:

Wow...thanks Trish! That seems doable like you said. The meds you mentioned are Chemo meds? I was just wondering what Chemo's process actually is. That's how much I really know about cancer (almost none). It sounds like so many have been through this. I feel like I'm part of an exclusive club of strong women!

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Nov 3, 2018 03:58PM Claire_in_Seattle wrote:

Dear duncmelsmom,,

I also realized that a grossly swollen lymph node was not normal, and went for help. I am just fine, as thankfully only one lymph node was involved. Distant metastases are what you need to be concerned about. That would be the reason for additional testing and scans.

I just did a chilly 20 mile bicycle ride in the rain which brought back memories of a similar ride 9 years ago following my first chemo. I learned on that ride that I would most likely be able to cycle all the way through chemo, but not anything too ambitious. And this proved to be true.

I also lost my hair etc. with the benefit that I now have a fab hair stylist so look much more chic than previously. As for wigs, a beret works great to keep them in place when venturing outside. I also had a cycling wool helmet liner which could do with replacing about now.

While treatment is no fun, I found that it was hardly the end of the world. 

Sending good vibes your way. If you are triple negative, it's really important to do chemo as your primary mode of attack after surgery. 

You will get your final staging after surgery, but I am guessing that you will also turn out to be 2b. - Claire 

Completed all treatment (AC +T, lumpectomy, radiation and 5 years of AIs - anastrazole). Now celebrating every single day for the wonderful life I have been granted. Dx 8/2009, IDC, Left, 2cm, Stage IIB, Grade 3, 1/21 nodes, ER+/PR-, HER2- (FISH)
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Nov 3, 2018 04:06PM Trishyla wrote:

Don't know where you are, but if you're in the U.S., then those are the standard chemo drugs for triple negative breast cancer.

Unfortunately, you'll start to know all of this terminology. It comes with the diagnosis.

Good luck to you, sweetie. Come here as often as you can. The wonderful women (and men) on this site will help you in any way they can. Sending warm hugs.

Trish

Dx 8/30/2016, IDC, Left, 1cm, Stage IIA, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 8/30/2016, IDC, Right, 1cm, Stage IA, Grade 3, 0/1 nodes, ER-/PR-, HER2- Dx 9/6/2016, IDC, Left, 1cm, Stage IIA, Grade 2, 1/2 nodes, ER+/PR+, HER2- Chemotherapy 9/28/2016 AC + T (Taxol) Surgery 4/4/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Nov 3, 2018 04:30PM LaughingGull wrote:

Hi duncmelsmom,

I was you a year ago. Same exact steps, except I started on Oct 22nd 2017, and my cancer was triple positive. Breast cancer that has metastasized to your lymph nodes is not Stage IV cancer even if the biopsy says metastatic. If it is not anywhere else, it would be early stage, stage II or so, depending on size of primary tumor and other stuff. Those first weeks were terrifying and I thought I would die within months. Please take a deep breath.

I also had 4 biweekly rounds of AC, then I had Taxotere + Herceptin + Perjeta, four every-three-weeks rounds. It was hard-ish but doable. I worked (I do office work) during chemo, and went on disability for a month when I had surgery. Kept life as close as normal as possible during the chemo months. I rested a lot more than normally, though; I didn't do much other than going to the office and work out lightly. It all went fast. By March I was done with chemo. By end of June I had (very short) hair. Life is kind or normal now. Take care of yourself. Wish you best.

LaughingGull

Dx 10/26/2017, IDC, Right, 3cm, Stage IIB, Grade 3, 2/6 nodes, ER+/PR+, HER2+ (IHC) Chemotherapy 11/16/2017 AC Chemotherapy 1/18/2018 Taxotere (docetaxel) Targeted Therapy 1/18/2018 Perjeta (pertuzumab) Targeted Therapy 1/18/2018 Herceptin (trastuzumab) Surgery 4/26/2018 Lymph node removal: Underarm/Axillary; Mastectomy: Right; Reconstruction (right): Tissue expander placement Targeted Therapy 5/16/2018 Perjeta (pertuzumab) Targeted Therapy 5/16/2018 Herceptin (trastuzumab) Radiation Therapy 6/5/2018 Whole-breast: Breast, Lymph nodes, Chest wall Surgery 7/27/2018 Prophylactic ovary removal Hormonal Therapy 8/17/2018 Arimidex (anastrozole)
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Nov 4, 2018 05:36PM Bookworm14 wrote:

duncmelsmom,

Saw this thread and just wanted to respond. First off, sorry to hear of your diagnosis. It sucks, but this site and the people really help to make a tough situation better. I completely understand your concerns over seeing Metastatic in lymph nodes! Completely freaked out when I saw that something very similar on my path report I ntil some very nice ladies in the October 2018 Surgery forum helped to explained it to me. Also many of the ladies on here provided excellent info and excellent explanations of what the Metastatic meant in your report. Just keep your head up and eat wishes with the rest of tourneys tests and treatments.

Diagnosed @35, BRCA2 + Surgery 10/14/2018 Lymph node removal: Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Dx 10/25/2018, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 1/16 nodes, ER+/PR+, HER2-
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Nov 6, 2018 02:49AM claireinaz wrote:

I also want to point out that grade (speed of growth) also counts. You'll find out all that after your surgery. I echo the others: you aren't Stage IV till they tell you (and I bet you aren't), and Dr. Google is often unreliable, lies, or offers really old research to scare us all silly. What you probably read was a stat that didn't even factor in treatment for stage IV cancer. It could very well have been reporting something like "without tx, Stage IV bc patients only live 22%" etc. etc. I had to learn how to read a scientific article, how to look up definitions, how to gauge how old the research was, and I couldn't do any of that till I talked myself off the cliff of the initial shock that I had c to begin with.

If you are triple negative you'll get good aggressive treatment to kick cancer to the curb, and there is an active discussion thread for triple negative on these boards, too. Hang in there--we are here for you!

9/29/11 ILC, 2 c. stage II grade 1, ER/PR+ HER2-, 6/11 nodes, lumpectomy, DDAC x 4, Taxol x 12, 33 rads, Tamoxifen/arimidex/aromasin, BMX/immed recon 7/3/13 "In the midst of winter, I found in me an invincible summer.” Albert Camus
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Nov 6, 2018 07:15AM CaliKelly wrote:

Just wanted to send you best wishes and positive vibes for your mri results and upcoming meetings with oncology and surgeon and whatever else you have scheduled. Anytime you need advice, clarity and encouragement, come to these boards. Someone here will have gone through whatever you are feeling or facing! When I was going through all my various treatments, I'd come here when I had questions that seemed too trivial to call my doctor, I'd always find answers! Even just quality of life, or"vanity" questions. Good luck! You can do it! And by IT, I mean ANYTHING!(My Mom's quote to me)

Dx 6/17/2015, IDC, Left, 6cm+, Stage IIIC, Grade 2, 8/20 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 8/10/2015 TAC Surgery 1/19/2016 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/29/2016 Arimidex (anastrozole) Surgery 6/28/2016 Reconstruction (left): Silicone implant Chemotherapy 11/2/2016 Xeloda (capecitabine) Surgery 10/6/2017 Reconstruction (left): Latissimus dorsi flap Surgery Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Nov 6, 2018 12:08PM duncmelsmom wrote:

Thanks you guys! I no longer feel so gloom and doomish. Today I had my MRI. They didn't tell me I would have an IV for dye. Other than that, it wasn't bad at all. They were super nice, and I was able to go back to work afterwards.

Tomorrow is the meeting with the oncologist. The waiting is finally coming to a hault (I hope he doesn't have an emergency and can't make the appt). They needed a medical advance directive, so that's done. My husband and I needed to do that anyway. Tomorrow I can meet everyone in the November 2018 Chemo thread, since I think I'll know my schedule. Thanks for making this girl feel better about things, especially the metastatic part of my dx!

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Nov 8, 2018 05:49AM Each_day_2018 wrote:

I too am surprised about a stage IV diagnosis before you've had scans/surgery, etc. In most cases, they cannot determine stage until after surgery when they get the pathology report back. This was the case with me. I even asked my doctors about stage and they were hesitant to even provide an answer because they didn't want me to worry unnecessarily, and quite frankly, they just didn't know until after the surgery. Mine had spread to the lymph nodes, but not to any organs, bones, etc and they didn't even know that until after the surgery results came back.


Try not to worry too much until you have ALL of the information. Don't drive yourself crazy trying to piece together the missing parts. It'll drive you crazy! Best wishes at your appointment and hope you get better news!

Dx 6/28/2018, IDC, Left, 4cm, Stage IIIC, Grade 2, 3/4 nodes, ER+/PR+, HER2- Surgery 9/5/2018 Mastectomy: Left Dx 9/6/2018, LCIS, Left, <1cm, Grade 2, 3/4 nodes, ER+, HER2- Chemotherapy 10/10/2018 AC + T (Taxol)
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Nov 8, 2018 06:35AM CaliKelly wrote:

Yes, please, please, do not assume stage 4! I had 8 axillary nodes still positive after chemo, when i had my mastectomy. Out of 20 nodes removed. I was staged 3C before chemo, and 3A after chemo and surgery. We threw the entire arsenal at it, and right now...CANCER FREE! They don't say cured, but to me, I am cured! And doing GREAT, so even if it's locally advanced ( in your lymph nodes, like me,) youll be ok. Just have some challenges to get through, one by one. You will discover inner strength you didn't know you had! You are a tough girl, we all are!😚❤❤❤

Dx 6/17/2015, IDC, Left, 6cm+, Stage IIIC, Grade 2, 8/20 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 8/10/2015 TAC Surgery 1/19/2016 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/29/2016 Arimidex (anastrozole) Surgery 6/28/2016 Reconstruction (left): Silicone implant Chemotherapy 11/2/2016 Xeloda (capecitabine) Surgery 10/6/2017 Reconstruction (left): Latissimus dorsi flap Surgery Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Nov 8, 2018 02:21PM duncmelsmom wrote:

Thanks you all. I think I jumped to the wrong conclusions. I finally met with the oncologist yesterday. He said not to worry about the Stage. Because I'm TNBC, I'm going to start on the maximum amount of Chemo first (8 treatments biweekly). It doesn't matter if I'm stage II or stage IV, I'm going to have the same treatment. The Stage will be more important after Chemo and before surgery.

I'm starting to understand about 5% of this strange trip I'm on.

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Nov 13, 2018 03:26PM Perez598 wrote:

I love the support on this thread! I am finished with surgery and chemo. I worked all through chemo and only took time off the day of chemo and the next day. I had treatment every other week due to TNBC status. I am now in the middle of 33 radiation treatments. I found out staging after surgery and 10 days after surgery, while my mom was at my house taking care of me, she passed away suddenly of a stroke. I thought there is no way I am going to get through all of this without her but I am doing it. One day at a time. You can do this! It is all doable if you just get through each phase.

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Nov 13, 2018 03:45PM Kat22 wrote:

Couple things: You will get through this, as others have already said. It ain't easy, but hey, this is the best resource in the world, and the support is phenomenal.

Don't rely toooo much on imaging, be it MRI or ultrasound. Useful tools, but until they cut whatever is there out of you, no one will know for sure. I wish I had known that earlier. Would have saved me a lot of worry.

There will probably be days where you feel like you absolutely cannot do another chemo. Guess what? Yes you can! I was triple positve, different chemo regimen than you'll like have. After treatment #5 of 6 I told my MO that I CAN"T do any more. She wasn't having it lol. So I went for #6, then a month later I went for surgery (lymph nodes and lumpectomy on 2 spots in breast). That was Oct. 25. Now I feel better than I ever thought I would again, and am cancer-free!

Good luck to you, you got this! Hugs.

Dx 4/6/2018, DCIS/IDC, Right, 5cm, Stage IB, Grade 2, ER+/PR+, HER2+ Targeted Therapy 6/5/2018 Herceptin (trastuzumab) Targeted Therapy 6/5/2018 Perjeta (pertuzumab) Chemotherapy 6/6/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 10/24/2018 Lumpectomy: Right; Lymph node removal: Right, Sentinel
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Nov 13, 2018 05:08PM Salamandra wrote:

Perez,

I am so so sorry about your mother. It is terrible to lose that bond and support.

I have found solidarity and help from the Motherless Daughters books and Facebook group.

Hang in there.

Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 12/3/2018 Whole-breast: Breast
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Nov 14, 2018 01:07AM duncmelsmom wrote:

Perez598, I'm so sorry about your mother passing. That had to have been so difficult. You're amazing for pulling through! Are you saying that you only missed a couple of days of work? Wow!

Kat22, great advice well taken. I'm not going to worry until they cut inside. I've heard something like that before, and needed to hear it again! Thank you!

Much love everyone!!



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Nov 14, 2018 06:55AM CaliKelly wrote:

Hi Duncmelsmom, Have you been given your chemo type and schedule? I know TN is different chemo mix than mine, but want you to know, I had TAC chemo×6 every 3 wks. I wasn't working at the time but I'd say I would have wanted maybe 3 -4 days off each cycle. If you could have your chemo sessions on a Thursday let's say, recovery over the weekend you might be good to go by Mon.Just be really germ conscious, your immune system is compromised on chemo. They do your blood count before every infusion and won't do it if counts are too low. Mine were always ok. I never threw up from chemo, took anti nausea meds. But I still lost weight, food very unappealing 😜 I only wanted bland food, because nothing tasted right! Even water! I forced myself to drink my kale &berry protein smoothies. Even put ice cream in it to gain! Food took awhile to taste right. Avoid vinegar, spicy food tomato sauce, all caused major digestive and mouth problems. My lips were so sore! Keep them protected! So much more advice!😂 Can't put it all in😄😚💜

Dx 6/17/2015, IDC, Left, 6cm+, Stage IIIC, Grade 2, 8/20 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 8/10/2015 TAC Surgery 1/19/2016 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/29/2016 Arimidex (anastrozole) Surgery 6/28/2016 Reconstruction (left): Silicone implant Chemotherapy 11/2/2016 Xeloda (capecitabine) Surgery 10/6/2017 Reconstruction (left): Latissimus dorsi flap Surgery Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall

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