Just diagnosed with bilateral breast cancer

Chrs

I have a feeling I won't know how bad my condition really is until after surgery? The pathology report is scary: Left breast: infiltrating moderately differentiated duct carcinoma, associated with ductal carcinoma insitu, intermediate grade. Right breast: Lateral: Moderately differentiated invasive ductal carcinoma. Ductal carcinoma in situ (DCIS) is also present, cribriform type, low nuclear grade. My surgeon said the left lesion was 15 mm and the right lesion 5 mm. and they looked non aggressive. I'm scheduled for a bilateral lumpectomy on Nov 14. I'd like to believe the lesions are not aggressive but the pathology report says "infilftrating" and "invasive". After they biopsy the sentinel lymph nodes, if they find cancer, I wonder if that means mastectomy? I wonder how it affects you if they remove lots of lymph nodes? I think once they remove the cancerous lesions then you get staged. I had bad vibes from the technicians when I finished with the core needle biopsies at the radiologist; I'm not sure what I'm asking..may-be someone else has a similar pathology report and you could tell me what happened with your situation.

jerrym

Chris, it would appear as though your tumors are small. Hopefully they will not have invaded the lymph nodes yet.

24242

It is a very scary time for since there is so much that is unknown. Sometimes we have to let our questions go for a time to concentrate on what we must face at hand. I was compelled to write so that you know there are many of us who have survived our poor diagnosis and have found a life to live at the end of our treatments. I am stage 3 with 11 out of 21 positive nodes and a survivor for over 8 years. Yes sometimes mastectomies are recommended but seems I knew that was the coarse when I went and saw my surgeon. Being informed is the best that we can do for ourselves and you are on the right track for that.
My thoughts are with you and can only hope that you find what you need to cope with all you must face, sometimes that is the best that we can do.
Be good to yourself always,
Tara

inkblot

Hi:

It is a scary time and our hearts are with you as we understand how you must feel at this point.

Your lesions are very small and that's always a plus.

To my knowledge, finding cancerous cells at Sentinel Node Dissection does not necessarily indicate that mastectomy is necessary. Typically, the physician can feel your axillary nodes and this gives him/her a pretty good idea of whether you may have any actual tumor growing in your nodes there. If they find a few cells in the Sentinel Node, then that is usually considered to be a "micrometastasis" and not necessarily any reason to jump to mastectomy, unless that's what you prefer. Remember, regardless of what may be found in your axillary nodes, the tumors in your breast are still very small. Any cells found in the axillary nodes are usually a determining factor as to what type of treatment you may best benefit from, post surgery. Not necessarily a factor which, alone, would indicate a mastectomy vs. lumpectomy.

With small tumors, all the research/studies state that a lumpectomy yields the same result as mastectomy. So that's something you need to take your time about deciding. Which would you prefer? Lumpectomy or mastectomy and why?

Re the axillary lymph nodes: If tumor should be discovered in the nodes, then the surgeon may
take more nodes for testing (during the same surgery or at a later date)...maybe removing all of level I and Level II nodes. This is something you should discuss with your surgeon prior to surgery.

Re the infiltrating/invasive factors: that basically just means that the tumor has broken out of the duct into surrounding breast tissue. Not really an indicator of how "aggressive" your type of cancer may be. You really need to sit down with your doc, prior to surgery, and go over your pathology report, item by item, and ask any questions you may have. Your doctor should take the time to explain it all in terms that you can easily understand.

Additionally, you could benefit from doing some of your own research. Look up cancers with similar pathology to your own and see what's typically recommended re surgery and/or adjuvant treatment.
(adjuvant just means treatment beyond surgery, such as chemo/radiation/aromatase inhibitors, tamoxifen, etc.)

You can go to: www.nci.nih.gov A good site for finding stats, different treatments, etc.. Just choose, under type of cancer, "breast cancer" and follow the links from there. You can also try: www.breastcancer.org Also, it wouldn't hurt to give google a try. Just type in bc surgery then try bc treatments, lumpectomy, mastectomy, etc. and you should find a wealth of links to info which can help you now, before surgery.

I'd advise against allowing your doctor to make all your decisions, for several reasons. The first reason is that at diagnosis, we're upset, afraid, concerned and basically on the ceiling, so to speak, emotionally. The next reason is that until we have it, most of us know almost nothing about bc, treatments or anything else about it. It's frightening enough as it is and not knowing or understaning our options/choices, just makes it more frightening. The more we can educate ourselves before the fact, the better we're going to manage. While we can't control the fact that we have bc, we can take control of the decision making process and that's powerful. It's all we have at such a time really, aside from the love and support of our families, friends and community. While that's also powerful, it doesn't help us with the facts and/or making our best decisions for ourselves. I've talked to more than a few women who would have chosen differently if they'd had the info they needed prior to going into surgery and beginning treatment.

You pay your doctor for his/her services and part of that constitutes explaining your pathology, your options and what to expect at surgery and what the dr. typically does in surgery for different scenarios. You NEED all this info and deserve the doctor's time in order to have your questions answered so that you may choose options which you consider best for yourself.

Lastly, talk with as many women as you can. If there's a breast care center in your area, find out when they have meetings and go. There's typically a dr. and/or oncology nurse on hand with whom you may speak also.

Finally, know that you CAN do this. Yes, it's scary and overwhelming but you CAN get through this a bit more confident if armed with solid info to help you make your best choices.

Good wishes and keep us posted.

Love, light and laughter,
Ink