mom meeting with surgeon tomorrow

caper girl,

Sorry to hear about your mom’s diagnosis. Breast cancer has several variants and hormone status, size of tumor, lymph node involvement all play a part in determining what the treatment plan will be for each person. Until those things are known, and they will be known after the surgical pathology is complete, it’s not really possible to speculate on what her treatment might be. Some of this info might be available as a result of her biopsy sample, but the final pathology report will be what drives it. All the best

capergirl39, Also your Mom will have to see a Medical Oncologist to plan treatment. Sometimes the surgeon's office will assign your Mom to a MO and RO. They will schedule a group meeting with your Mom, after surgery, to talk about a plan of treatment. If this isn't offered your Mom should be thinking about who she would like to see and where.

It depends on what system is in place. Many doctors/medical institutions have patient portals where biopsy/test results can be viewed on line. Others are given paper copies during follow up visits. There is no one way in which this is communicated so be sure to have your mom ask about how she will receive the report

Hmmm, you do need to determine if this is a biopsy or actual surgery such as a mastectomy or lumpectomy. Regardless, a treatment plan is developed by an oncologist based on surgical pathology. Biopsies provide a window into aspects of a persons tumor but treatment plans are based on the surgical pathology report. All the best

capergirl, what your mother needs to understand is that she is the one who gets to decide. Doctors recommend, patients decide. So whatever information your mother needs to make her treatment decisions is owed to her. And no doctor should be making her surgery or treatment decisions without consulting with her first.

In most cases (but not always), the first major decision is the surgery decision - lumpectomy + radiation vs. mastectomy (which usually isn't followed by radiation but sometimes is). With certain diagnoses, if chemo is required, chemo might be given prior to surgery. Your mother needs her pathology and imaging reports to understand her diagnosis and how it affects these different treatment options.

Key pieces of information: Is the cancer ER+ or ER-, PR+ or PR-, HER2+ or HER2-? How large is the area of cancer estimated to be, and is the cancer in one location only or it is multi-focal? What is the grade of the cancer? From imaging, does there appear to be nodal involvement? It sounds like a possible "yes" to the last question but no information yet on any of the other questions. No decisions, even about surgery, can be made without this information.

Get those reports, get the opinion of the surgeon, and let us know how it goes. Lots of us here can help with interpretation of the reports and let you know which factors impact treatment options.

capergirl39

You say your mother is in good shape for age 75. Why not ask her to sign up as a member here so we can see what questions SHE has, and we can talk to her directly? I'm close to her age, and I'd have been very upset (as in furious) if a grown child of mine tried to get involved in my medical decisions.

capergirl, you are right - we shouldn't assume. I think it's just that most of us have been in your mother's shoes and many of us are close to her age, so we're commenting from our own perspective - that's human nature but it also means we sometimes make the wrong assumption. It's easy to get tangled up in words but we're all here to help and offer support, and I'm sure no one intentionally means to be rude. It's great to know that your mother knows that you here and that we can speak to her through you.

With Covid, many doctors don't allow anyone but the patient to be present for appointments. You mentioned that "we meet" with the surgeon tomorrow. Does this mean that your mother is among the lucky few who can bring someone with them to the appointment? It's always good to have a second set of eyes and ears present.

capergirl39, My sister was allowed to bring her daughter to the team meeting. They do make exceptions during Covid! Also, my MO's portal can be shared with family members. Your Mom would have to give her permission. The office staff is usually pretty helpful and the portal is a great resource.

My daughter's best friend parents don't have internet and just got a cell phone last year! They don't text!!

Good luck and let us know how we can help.

Ah, capergirl, I'm sorry.

Did the surgeon refuse to give your mother the pathology report or was the report not signed off yet?

Anything on the ER and HER2? I'm guessing ER+ and HER2-, if the surgeon is thinking oral meds prior to surgery. Of course the recommendation on the sequence of treatments comes from the MO.

As LivinLife said, hopefully the CT scan and MO appointment can be scheduled quickly.

Hello, capergirl and capergirl's mom!

One reason to do either hormonal therapy or chemotherapy before surgery is to shrink the tumor so that breast-conserving surgery (lumpectomy) becomes possible. Another reason to do chemotherpy before surgery is to go after any rogue cells that may be hiding somewhere in the body right away, in cases where the cancer is a more aggressive subtype (either triple negative or Her2 positive). In this case local therapy (breast surgery) comes second.

Some things to know:

If the scan finds the breast cancer has spread, the treatment plan could be quite different from the plan for stage III. It could actually be milder. It also depends on where it has spread. Hopefully it has not! They are right to check now.

Lumpectomy and radiation is typically a package deal, so your mom will want to learn about radiation in order to help with that decision. But in some cases radiation is recommended even if the patient has a mastectomy, when there are nodes that need it.

Do start a binder and collect copies of all reports, especially as your mom does not use a computer which would give her access to a patient portal. It may be easier to ask for a copy when you are there; otherwise you have to submit requests to the medical records department.

There may be a nurse navigator available to your mom, to help smooth the way.

This time when you don't know exactly what is going on or what the plan is, is the most stressful time for most people. You will both feel better when things are settled and you can take action.

This is all do-able. Don't believe horror stories or quack medicine you may read. Your mom's otherwise good health is a great thing in her favor, as is having a supportive daughter.

It sounds like her doctors are really on top of things and moving ahead without unnecessary delays.