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Topic: waiting for Biopsy- what is the average treatment course?

Forum: Waiting for Test Results —

For members not diagnosed with breast cancer, but waiting for test results:  Biopsy, mammogram, ultrasound, or other screening tests. Waiting is VERY difficult but remember...

"Worry does not empty tomorrow of its sorrow. It empties today of its strength." -- Corrie Ten Boom

Posted on: Feb 17, 2017 09:39AM

Jbburlington wrote:

Im a newbie, this is my first post. i had a routine Dr breast exam Jan 19, no lumps. Feb 1st i find a significant lump. ultrasound and mammo done. Feb 15 i am given a bi-rad 5. waiting for core biopsy this coming Tuesday. I have totally accepted breast cancer as diagnosis and i am strong, faithful, surrounded by love and ready to fight. :)

I run my own landscape business which i assume i will have to give up for the year but it would be helpful to have an idea what this might look light. So i understand that speculation is probably not a favorite topic here but here is my question...

IF... it turns out to be all the averages...IDC at a stage 2(lets say) and i am a previously healthy, fit ,pre menopausal mom of 4, 47 years old...what might be the average order of treatments and time lines for surgery, radiation, hormone, chemo? I am in Ontario, Canada. Referral to surgeon has already been made with anticipation of biopsy results.

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Feb 17, 2017 10:05AM Scwilly wrote:

I am wishing you a benign result from your biopsy, or if not that you have a low stage cancer.

I was DX with stage 3 Inflammatory BC in Nov 2013, had 5 months of chemo, a month off, surgery, another 5-6 weeks off then radiation 6 weeks, finishing up in Jul 2014. So my treatment lasted about 8-9 months. For lower stages without chemo the time would be a lot less.

Best wishes.


Dx 11/4/2013, IBC, Left, 2cm, Stage IIIB, Grade 2, 0/3 nodes, ER-/PR-, HER2- Chemotherapy 11/14/2013 AC Chemotherapy 1/14/2014 Taxol (paclitaxel) Surgery 4/29/2014 Radiation Therapy 6/24/2014 Whole-breast: Breast, Lymph nodes, Chest wall Dx 2/16/2015, DCIS, Right, 2cm, Stage 0, Grade 2, 0/6 nodes, ER+/PR-, HER2- Surgery 4/6/2015 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Surgery 3/23/2016 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 11/15/2016, Stage IV, metastasized to liver, ER+ Hormonal Therapy 11/15/2016 Arimidex (anastrozole) Targeted Therapy 2/17/2017 Ibrance (palbociclib) Chemotherapy 8/31/2017 Xeloda (capecitabine) Dx 4/5/2018, Stage IV, metastasized to bone, ER+ Surgery 4/5/2018 Radiation Therapy 4/18/2018 Chemotherapy 5/3/2018 Other Hormonal Therapy Aromasin (exemestane)
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Feb 17, 2017 10:06AM cliff wrote:

the treatment and length of time depends on the cancer. they should know when the biopsy comes back. for example, my treatment is one pill a day and one shot per month.

Dx 3/16/2016, IDC, Left, 1cm, Stage IV, metastasized to bone, 2/21 nodes, ER+/PR-, HER2- Surgery 4/1/2016 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 17, 2017 10:10AM ElaineTherese wrote:


There is no average treatment course. Your treatment regimen will depend on a number of things: type of cancer, growth rate of cancer, size of cancer, whether it is fed by estrogen, whether its growth is fed by an overexpression of the HER2 protein, whether it is invasive, choice of surgery, whether it has spread to the nodes, and whether (if ER+/HER2-) an oncotype test shows that the benefits of chemo outweigh the risks of chemo.

That said, about 80% of invasive BC is IDC (invasive ductal carcinoma). Most of the women with IDC are ER+/PR+/HER2-. If you fit that profile, your cancer will be tested after surgery with an oncotype test to determine whether or not you will benefit from chemo. Many women don't benefit from chemo, and they can skip it.

If you are triple negative (ER-/PR-/HER2-), you will be advised to do chemo. If you are triple positive (ER+/PR+/HER2+) or ER-/PR-/HER2+, you will be advised to do chemo. Chemo can take 4 -- 6 months to complete, depending on the regimen.

If you choose a mastectomy, you might be able to skip radiation (but you might not). If you choose a lumpectomy, you will be advised to do radiation. Radiation can take 4 -- 6 weeks.

So, as you can see, there is no one path. It can vary significantly from patient to patient. As a triple positive, I ended up doing five months of chemo, six weeks of radiation, and a year of targeted therapy. Most women don't have such a lengthy course of treatment.

Best wishes!

DX IDC June 28, 2014, 5 cm., 1 node tested positive (fine needle biopsy); 0/20 after neoadjuvant chemo + ALND; Grade 3; ER+ PR+ HER2+ Neoadjuvant chemotherapy starting 7/23/14 ACX 4, Taxol X 12, Perjeta X 4; Herceptin: one year Chemotherapy 7/22/2014 AC Targeted Therapy 9/16/2014 Perjeta (pertuzumab) Targeted Therapy 9/16/2014 Herceptin (trastuzumab) Chemotherapy 9/16/2014 Taxol (paclitaxel) Surgery 1/11/2015 Lumpectomy: Right; Lymph node removal: Right, Underarm/Axillary Hormonal Therapy 2/24/2015 Aromasin (exemestane), Zoladex (goserelin) Radiation Therapy 3/8/2015 Breast, Lymph nodes
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Feb 17, 2017 11:24AM Jbburlington wrote:

I DO totally understand that there are many factor depending on results and no one answer. But getting an idea of what it may look like depending on results, is so VERY helpful. THANK YOU! The more stories i hear, the more prepared i will be when presented with results and future decisions. :)

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Feb 17, 2017 11:58AM Luckynumber47 wrote:

Think of this as a Chineese restaurant - 1 from column A, 2 from column B, etc., depending on your needs. This is my experience with a BMX, no reconstruction, no radiation, no chemo, no Lymphedema:

2 months of intense Drs appts, tests, surgery, follow up appts, etc, but I could still be as active as I wanted before surgery. I was out digging fence post holes and trying to get as much gardening done as possible before surgery.

I had 1 lymph node removed from each side during my BMX and spent 1 night in the hospital.

My BS hinted that I might not need chemo but was careful to say only my MO could say for sure. My first MO appt was 1 month after surgery and that is when I got my Oncotype results, so the uncertainty about chemo went on for a long time.

No gardening at all for about 1 month after surgery - bending over is not good for recovery of BMX.

By 3 months I was doing some heavy yard work (shoveling, etc) At 4 months I painted the whole outside of my house. At 5 months I started remodeling my kitchen - ripping out walls and ceiling, hanging insulation and drywall.

If you have a lumpectomy recovery will be shorter but add in up to 2 months of daily radiation. Only you will know how much you are up to.

If you have more lymph nodes removed then that recovery could also take longer.

I don't know anything about chemo, either as neoadjuvant (before surgery) or adjuvant. I guess that would be in column C

I'm 15 years older than you so you might bounce back a little more quickly. I just refused to let this ugly cancer keep me from doing what I wanted to do so I pushed myself pretty hard

The unexamined life is not worth living. (Socrates) My avatar is a Blue Footed Boobie. Cracked me up. Dx 2/15/2016, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 3/16/2016, DCIS, Right, <1cm, Stage 0, Grade 3, 0/1 nodes, ER-/PR- Surgery 4/6/2016 Mastectomy: Left, Right Hormonal Therapy 5/16/2016 Femara (letrozole)
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Feb 17, 2017 12:41PM wallan wrote:


sorry to hear about your diagnosis.

I am in Ontario Canada and been thru treatment here.

it took obout 6 weeks to recover from mastectomy, 4 months of chemo, and 6 weeks of radiation. I went to the Juravinski Cancer Centre. This was in 2004. I was 41 at the time with a 7 year old. I had stage 2B/3A ER+PR+her- with 2 positive nodes at the time.

I understand totally where you are coming from. The disruption and waiting is torture. I too want to know how long and what to expect.

Feel free to PM me for support.


Dx 3/29/2004, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/18 nodes, ER+/PR+, HER2- Surgery 3/31/2004 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Chemotherapy 5/31/2004 AC + T (Taxol) Radiation Therapy 11/30/2004 Whole-breast: Breast, Lymph nodes, Chest wall Dx 1/25/2017, LCIS/DCIS/ILC/IDC/IDC: Mucinous/IDC: Cribriform, Left, <1cm, Stage IB, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 3/7/2017 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Fat grafting Hormonal Therapy Aromasin (exemestane), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 17, 2017 01:21PM BG46TN wrote:

Hi! sorry you have to join us here...I am not in Canada, but I am also in my 40's (46) and healthy etc....I was diagnosed in Oct, started chemo in Nov...I have 2 more left, and should have a double mastectomy in the end of April, the possibly radiation and then reconstruction.

I don't think you have to plan on giving up your business...I have worked through my whole treatment so far (i'm a teacher) you may want to plan on cutting back some hours so you can rest more, but really as long as you are feeling ok you should be able to keep doing what your doing. I found that keeping my life as "normal" as possible, helped me get through this better....what was I going to do? sit home all day and worry? I guess maybe I am lucky that I have "minimal" side effects....yes I do have a few bad days each cycle, but nothing too too bad.

You sound like you have a great attitude and a great support system in place if you need it!


BGTN46 Dx 10/24/2016, IDC, Right, 3cm, Stage IIA, Grade 3, ER-/PR-, HER2- Chemotherapy 11/17/2016 AC + T (Taxotere) Surgery Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Feb 17, 2017 01:37PM Kicks wrote:

There is NO way to have a clue about "What is the average treatment course?" when there hasn't even been a DX of BC. The different types (DCIS, IDC, ILC, IBC) have different protocohol that is generally used with most but may be different for others of us who have a particular DX. In addition to type, there is also Stage, Grade, ER/PR +/-, HER2+/-, possible genetic involvement, age, overall health at time of DX, different Drs all come into play as to individual TX plans.

If you want a 'time line' from 'somebody', I can give you mine (but my DX isn't the 'average' nor was my TX plan what the vast majority do). For me, it was neoadjuvant (pre-surgery) chemo (8 weeks), 2 weeks til surgery, UMX, 3 weeks til adjuvant (post surgery) chemo (12 weekly), 1 week til starting 25 rads. My time frame for DX was late June annual mammo (same as for many years), end of July presented overnight as an enlarged lymph node under arm, saw my PA at 11 Aug 8, had new mammo, US and biopsies that afternoon, had path. report from Radiologist the next morning at 8, 17 days later started neoadjuvant chemo after Bone Scan, CT and MRI with contrast, PET Scan which resulted in a biopsy on an area along jaw that 'lit up' (nothing 'showed' in biopsy), an EKG, appts with Surgeon, Chemo Dr (MO), Rads Dr (RO) and port implant.. That and the rest of time since is HX - 7 yrs later, still NED (No Evidence of Disease - the best we can hope for)!

Even IF you do get a BC DX - there is no way (based on so called 'average') you can know how you will react to any TX you might do. Example - many have a worse time with A/C (Adriamycin; Cytoxan) than Taxol, me (and others) found A/C was easier than Taxol.

At least until you have a DX (IF you do get a DX of BC) and know a lot more about your total DX, it is useles to try to make plans for rather or not you need to close your business at alll. Functioning (aka 'living') do not automatically totally cease for a set period of time. Yes, some 'accommodations' will certainly be needed at some times - might need to hire an extra employ (at least part time) to fill in for the times you to be off. Bottom line is - you are the owner/boss so you set your own schedule to work around what you need.

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/25/2009 AC Surgery 10/21/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/11/2009 Taxol (paclitaxel) Radiation Therapy 2/4/2010 Breast, Lymph nodes
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Feb 19, 2017 07:14AM Jbburlington wrote:

All of these replies have been really helpful and I am so thankful 😊 I have been able to prepare my daughters for the best and the worst so there will be little shock if it's malignant as expected. We should know by wed or thurs and surgeon already has my file, she just need results.

So that's my next questions. If it is malignant, how much more will I learn from Core biopsy. I know I will find out type and grade, but what about stage, rate of growth, hormone receptors, her2 etc.

what will I NOT find out from this until further testing/surgery.


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Feb 19, 2017 08:20AM kae_md99 wrote:

i knew my type of cancer,er pr status,grade,her 2 status from my biopsy. her2 status came 2 weeks later. had an mri of the breast that showed no involvement of nipple,chest wall,skin and lymph nodes. but pathology after surgery will be the final say as to lymph node status. ultrasoud also cleared my nodes but mri is more sensitive for that.i was birads 6 so i knew before biopsy that i had cancer. goodluck! ultrasound and mri will give u a size

kae, 1-10-17, IDC,2.5 cm, right,er,pr,her2 (+),grade 2;DCIS, left, er,per(+),grade 2; 2-17-17- Taxotere, Carboplatin ; 2-17-17- Herceptin , Perjeta; july 14,2017,BMX,TE's,SNB,0/3;8/2017,Zoladex;1/26/2018,Arimidex
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Feb 19, 2017 08:40AM cive wrote:

Assuming it is IDC, the only thing you won't know after the biopsy is whether lymph nodes are involved.  They could find that out by doing a sentinel node check with dye, but may not depending on whether you were having a lx or mx.  That said, I think you will be able to work mostly through your treatment even if you require chemo.  You will need some time off from heavy lifting after surgery, but that will be relative to how involved the surgery is.  I and a lot of other people were able to work during chemo and radiation.  You should really give a sigh of relief when you find out it is b9.

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Feb 19, 2017 10:15AM Ridley wrote:

Jb - sorry to hear you are in the waiting game. I'm in Ontario as well and one thing I learned is that if the biopsy comes back as cancer (hoping it won't), you may not know your treatment plan for months. For me it was about 3 months - diagnosis, then more testing, then surgery, then full pathology, then oncotype, etc. As others have said, there are so many things that can impact treatment, that it's important to take things one day at a time. I was anticipating "knowing" what the path would be a few times, and then there would be another step.

Hang in there. Hoping for B9 results for you

Multiple areas of IDC and ILC (largest 1.8 cm) + DCIS + LCIS, Oncotype 8 Dx 6/2013, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 8/22/2013 Lumpectomy: Left; Lymph node removal: Left, Sentinel Dx 11/2013, DCIS, <1cm Dx 12/2013, IDC, <1cm, Grade 2, 0/1 nodes Surgery 12/11/2013 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Surgery 10/7/2014 Reconstruction (left); Reconstruction (right) Surgery 3/26/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Nipple reconstruction Hormonal Therapy

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