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Apr 25, 2008 09:00AM
Apr 25, 2008 09:03AM
Sorry you have to deal with this. If it were me I would get an appointment with a specialized breast cancer treatment center where the surgical, medical and radiological oncologists all work together as a team and review a patient's history together when making treatment decisions.
It is true that for many of us after initial diagnosis from a biopsy, will see the surgeon to discuss removal of the tumor, but there are many other factors to consider such as tumor size, tumor type, patient age etc. which can determine whether or not surgery is recommended as the first phase of treatment.
That being said, I believe for many women in your age group and particularly with Invasive Lobular Cancer, chemotherapy is much less likely to be used except in situations of known locally advanced growth with nodal involvement or possibly in the case of a hormonally negative ILC, which is rare.
Detecting tumor size and nodal involvement is not a perfect science with any of the scanning techniques, but I do believe that MRI may be more reliable in the case of ILC. Many women's ILC tumors are never picked up by standard mammogram or ultrasound, but a MRI can pick up the tumor more reliably. Size is often over-estimated or under-estimated by scans, however, and nothing short of surgical removal will be totally acurate.
It is so good that you are asking these questions now, so early on in the process. I would definitely want to set up an appointment with a medical oncologist as my first step to discuss the specifics of how she would envision your treatment plan to be, based on what they currently know about your tumor. Things may always change after knowing for sure if there is any nodal involvement, actual tumor size and hormonal status, but at least she can give you a general feeling for what is most likely to be your treatment plan. Discuss with the oncologist which scanning methods she would prefer to gain as much accurate information as possible prior to any surgical intervention.
At that point, make sure you see a surgeon who specializes in breast oncology. You do not want to go to a general surgeon who only sees a breast cancer patient "on occasion". If you have a breast cancer center in your area, finding a medical oncologist there will give you access to all their resources including the surgeons and radiologists who specialize in breast care.
Do not let anyone make you feel rushed during this very important decision making process. Taking a few more weeks or even a couple months to fully explore your options will be well worth it. Once you have a treatment plan in place with a team of professionals you feel you can comfortably communicate with, you will be well on the road to recovery!
Let us know how it goes. Continue to ask questions as they arise and you will find tons of good information here on these forums.
Life is not measured by how many breaths we take...but by the moments that take our breath away! ...I am a 14/9 yr survivor of 2 Primary BCs, 23/23 Positive Nodes (Zometa x 5 years) Started Paloma-3 Clinical Trial 4-14-14
7/14/2000, IDC, 1cm, Stage IIA, Grade 1, 2/7 nodes, ER+/PR+, HER2-
8/11/2000 Lumpectomy: Right; Lymph node removal: Right, Sentinel
8/30/2000 AC + T (Taxol)
2/26/2001 Breast, Lymph nodes
11/21/2005, ILC, 5cm, Stage IIIC, Grade 1, 23/23 nodes, ER+/PR-, HER2-
12/5/2005 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right
12/23/2005 Taxotere (docetaxel), Xeloda (capecitabine)
4/7/2006 Aromasin (exemestane)
4/7/2006 Breast, Lymph nodes
3/21/2014, ILC, Stage IV, mets, ER+/PR-, HER2-
4/14/2014 Faslodex (fulvestrant)