breast cancer next step after lumpectomy

I had 2 lumps removed last week, less than 2 centimeters each in my right breast. ductile carcinoma.  meeting with oncologist and radiologist next week.  is chemo in addition to radiation the way to go?  also, which is the best, the typical 6-7 once a day radation treatment or the mammosite option?

[Cleveland Clinic]

Dear winniepoo:  The mammosite is a type of localized radiation therapy that can be used in women who have a lumpectomy or breast conservation surgery. The idea is that it is a balloon type structure that is implanted into the cavity of the breast where the lump was. It is then filled with radioactive substance that is designed to provide a more localized approach to post operative breast conservation radiation therapy. It is generally appropriate for women with tumors less than 2 cm. As your cancer is multifocal, mammosite may not be a good option as the purpose of radiation may be to include the entire breast.  It cannot be done if the person has had a mastectomy. It does not replace the need for chemotherapy or surgery.  Without reviewing all of your information, including pathology reports, records and doing a physical examination, we cannot make any specific recommendations for your situation.

[Under Forty Pam]

You'll need to wait and get your pathology results to make sure you have clear margins.  If you had NON Invasive like DCIS then radiation is probably enough plus a chemo drug for 5 yrs like Tamoxifen.  If it was at all invasive then your doctors will probably recommend chemo.  Radiation is 5 days a week generally for around 33 sessions.

[winniepoo]

the margins were clear.  

[boninclyde]

I don't think she meant to say a chemo drug being tamoxifen. But chemo then the drug tamoxifen. Usually lumps over 1cm get chemo. I wish you the best.

[Under Forty Pam]

Actually Tamoxifen is a chemo drug.  My doc scared my at first calling it that but now I am used to it.

[boninclyde]

Hello Under Forty. How are the neck problems? Hope your feeling better.
I may be wrong. I take tamoxifen and it is hormone therapy. Using the word chemo is not even capariable. How could it be? I think we should do more reasearch and so we will know for sure.
Remember the question about the ovarian cyst. Well I was out this weekend and I doubled over in pain. Hubby brought me home and I could barely get out of the car. Made it to the porch where collasped there. Husband called my GYN and they said maybe one of the cyst had broken loss and all I could do was wait. They suggested an hour before going to the hospital. 45 minutes later the pain went away. I wonder if was the huge cyst (the group of three)(mass they said). Sure hope it was and that shi_ is over. That is still the only pain I had with them. This waiting 2/3 months to do another ultrasound is killing me. I still have the every little ache and pain syndrome. Will check on the chemo/tamoxifen info. More later.

[Under Forty Pam]

My neck still hurts, the medical oncologist says it is not the Tamoxifen which is what I expected him to say.  Thu I have another doctor appt with an Ears/Nose/Throat doctor to see what they have to say.

Sorry to hear about your pain.  Yep that sounds exactly like my pain when the ovarian cyst ruptured.  Yep I was doubled over too.  Boy I too hope I never get another one of those.

I know Tamoxifen is classified as hormone therapy as well.  Maybe my doctor just calls is chemo drug to scare me, just kidding.

[boninclyde]

I can see how some doctors would say it is a chemo drug considering some of the side effects some women have. I still consider myself very lucky only to have had a few side effects. When do you see your EENT doctor? Let us know. I hope it is just a pulled muscle. Try a different pillow tonight. Heat & cold compresses mixed.

[ziggy123]

Just a selfish request on my part for some good wishes from you both. I go for my six month follow-up next Wednesday. Please keep your fingers crossed for me.
Montana girl-when is your appointment? I think that you and I are on the same tiem track.
Boninclyde-I am sorry about your pain. Why do you have to wait for your x-rays?

[Montana girl 06]

I've been thinking about you and am glad you posted to let us know your appointment is next week. I will keep you in my prayers. Are you scheduled for a diagnostic mammogram or appointment with doctor or both? My mammo/us appointment is April 16. I feel much calmer this time around. I hope you get a good report.

[Montana girl 06]

It's interesting that you ladies are talking about ovarian cysts. Today I had lower abdominal pain that started out feeling sort of like cramps (but it's the wrong time of the month.) It gradually got worse and worse until it was so extreme I felt weak and out of breath. There was absolutely no comfortable position to lay or sit in. I remember a friend telling me about pain like this and how she  waited an hour before calling the doctor. Sure enough, the severe pain only lasted about 30 min. although the whole ordeal was over an hour. Is this similar to what happened to you?

[boninclyde]

ziggy you are always in my thougths. You have been since you first posted here. You should know that by now. I was almost like a stalker moving from board to board with you What will they do for your 6 months check-up?
And you Montana girl. Well you know you are always in my thought also. I do hope your appointment this time checks out great. That is exactly the kind of pain I was talking about? And like I said I hope I never feel it again but I guess I have to get rid of these cyst somehow. Better that surgery. Have you seen your OBGYN lately?  You might want to request them to do a vaginal ultrasound. Insurance should pay for it if you are having problems. I am always thinking of you ladies.

[Montana girl 06]

I'm due for an annual this summer. I hope I never get that pain again, but if I do I guess I'll have to schedule something sooner.

[boninclyde]

When is your mamo? Isn't it soon?  I am almost ready to pack up and come to Montana to see you. We just had 10 days off from school and it seemed like a regular weekend around here. Time sure does fly. Montana seems like it would be laid back,  time would last and the sky would go on forever.  My husband has begged me to moved there but I don't think I could stand the cold. How is employment? Schools? Crime?Tomorrow the girls go back to school. I am sad. Again thanks for the info.

[ziggy123]

"Everything looks stable!" These were the best words that I could have heard this morning when I had my follow-up mammogram. So I breathe a sign of relief and wait until August when I will be back on track with my yearly mammo. Thank you both for all of the good vibrations and prayers that I could feel coming my way. Montana, I will be thinking of you next Monday when you go for your follow-up.

[Montana girl 06]

Thanks for posting right away. I'm so glad you got a good report. Hopefully, you can relax for another six months. I love good news!

[boninclyde]

That is great news. So happy for you. I am just curious if you have to have yearly CAT scans or MRI. My doctors haven't mentioned it to me but I am thinking of mentioning it to them. Have a great day.

[ziggy123]

Hello to you both!
Thank you for the good wishes! I just got off the phone with my breast surgeon who verified the good news that I heard from the radiologist yesterday. I am impressed with how fast he got back to me as I am always reading posts about how long everyone's wait seems to be.
He said not to come back for six months and then to schedule a bi-lateral mammogram. Boninclyde, he did not suggest either an MRI or a scan. I remeber when I was first diagnosed he suggested one, but later changed his mind and said it was not necessary. Why do you think you should ask for one? Am I missing something? Montana girl, have you had an MRI with your calcifications?
These are my last few days off of school for our Easter break, so I have been trying to relax before the big final push to the end of the year.
My best to both of you.
Ziggy

[Montana girl 06]

When I discussed options with my surgeon he mentioned MRI but didn't recommend it. He felt MRI's didn't offer enough helpful info when compared to the cost (especially when insurance doesn't pay.) But, everyone's circumstances are different.

I'm glad you could enjoy your spring break. We have 29 days of school left...

[boninclyde]

I was just thinking if mine does spread I would like to catch it early before and symptons appear. Like breast cancer when symptons appear it is usually harder to treat. But then again yearly test exposes you to more radiation. I hurt really bad all over sometimes. I think that comes from the tamoxifen. But now that I have these 4 cyst that pop up on my ovaries I am more concerned. I will make my appointment for my PCP tomorrow and when I go I am going to ask for a CAT scan. I think it is better at detecting abnormalitites than MRI. And I don't like that dye they have to use with the MRI.

[ziggy123]

I have been thinking of you today. How did everything go with your follow-up mammo?

[Montana girl 06]

I was impressed with how clear the digital mammogram came out. The technician said that digital makes dense breasts much easier to read. They showed me the clusters of calcifications but couldn't say if they had changed or not. I asked to talk with the radiologist but he had left for the day. He's the same guy that said I needed the biopsy last time. The other radiologist that said I could monitor the calcs instead of biopsy is on vacation this week. They said I could meet with him next week. So, now I have to wait for the report...and wait some more to meet with my preferred radiologist. If I don't hear by Thursday I'll call my surgeon and get a copy of the report. (The 1st radiologist will actually do the report from what I understand.) The ultrasound took a loooong time again...a number of new cysts and fibroadenomas to map in addition to all the old ones but nothing the tech felt was worrisome. I feel pretty upbeat about the results, not nearly as stressed as the last 2 times. I guess I won't be surprised if the calcs have changed, I'm just more at peace about it. Prayer works!

Boninclyde, I totally missed your post  about Montana until today. I love living near the mountains in an area where there are few traffic delays (other than road construction all summer long) but for many of us the pace is still way too fast. The schools are great and so is the blue sky that goes on forever. Economic statistics look really good in our area right now with lots of new businesses moving in. We often  have a couple weeks below zero weather in the winter but we have warm spells in the winter months, too. It just makes us appreciate summer that much more. Summer is a great time to visit. Where do you live?

[Montana girl 06]

I was really impressed with the digital mammogram. The pictures are so much clearer. They showed me the calcifications, but couldn't tell me if they had changed or not. I asked to talk with the radiologist but he already left for the day. He's the guy that said I needed a biopsy. The other radiologist (that said I could monitor the calcs) is on vacation. They said I could meet with him next week. So, the 1st radiologist will do the actual report from what I understand but I can meet with the other radiologist... If I don't hear from my doctor by Thursday I'll probably call and ask for a copy of the report. I'm much less stressed this time around. I realize the calcs may have changed and they may recommend biopsy but I'm calmer about it. Prayer works! Thanks for your good wishes, too.

Boninclyde, I totally missed your post about Montana until I read back through this thread today. Montana is a great place to visit, especially in the summer. I love being close to the mountains, and we rarely have traffic delays (except during road construction in the summer.) Our area is doing much better economically recently with several new businesses moving in. The schools are great (of course I'm prejudiced!) We often have a couple of below zero weeks in the winter, but we have warm spells, too. It just makes us appreciate summer that much more! Where do you live?

[Montana girl 06]

Well, I feel stupid. My post didn't show up on the forum so I though I must have pressed the wrong button and decided to repost. Here I am taking up all this space... I am definately technically challenged.

[boninclyde]

Don't worry abput the additional post. Theres plenty of room. We'll just skip to another if need be. I think it happens to all of us at some point.
Thanks for the description of Montana. Sounds like it's beautiful. Sad to hear about the new businesses moving in. Just means more people and more crime. I am from Charlotte, North Carolina. Talking about a big city. When I came here some 28 years ago Charlotte was mostly country. Now a BIG CITY.
Anyways, I am glad that you feel so confident about your results. I can't believe they are making you wait for info. Looks like the tech would have hung around knowing you would have questions. Keep us posted and I will be thinking about you.

[ziggy123]

I am glad to hear that you have peace of mind. That helps when so often, we are forced to "wait." I hope that everything workd out. Please let us know. Like Boninclyde, I aloved your decription of Montana. Twice, many moon ago when I was young, my family took camping trips across the country. I remember Montana as being one of my favorite places.

[boninclyde]

Ziggy wouldn't it be great. I like your imagination of Montana. Ziggy where are you from again. Sorry chemo brain and i did not even have chemo. Do you guys remember my conversation with kristenCB. Well she posted here about her copndition and We responded to her as best we could. I suggested she go to breastcancer.org. I hate sending ladies away from here but it is a really good wibsite. Anyways she had her masectomy after her vacation and she is doing reasllly good. I ask her to post back her several times because we care. I guess she forgo us ior hasn't had time. Just wanted to guive you girls an update on her. Isn't it great us 3 haven't left the board and continue to try to help others. I am lucky to have you guys. Lets stay together. A sisters glub. No boys allowed. Not that they would want to join.
OK another subject. Montaba girl and ziggy you always wondered where I came up with boninclyde. Well here is a short story. I come from a long line of bank robbers. They never hurt anyone like boninclyde did in the real days. When I was diagnosed I was devistated. It was storming here the day the doctor called. And I had just adopted these two german shepard/lab mixes. They were nothing but trouble, trouble, trouble, I still have them and well, will they ever grow up. Love them. I feel like I have 7 kids. Huddy 1, 3 girls, and 3 dogs. Ok to to get to the point. I was devastated and so the only log in name that came to mind was Boninclyde. Someday I will tell you about the family history of bank robbers. The reason I am telling you this now is because well the cops are closing in on me. No just kidding but I am going to change my login name since the cops are getting close. I mean since believe it or not a lot of people don't like my name and is time for a change. Did you girls know everything we post goes out worldwide? Or  try googling your log in name. Try googling your headline post. Just time for a change.
So goes the story,  of boninclyde!?
Look for me signing in as idobelievenfaires.

[Montana girl 06]

Boninclyde, are you serious or pulling our leg? I was sure you'd say something like, "My nickname is Bon, short for Bonnie, and my husband's name is Clyde." I agree that it's wonderful that a few have stuck around for support. But, I also have gotten attached to your name. I hate to see you change it because I associate it with you.

Today on the news they said the state of Montana is rated 7th in the nation for least amount of crime. When I talked about traffic and schools I was referring specifically to my town of Butte. (That's pronounced with a long u ladies.)

Thanks for caring. Again, you ladies are the only ones that asked how my mammogram went...