need advice on mom's biopsy results

halekan · New User Joined: 13 Jul 2007 Posts: 2

Hello,
My mother was recently diagnosed with breast cancer

age 73, post menopause
diagnosis June 2007
invasive ductal carcinoma, 7 mm
ER+, PR+, HER2Neu (-)
moderate differentiation
no angiolymphatic infiltration (?)

I live in TX and Mom is in OH. I would like to be as informed as possible about her options and her medical care. She relies heavily on my opinion as I have a science background. She is scheduled for a lumpectomy and lymph node dissection in a week, followed by radiation treatments. I believe that her doctor is a good one I just fear that a lumpectomy may be too conservative. She is asking for my opinion on whether to just have the lumpectomy or a mastectomy.

Thank you for reading this.
HA Lekan

Muttsmom

Hi,

From the part of the pathology report you posted, if your mom or anyone had to have BC, she's got an extremely good path report. The tumor was small and her being er/pr+ and Her2- is also really good. One thing is, when they do the lumpectomy, they probably will find more cancerous tissue, if they just did a biopsy vs. a lumpectomy in the beginning. If it's under 1 cm, most will have a lumpectomy followed by radiation, as long as no lymph nodes are involved. I'm very pro-active in doing everything possible the 1st time, and pray it doesn't come back, but knowing that you did everything you could. If I had her dx, even at the age I was dx, I would have had a lumpectomy, I truly believe. I'd say not to make a decision about lumpectomy vs. mastectomy until you see if they got "clean margins" after the lumpectomy and see how large the actual tumor is and if there is any node involvement. That's what I would do, but of course I realize that the decision is your mom's and of course, she wants your help, so yours as well. I don't like surgeons who don't believe in mastectomies and "mutalating" a woman. I don't feel mutalated, I feel alive. My best friend's surgeon believed in breast conservative surgery, even though Kim wanted a double mastectomy. We were both dx with Stage III, about the same size tumor and # of nodes involved. He refused to do the mastectomy and ended up, there was more cancer in the remaining tissue and I lost my best friend. Now, with that said, your mom has NO WHERE near the dx that her or I had, so that's not by any means said to scare you, but to remind you that the surgeon works for your mom, she doesn't work for him, and whatever she is most comfortable having, that's what she should have. I was 43 and boobless, but I'm alive and doing great 5+ years later Smile

)))))

Unless they find a lot more cancerous tissue and node involvement, she caught hers about as early as can be, so that's awesome!!!!!

Please let us know what they find when they do the lumpectomy. If they don't get clean margins, they will have to go in again to get more tissue, so that would be the time she would decide if she wants to go again and have the mastectomy, or keep trying surgery until they get clean margins.
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

brainman

Hi halekan,

Another factor that the doctors will probably take into consideration in the lumpectomy/mastectomy recommendation is family history. If a lot of women in your family have had breast cancers, the doctors might consider going ahead with a mastectomy. However, this is rather rare. As Nancy said, with a lump that small, most doctors will be inclined to do a lumpectomy first. If they find any cancer, then the decision of a masterctomy will need to be made.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

halekan · New User Joined: 13 Jul 2007 Posts: 2

Thank you Nancy and Jim!
We do realize how lucky Mom is to have found the lump so early. We also have no history of breast cancer in the family. We know that it could be worse. I lost one friend to breast cancer after a long battle but I also have a friend who is a survivor (double mastectomy, 21 positive lymph nodes, radiation, chemo, the works) - 8 great yrs and counting!!

I worry about Mom having multiple surgeries at her age and so we wondered if she should just have a mastectomy to be on the safe side. I understand better now why the surgeon suggests a lumpectomy. And I feel better now about the current plan for lumpectomy. Hopefully the margins will be clean and the lymph nodes negative. Mom has no problem with the idea of a potential mastectomy. She jokes that she will be able to drop some of those extra pounds she's been carrying around. Laughing

Thanks so much for sharing your advice and your hope.

I wish you both strength and hope to continue the fight, day by day, minute by minute.

Thanks again and God bless you,
HA Lekan

Muttsmom

Hi,
Thanks for sharing your friend's 8 years NED (No evidence of Disease). This Stage III lady loves hearing that kind of news:-) I'm sorry you lost a friend to BC. It's a cruel disease and my best friend died from it in Dec of 2004, and others I've met along the way. There is also alot of wonderful news out there like your friends Smile

We never lose hope or give up!!!

Please do let us know what your mom's results show. We'll never tell you what she should do, but we can help you sort through things.

Best wishes to you and your mom!! Thanks for the well wishes too. I have 4 dogs and 2 cats that need their "mom", and SO many in shelters that need help getting adopted or into rescues before it's too late, so I can't go anywhere for MANY years Smile

)))))))
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

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