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All TopicsForum: IDC (Invasive Ductal Carcinoma) → Topic: anyone else ER-/PR- HER2+

Topic: anyone else ER-/PR- HER2+

Forum: IDC (Invasive Ductal Carcinoma) — Just diagnosed, in treatment, or finished treatment for IDC.

Posted on: May 10, 2017 01:34PM

hhuey wrote:

s I had my first visit with my surgical oncologist. She told me I am ER- PR- but HER2 +. I have an MRI friday, lymph node biopsy, genetic testing since I do not know my biological father's history, CT scan and bone scan coming up. She also stated because I am HER + I would have to begin Chemo before having surgery which will most likely be a mascectomy vs a lumpectomy because I have some calcification showing around my lumps. Anyone else with the same diagnosis and similar plan of action?

Dx 5/1/2017, IDC, Right, 2cm, Stage IIB, Grade 3, ER-/PR-, HER2+ Chemotherapy 6/1/2017 AC Targeted Therapy 7/27/2017 Herceptin (trastuzumab) Targeted Therapy 7/27/2017 Perjeta (pertuzumab) Chemotherapy 7/28/2017 Taxol (paclitaxel) Surgery 11/29/2017 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 1/10/2018 Whole-breast: Breast, Lymph nodes
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May 10, 2017 01:48PM exercise_guru wrote:

hhuey

I had a similar diagnoses but they did not allow me to have a CT or bone scan because the tumor was small. I was shocked to find out that I would need chemotherapy for such a small tumor. You should prepare yourself for that reality. Depending on the size of the tumor and whether you are in the US they have a second chemo drug they like that is newer called perjeta. You are definitely want to ask and read for that. It impacts whether you have lumpectomy/mastectomy before or after chemo. It was recomended 6 doses of TCH( sometimes they add perjeta) chemo one does every 3 weeks and then Herceptin on intervals until next year.

feel free to pm me.

Age 42 05/15/2015 PALB2 mutation, DBL Breast Cancer Type 1A Grade 3 ER+PR+(right 1.3cm,.5cm) HERr+(left1.6 cm), 06/26/2015 BMX with TE 8/27/15 Chemotherapy TCH 12/30/2015 TAH/BSO/Reconstruction 1/29/16 Arimidex 3/1/16 Femara 5/6/16 Tamoxifen
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May 10, 2017 01:59PM - edited May 10, 2017 01:59PM by hhuey

Thank you

Dx 5/1/2017, IDC, Right, 2cm, Stage IIB, Grade 3, ER-/PR-, HER2+ Chemotherapy 6/1/2017 AC Targeted Therapy 7/27/2017 Herceptin (trastuzumab) Targeted Therapy 7/27/2017 Perjeta (pertuzumab) Chemotherapy 7/28/2017 Taxol (paclitaxel) Surgery 11/29/2017 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 1/10/2018 Whole-breast: Breast, Lymph nodes
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May 10, 2017 03:52PM BellasMomToo wrote:

I'm ER-/PR- and HER2+. Before chemo, I had a Breast MRI, but no other scans. No genetic testing, I think because I'm ER-/PR-. I had neoadjuvant chemo (chemo before surgery) that included Perjeta because I'm HER2+ and my tumor was at least 2 cm. (Insurance won't cover neoadjuvant chemo with Perjeta unless the tumor is at least 2 cm.)

I had my SNB when I had my UMX in March. My node was negative and there were no active cancer cells found in what remained of the tumor. So I was declared 'cancer free'. No other scans/tests have been recommended at this time, other than my annual mammogram for my remaining breast.

Good luck to you!

Dx'd at age 56. Tumor found by my annual mammogram -- cancer can grow fast! Dx 10/6/2016, IDC, Left, 2cm, Grade 2, 0/1 nodes, ER-/PR-, HER2+ (IHC) Dx 10/6/2016, DCIS, Left, Stage 0, ER+/PR- Targeted Therapy 11/1/2016 Herceptin (trastuzumab) Chemotherapy 11/1/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 11/1/2016 Perjeta (pertuzumab) Surgery 3/27/2017 Lymph node removal: Sentinel; Mastectomy: Left
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May 10, 2017 09:53PM Dotter95 wrote:

hi - my daughter who is BRCA1 was just diagnosed with ER-/PR-/ HER2 equivocal which means the sample has to be tested with the FISH method to determine if she is negative or positive. The lesion is small 7 mm in the pathology report. She is scheduled for a Lumpectomy next week, so we will know more then. Do any of you know what the expected regimen is if she is HER2+?

She is just 38 and only found out she was BRCA 1 this spring. Her first mammogram showed up the small tumor thank goodness, but she was hoping to start a family so this news has been very hard.

One step at a time...

Joan

Dx 8/2016, IDC, Left, 2cm, Stage IB, Grade 3, 0/2 nodes, ER+/PR-, HER2- Surgery 9/21/2016 Lumpectomy; Lymph node removal: Sentinel Chemotherapy 11/9/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/6/2017 Multi-catheter: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 11, 2017 01:02PM Kimm992 wrote:

I was also ER- & PR - and HER2+.

The day after my diagnosis I had an MRI, CT and bone scan and genetic testing (all negative).

I started neoadjuvant chemotherapy 2 weeks after that (6 rounds). I did not get Perjeta because my largest tumor was 1.7cm so it wasn't large enough (I had 4).

6 weeks after finishing chemo I had a right mastectomy w/ a SND (nodes were thankfully clear).

25 rounds of radiation.

Dx 10/14/2015, IDC, Right, 1cm, Grade 3, 0/3 nodes, ER-/PR-, HER2+ Chemotherapy 11/3/2015 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil) Chemotherapy 1/7/2016 Taxotere (docetaxel) Targeted Therapy 1/7/2016 Herceptin (trastuzumab) Surgery 3/24/2016 Mastectomy: Right Radiation Therapy 5/1/2016 Lymph nodes, Chest wall
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May 11, 2017 07:01PM hhuey wrote:

Sounds like this may be the road that I am facing. How did you do handling all the chemo? I think that's my biggest concern. I could almost care less about the mascectomy. It's the therapy I worry about I guess because I am afraid I will be useless and it will be super scary for my 3 kids to watch

Dx 5/1/2017, IDC, Right, 2cm, Stage IIB, Grade 3, ER-/PR-, HER2+ Chemotherapy 6/1/2017 AC Targeted Therapy 7/27/2017 Herceptin (trastuzumab) Targeted Therapy 7/27/2017 Perjeta (pertuzumab) Chemotherapy 7/28/2017 Taxol (paclitaxel) Surgery 11/29/2017 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 1/10/2018 Whole-breast: Breast, Lymph nodes
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May 12, 2017 10:40AM Kimm992 wrote:

There are good days and bad days.

When I was diagnosed I had a 2.5 year old and a 4 month old baby. I was terrified about being able to take care of my kids...it really wasn't as bad as I imagined.

Once you have your first chemo you will have an idea of the days you tend to be most tired (for me it was days 5 & 6) and then you can plan ahead and have help for those days. MOST days I was able to function just fine and take care of my kids...we were outside playing, doing errands, etc. It really does go by pretty fast.

I found the mastectomy and the radiation a breeze.

It is scary but the treatments available these days are really really good. You are going to be fine...believe it!

Dx 10/14/2015, IDC, Right, 1cm, Grade 3, 0/3 nodes, ER-/PR-, HER2+ Chemotherapy 11/3/2015 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil) Chemotherapy 1/7/2016 Taxotere (docetaxel) Targeted Therapy 1/7/2016 Herceptin (trastuzumab) Surgery 3/24/2016 Mastectomy: Right Radiation Therapy 5/1/2016 Lymph nodes, Chest wall
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May 12, 2017 04:42PM hhuey wrote:

oh my gosh..I'm sure you understand how much I appreciate this response. I have a 10 year old, a 6 year old and a 4 year old. It's nice to know I will still be functional except for maybe a few days out of the week. They definitely keep me on my toes. Luckily my husband and family are a tremendous help so I'm ready to get started. I'm doing all the tests and scans now and meet with my primary oncologist on the 25th to see where we go first. Looking like chemo first step, then surgery for the beast and then who knows what. I can handle surgery (had 3 c sections) .my only fear is me losing my hair. Since it such an outward sign how my kids will react. The last thing I want is for them to worry or be afraid.

Dx 5/1/2017, IDC, Right, 2cm, Stage IIB, Grade 3, ER-/PR-, HER2+ Chemotherapy 6/1/2017 AC Targeted Therapy 7/27/2017 Herceptin (trastuzumab) Targeted Therapy 7/27/2017 Perjeta (pertuzumab) Chemotherapy 7/28/2017 Taxol (paclitaxel) Surgery 11/29/2017 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 1/10/2018 Whole-breast: Breast, Lymph nodes
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May 15, 2017 11:23AM Kimm992 wrote:

Yes, the hair thing can be difficult for the kids because then you actually LOOK sick.

My 4 year old handled it quite well...when I shaved my head I tried to spin it in a fun/funny way. "Look at mommy's new funny haircut!!". She loved it.

It was easy at 4...I'm sure 6 and 10 will be a little trickier. I found that if I talked about the situation in a positive, light way that it worked well for my daughter.

Dx 10/14/2015, IDC, Right, 1cm, Grade 3, 0/3 nodes, ER-/PR-, HER2+ Chemotherapy 11/3/2015 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil) Chemotherapy 1/7/2016 Taxotere (docetaxel) Targeted Therapy 1/7/2016 Herceptin (trastuzumab) Surgery 3/24/2016 Mastectomy: Right Radiation Therapy 5/1/2016 Lymph nodes, Chest wall
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May 24, 2017 01:27PM - edited May 24, 2017 02:33PM by Maggieroe1

I did not have a large tumour, no evidence of cancer in the sentinal nodes, but was Her-2 +. I had a lumpectomy, followed by three months of weekly infusions of Taxol and Herceptin. After that I continued with Herceptin every three weeks and will have it for a year, ending in September 2017. I also had three weeks of daily radiation. My oncologist explained that because of my Her-2+ status, there was a greater chance of recurrence and the chemo/targeted therapy greatly reduces the odds. Time consuming though the continued treatment is, I wanted to do everything I can now so, hopefully, will not have to go through it again! I did not suffer much with the Taxol and other than a few aches and some fatigue, the Herceptin is a breeze

Dx 7/4/2016, IDC, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2+ (IHC) Surgery 8/9/2016 Lumpectomy: Left Targeted Therapy 9/11/2016 Herceptin (trastuzumab) Chemotherapy 9/11/2016 Taxol (paclitaxel) Radiation Therapy 1/10/2017 Whole-breast: Breast
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May 25, 2017 08:25PM Fiddler wrote:

hi, I am also ER/PR negative and HER2 +. I had a lumpectomy (luckily no cancer in the lymph nodes) followed by chemo and Herceptin followed by radiation. I will be on Herceptin through next September. The chemo was pretty rough for me, unfortunately I had a rare serious side effect (only 1% of patients get it) that landed me in the hospital, and I had a lot of other side effects. Other people breeze through it so it's really hard to tell. Couldn't have made it through without the support of my hubby. (Luckily kids are grown and out of the house.)The HER 2 does make recurrence more likely, my doc said I have a 20-25% chance of recurrence.

But now I am finally feeling better, my hair is growing back in, it is short and curly and everyone loves it! So there will be light at the end of the tunnel.

Good luck!

Alana Dx 6/24/2016, IDC, Left, 3cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ Surgery 8/8/2016 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 9/26/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Targeted Therapy 10/17/2016 Herceptin (trastuzumab) Radiation Therapy 12/27/2016 Whole-breast: Breast
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Jun 6, 2017 01:44AM Vicki_L wrote:

Hi everyone,

This is my first post on this forum.

I was diagnosed in September 2015, I too am Her2+ er- pr- . I did treatments of herceptin and perjeta from October thru Maya and they reduced the tumor from 5.5cm to small enough for a lumpectomy. We did not get clear margins and began to use tdm1 / kadcyla to get rid of the residual cancer. By October 2016 I had a clear pet scan. Stayed on kadcyla thru March 2017 to reduce chance of recurrence. Then started on herceptin. Unfortunately, I found a lump in the same area a few weeks ago. MRI revealed another 5+cm mass. No lymph node involvement. The oncologist recommended getting a mastectomy right away. Second opinions have recommended having chemo before the surgery.

Currently I'm waiting for a pet scan to be scheduled to make sure there is not disease in other parts of the body. I began taking artemisinin, Graviola, cbd oil, and pau d'arco, to hopefully reduce spreading while I'm waiting for surgery to be happen. Got back on a rigorous anti cancer diet.

I'm wondering whether to do chemo before the surgery or not. I would love to hear from any of you her2+ er-pr- sisters who did surgery and not chemo. What was your outcome?

Thanks for sharing your experiences.




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Jun 10, 2017 10:42PM Gramadeb2 wrote:

I have IDC with HER2 + and ER-/PR- according to the biopsy but I have not had any treatment yet. Monday I will see both the surgeon and radiation oncologist. I saw the chemo oncologist last week. It's getting more real the closer it comes to these appointments. My Ki-67 was 38 and my doctor told me that this was small but very aggressive, "a mean one". I've known my oncologist for many years because he has also been my hematologist. I've learned a lot on this forum but it is the first time I've posted so I hope I'm doing it right. This is so new to me (just got the call on May 30). Had a plane ticket to fly out to my daughter's wedding the next day and the doctor suggested that I stay home and get this taken care of immediately instead. So that is where I am now. I know just enough about my pathology report to be able to understand what I've read on this site and I feel confident about talking to the doctors on Monday but I am nervous about the surgery and radiation. Has anyone here had the type of radiation that puts a tube and balloon in place of the tumor at the time of the lumpectomy, then you have radiated pellets put in the tube for a short period of time twice a day for five days and your radiation therapy is done? Thank you.

Dx 5/30/2017, IDC, Right, <1cm, Grade 3, ER-/PR-, HER2+
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Jun 16, 2017 06:33PM hockey7chick wrote:

I was diagnosed Dec 1 2016 idc, er/pr- her2+ had 6 rounds of chemo tchp, a bilateral mastectomy and will be doing 30 rounds of radiation. I don't have children but as posted earlier the more positive you can make it, the easier it will be for them. There is a movie "Miss you Already" that had a fun little way of explaining chemo to kids. I was able to work two jobs through all of chemo and was just down for the the 2nd and 3rd day after chemo.

My best suggestion is to stay positive, the one round I went into with a crappy attitude was the worst of them all.

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Jun 16, 2017 08:17PM Moderators wrote:

Thank you, Hockey7chick, for your encouraging words! We wish you continued luck with the rest of your treatment!

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Jun 16, 2017 09:06PM KayLBea wrote:

Hi,

I was Her2+ as well but invasive ductal, lobular, and the worst case of the other 4 characteristics they check for.  I was stage 4 in the beginning but it spread everywhere but not any other major organs, although I am beginning to think something is going on in my lungs now.

It is great you are starting with chemo because if it is starting anywhere else it will be treated.  Also there is targeted therapy for Her2, the Herceptin.  So that is good. 

A week before your surgery start taking arnica, people who have done this have less bruising and pain. Start taking raw organic greens for nutrition and detox.  If you can afford it try acupuncture to help keep your energy levels balanced, etc...

Just focus on yourself!  Have to go but will post again soon.

Kay B


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Jun 16, 2017 10:06PM Moderators wrote:

KayLBea-

Thank you so much for chiming in and sharing such good advice! it's so helpful. We hope everything checks out ok with your lungs, you're in our thoughts!

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Sep 8, 2017 06:28PM HopefulAC wrote:

I also found out today that I'm I am ER- PR- but HER2 +. I meet with the oncologist next week but was told by surgeon today that course of treatment would likely be chemo first , then surgery, then radiation. My mass is less than 2 cm and just in shock this is happening. Any helpful questions I should ask? I'm trying to stay positive. I'm single, 41, no kids, but super supportive family and friends and boyfriend though very worried about the impact this will have

Dx 8/30/2017, IDC, Left, Stage IB, ER-/PR-, HER2+ Targeted Therapy 9/26/2017 Herceptin (trastuzumab) Targeted Therapy 9/26/2017 Perjeta (pertuzumab) Chemotherapy 9/26/2017 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Sep 9, 2017 12:46AM Moderators wrote:

Hi HopefulAC-

We want to welcome you to BCO, and tell you that we're so sorry you find yourself here. It's a club no one wants to join, but hopefully it helps to know you are not alone! Have you read through our HER2+ forum? Lots of great info there, and members who can offer some insight: https://community.breastcancer.org/forum/80.

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Sep 9, 2017 10:48AM - edited Sep 10, 2017 08:29PM by lily2

I was diagnosed with er-pr-her 2+ back in February at 43 yrs old.I had a petscan prior to chemo which was clear.I had 6 rounds of tchp with a complete responce.I then had surgery which was a quadrectomy and had clear margins and neg sentinal nodes.I am now doing Herceptin and Perjeta for the remainder of the year and radiation will start soon 33 rounds.


Dx 2/27/2017, IDC, Right, 4cm, Stage IIIA, Grade 2, 0/2 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 3/20/2017 Herceptin (trastuzumab) Chemotherapy 3/21/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 7/30/2017 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy
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Sep 10, 2017 10:39AM osu wrote:

I start my tchp treatment this Friday. Any advise from someone who has finished this treatment. I have been told it's a rough chemo on your body. I am 47 years old going into this heathy. I am lucky to live in a city hat has a amazing cancer hospital in town that I will be doing my treatments at.


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Sep 10, 2017 07:32PM Moderators wrote:

osu, sorry you had to join our Community, but welcome! We know you'll find great advice, support and information here. Please feel free to contact us if there's anything you need help with or have any comment for us.

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Jan 7, 2018 05:56PM Rooney26 wrote:

Hi,

I'm just joining this forum and so glad to see others with this profile. I had double mastectomy for a DCIS mass found in my left breast on December 20th, and the pathology report came back with a small (0.7 cm) IDC mass as well. ER/PR -, Her2+. Lymph nodes came back clean. Clean margins. I was really hoping the DMX would be the end of it for me, but surgeon says because of the aggressiveness of this type of tumor, the oncologist will likely want to do chemo and Herceptin. I meet with the Oncologist tomorrow morning. I'm curious why some of you have had to also do radiation on top of everything else? I really don't want to do all that.

Dx 12/5/2017, DCIS/IDC, Left, <1cm, Stage IA, 0/3 nodes, ER-/PR-, HER2+ (IHC) Surgery 12/20/2017 Mastectomy: Left; Prophylactic mastectomy: Right Chemotherapy 1/17/2018 Targeted Therapy 1/18/2018 Herceptin (trastuzumab)
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Jan 9, 2018 05:27AM Photopol wrote:

Hello Bellasmomtoo!

What is SNB and UMX?

Photopol

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Jan 9, 2018 04:34PM BellasMomToo wrote:

SNB = sentinel node biopsy

UMX = Unilateral mastectomy (one breast) A BMX = bilateral mastectomy (both breast)

Dx'd at age 56. Tumor found by my annual mammogram -- cancer can grow fast! Dx 10/6/2016, IDC, Left, 2cm, Grade 2, 0/1 nodes, ER-/PR-, HER2+ (IHC) Dx 10/6/2016, DCIS, Left, Stage 0, ER+/PR- Targeted Therapy 11/1/2016 Herceptin (trastuzumab) Chemotherapy 11/1/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 11/1/2016 Perjeta (pertuzumab) Surgery 3/27/2017 Lymph node removal: Sentinel; Mastectomy: Left
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Jan 11, 2018 10:49PM jo6359 wrote:

im puzzled. Hormone negative and HER+. 2 small tumors on right breast. Scheduled for a double masectomy on Jan. 29 with Chemo starti ng postop. Radiation was never mentioned. My lymph nodes havent been dissected yet. It's radiation something I should ask about?

Dx 12/8/2017, IDC, Right, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 1/2/2018, IDC, Right, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Surgery 1/29/2018 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy; Prophylactic mastectomy: Left
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Jan 12, 2018 12:42AM BellasMomToo wrote:

Radiation is usually required with lumpectomies. Radiation is usually NOT required with mastectomies unless the tumor is too close to the chest wall or there is node involvement.

I had a mastectomy and did not require radiation because my SNB was clear and my tumor wasn't close to the chest wall.

Dx'd at age 56. Tumor found by my annual mammogram -- cancer can grow fast! Dx 10/6/2016, IDC, Left, 2cm, Grade 2, 0/1 nodes, ER-/PR-, HER2+ (IHC) Dx 10/6/2016, DCIS, Left, Stage 0, ER+/PR- Targeted Therapy 11/1/2016 Herceptin (trastuzumab) Chemotherapy 11/1/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 11/1/2016 Perjeta (pertuzumab) Surgery 3/27/2017 Lymph node removal: Sentinel; Mastectomy: Left
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Jan 12, 2018 03:37PM jo6359 wrote:

Bellasmom, Thanks for the ckarification.

Dx 12/8/2017, IDC, Right, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 1/2/2018, IDC, Right, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Surgery 1/29/2018 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy; Prophylactic mastectomy: Left
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Jan 16, 2018 07:37PM - edited Jan 16, 2018 07:38PM by TiTi1020

I was diagnosed in December, and started a Taxol/Carboplatin/Herceptin/Perjeta regimen as I am HER2+. I have TC every week for 12 weeks, and every 3 weeks I also have the HP too.

So far after my first TCHP I have developed an itchy rash on my chest, face, and back of my neck. Ugh! I will see my oncologist for my round of TC this Friday and see what he thinks. Otherwise, just tired and a little upset tummy.

Did anyone else have a PET scan before starting chemo? I had a biopsy and Breast MRI. It was determined there is no node involvement and it was only in my left breast, but I can't help it worry still.

Hoping these next 11 weeks go fast! I am lucky to have a supportive fiancé and snuggly, sweet doggy

Dx 12/7/2017, IDC, Left, Stage IIA, ER-/PR-, HER2+ (FISH)
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Jan 16, 2018 08:39PM jo6359 wrote:

Two weeks after my biopsy, a breast MRI was done and found another 1.2 cm tumor in same breast. A week later a PET/CT scan was done. I was lucky, breast MRI and PET showed no lymph node involvement. The PET showed no spread of the cancer. My surgeon told me do not get my hopes up the only way to really tell if there's lymph node involvement is with a biopsy. Im still on pins and needles until my surgery and SNB. I do get where you are coming from.


Dx 12/8/2017, IDC, Right, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 1/2/2018, IDC, Right, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Surgery 1/29/2018 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy; Prophylactic mastectomy: Left

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