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Aug 23, 2017 04:23AM
I had my follow up appointment yesterday. The BS basically released me and I won't see her again until February 2018. The bad news is my pathology still isn't complete. The good new is why it's not ready. I feel like my numbers don't fit at all, but I'll try to explain this so I can hopefully get some good input...
My initial mammo and US was done locally. They showed one suspicious spot, so my gyn sent me to a hospital in the city for an excisional biopsy and said basically it's no big deal. They'll cut it out through the needle and life will go on as before. When I go at to the hospital, they did an US and found 5 spots, 2 of which were suspicious, the other three were cysts. They biopsied the 2 sites and found 1 was a papilloma and the other IDC 7mm. They sent me to an MRI which showed the tumor to be 1.2cm. At this point I saw an MO locally and she suggested I consult with a teaching hospital in the city since I wasn't super pleased with the communication at the first hospital. I met with their team and received another US and mammo which showed the tumor at 8mm. They said the site was possibly inflamed during the MRI which would explain the higher number.
The good news from the lumpectomy is I had clear margins and no node involvement. She took 5 nodes though because they stuck together (is that even a thing) which explains my cording I suppose. She gave me an rx for PT to help with that.
The reason my pathology is taking so long is that my tumor only measured 3mm. They are looking over my old slides and scans and they believe my tumor may actually have been surrounded by a cyst which is why it appeared larger than it actually was. My MO said it's not likely the needle biopsy took 4mm, thus this explanation makes sense. She said after the biopsy the cyst probably filled with blood which would explain the apparent increase in size. Of course, they want to be sure and that's why it's taking so long. The pathologist and my MO have both been looking at it and researching this possibility. It may take another week before I know for sure.
If the tumor is less than 5mm, the MO said the need for chemo probably won't outweigh the risks, thus I probabaly won't need it. She said that although they wouldn't have considered me her2 positive based in the ISH test done by the other hospital, since they did go on and do the fish analysis which showed me as positive, they can't overlook that, thus if the tumor is determined to be closer to 1cm, chemo is warranted, although it would be one of the weaker options (taxol?). She said even if the tumor is determined to be 7mm, we can discuss benefits vs potential risks, but for now they just want to be sure we have an accurate size.
So my take away from this is there is still hope I won't need chemo and I'm so thankful my local MO suggested I consult with the teaching hospital. I like having an entire team of doctors looking at my situation. The BS I met with at the first hospital was leaning toward a mastectomy and TCH and said I didn't need to see an MO until after my surgery. She seemed very smart, but I didn't like her cavalier attitude about cutting off my breast, nor did I like the apparent lack of communication between her and the PS at their facility. I'm lucky to have been a medical social worker years ago so my daughter called an old friend of mine who still works with cancer patients and asked for her opinion. She suggested I see the local MO, who is highly recommended, which led me to the doctor said I'm seeing now.
I'm so thankful for this site. I may not have asked the right questions and may have just gone with the first BS recommendations if I hadn't found you.
Invasive ductal carcinoma
6/2017, IDC, Right, <1cm, Stage IA, 0/5 nodes, ER-/PR-, HER2+ (FISH)
8/9/2017 Lumpectomy; Lymph node removal: Sentinel
9/13/2017 Herceptin (trastuzumab)
9/14/2017 Taxol (paclitaxel)