HELP -- 2 DIFFERENT TREATMENT OPTIONS FROM SURGEONS

roseann4 said:

Hmmm.....
I understand your confusion. Chemo first is done to shrink the tumor before surgery. So if your tumor is large, that seems to be normal procedure. Is the first surgeon talking lumpectomy or mastectomy? The sentinal node is often removed and checked during surgery but it has also been done seperately. Even if there is cancer in the node does not necessarily mean that the cancer has spread outside the breast but it does increase the chances. Did either of them recommend bone scans, cat scans or an mri? All those tests were ordered for me and are commonly requested today. I do not remember your earlier posts, do you have cancer in both breasts? I'm just wondering why the second doc is recommending a double mastectomy unless you have cancer in both breasts, have genetic issues or want that yourself.

I would not do anything until you understand why those treatment options were recommended. If you trust your primary care physician, you can ask him/her to call both doctors and get more information. Of course, you can also get a third opinion.

I hope one of our other sisters can be of more help to you.

Hugs.

Roseann

For me
I was dx on May 8th 2009 with IDC by having a needle core biopsy then sent for tests. Through a ultra sound my tumor was small enough that they didn't rush me to surgery. They recomended a lumpectomy but I chose a bilateral with immediate reconstruction (July 29). I had genetic testing, and a sentinal node biopsy before surgery (no node involvement), plus an mri to see if i had it in both breasts. after my surgery they did the oncotype test on my tumor and my score was a 10 which ment chemo was not recomended for me. I was glad they didn't rush me in right away even though I was so worried about the tumor growing. It gave me a chance to figure out what I wanted to do and why. Unless your breast cancer is agressive then waiting a little while to research your options won't make alot of difference. Some breast tumors are more agressive than others. You should have a initial path report from your biopsy which tells you what kind of cancer it is.

can't sleep
Hi, being scared and not sleeping seems to be the norm, when my wife was first diagnosed she had the same problems, I had trouble as well,

having a few options can be good and bad, too bad we couldn't trust our drs completely and say just do it, fix me

we got three opinions, they all offered pretty much the same procedures with little difference, she was told she was a perfect candidate for a lumpectomy, tumor 2.4, one lympnode had microscopic evidence of cancer, estrogen pos
we are in the milwaukee wi area and chose to be treated at freodert, a medical college hospital, main reason believe it or not was because of the plastic surgeon, the surgeons all seem comprable as well as the oncolgists, but the plastic surgeon was very easy to talk to and he gave an opinion on a procedure the others just gave statistics, he seemed to be very trustworthy, he got the job,

they wanted her to do chemo first to shrink the tumor for a lumpectomy, she chose not to because the surgeon said that they would not be able to tell how much the cancer was in the lymp nodes, also she felt she would be stronger for surgery before chemo, and bottom line was she wanted the whole thing out of her body

question for you is what is your cancer?? your age??
it seems wierd to me that first they want to do chemo then surgery..why, for a lumpectomy cause the second surgeon wants to check nodes then do a double mestectomy
and maybe chemo
if the second is questioning chemo and the first thinks it is definte...hmm

I tried writing you last night but when I sent previewed what I wrote it vanished, and I was way too tired to try again sorry,

God I hope the best for you, when we made our decisions we started to sleep a little easier,

Jerry

denbralou said:

Thanks - MCJ
Thanks for your info MCJ. How is your wife doing now? Hope she has recovered and is doing well. Yes, it is very scary trying to make the right decision. Both surgeons have said that I would need a masectomy so they agree on that. I am choosing a double masectomy because I don't want to have to go through this again. I have invasive carcinoma with multiple tumors. My age is 43. Did your wife have the sentinal node biopsy as a separate surgery before the masectomy? One wants to do this during the mastectomy, the other said they do it as a separate surgery before the masectomy. One wants to do chemo first, the other wants to do the surgery first. I am going for one more opinion on Wednesday and then we will have to make a decision. The 1st opinion wants me to start chemo on the 21st of this month and get a mediport installed on the 17th. Did you wife have a mediport? Thanks you. Denise

choices
My doctor also gave me two choices, I did decide to start with chemo. I also requested a pet ct scan, which I would highly recommend, without the scan they wouldn't have known that it had spread to the lymph nodes and a spot on my chest wall. Good luck with your decision.
betty

Sunrae said:

I also was offered 2
I also was offered 2 different types of treatment by 2 surgeons. One had me having a masectomy in one week and checking the lymph nodes and then chemo. The second one had me go thru a lot more tests, inc. Oncotype D, which showed I might not benefit for chemo even tho I had tumors, 2.2cm and 1.5 close together and lymph node positive. The onc decided to put me on Femara, therapy used to shrink tumors, which it's doing and then I'll be scheduled for surgery after the first of the year. I was so glad I went for a second opinion. If you don't feel comfortable with either surgeon, get a third opinion. A lot of treatment depends on whether you have large tumors, aggressive and how much its spread. Did you have many tests to determine any of this? Keep us posted and let us know how this goes. We're here for you and are holding your hand thru this. Take care.

oncotypes...and chemo before or after....
what does oncotype D mean? Have never heard the term before.
I was diagnosed in January this year with breast cancer - two positive lymph nodes - but no primary tumour. Although a surgeon told me to have a left breast mastectomy, the oncologist he works with said chemo first. I did that, had four treatments of AC - and had a complete response. Then the oncologist said I could choose: radiation or surgery. Went to see the surgeon who said "no surgery". So I had chemo first and ended up with no surgery at all - but then had no evidence of cancer in the breast itself, even with an MRI.

denbralou said:

Thanks - MCJ
Thanks for your info MCJ. How is your wife doing now? Hope she has recovered and is doing well. Yes, it is very scary trying to make the right decision. Both surgeons have said that I would need a masectomy so they agree on that. I am choosing a double masectomy because I don't want to have to go through this again. I have invasive carcinoma with multiple tumors. My age is 43. Did your wife have the sentinal node biopsy as a separate surgery before the masectomy? One wants to do this during the mastectomy, the other said they do it as a separate surgery before the masectomy. One wants to do chemo first, the other wants to do the surgery first. I am going for one more opinion on Wednesday and then we will have to make a decision. The 1st opinion wants me to start chemo on the 21st of this month and get a mediport installed on the 17th. Did you wife have a mediport? Thanks you. Denise

You're very welcome, thanks
You're very welcome, thanks for the good wishes, my wife has begun chemo, AC, she hasn't lost her hair yet, but got this really cool short hair cut, she is doing better as the days go, but she will soon get another dose, she is handling that pretty well, I give her a lot of credit, my gut is in a knot just thinking and seeing what she is going through, we do know that the end justifies the means, I want her around for a long time,
She had her lymph node checked through an MRI, they were not swollen to the touch, but one was noticed swollen by the MRI, that's where the needle biopsy was performed, it was positive, I'm very curious about this because she then had her surgury [mestectomy] the nodes removed at this time, and the pathology report stated 15 of 15 nodes were clear,
She will get a port on the 15th when she does her second round of chemo, the reason for that is originally she was to only get 4 rounds and did not need the port, but because the oncotype test dx her and changed her from estrogen pos to estrogen neg the doc wants to give her a more aggresive treatment,
Can you ask the surgeons the advantage of chemo first or surgery first? I think chemo first and shrinks the turmors tell you the chemo is working, but chemo first then doing lymph nodes at same time of the mestectomy then you can not tell the status of the rest of the nodes, so said our surgeon,
Bottom line is to get yourself cured, you have a lot of life in front of you
Can you let me know what the third surgeon said? Are you doing reconstruction? Anyone talking radiation?
Jerry