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November 26 I went for a ultrasound because my doctor found a hard moveable lump in my left breast that is pain full, last week a received a letter stating I had to call my dr because of a suspicious abnormality. I called to make an appointment but I was told I have to wait till DEC 21 for my appointment also the tech kept asking me do I have a family history of breast cancer I told her no should I be concerned? i am 42 years old last year I had a mammo that was fine this year it was just the ultrasound
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962875 tn?1314210036
Hi again,

Thanks for getting back to us!

I hope you are recovering well from your mastectomy and that you are satisfied with your reconstruction results.

As ncmichigan indicated, there are many different chemo protocols, and patients may have different experiences even with the same protocol. As she also commented, medications are routinely administered to reduce or prevent side effects such as nausea/vomiting/diarrhea which used to be a major problem, to keep blood counts from dropping too low, etc.

Someone close to me who had chemo tolerated it relatively well, and in fact went out to eat as a treat after each treatment. On the other hand, some of our members have had a rough time, due to extreme fatigue, mouth sores, discoloration and sometimes loss of fingernails and toenails, and/or allergic reactions. Loss of head and body hair is very common, but generally it grows back, although the color, texture, and thickness may be different.

Your oncologist and his/her office staff will be the best source of information regarding what you can expect, and to offer assistance in regard to any side effects you may experience.

Please keep us posted regarding how things are going--we care!

Wishing you all the best,
bb
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Avatar universal
I can't comment on chemo from personal experience, but I do know everyone reacts differently to the various treatments. I also know there
are medications that minimize the side effects. I hope your team will explain all this to you, but if the don't, please don't hesitate to ask whatever questions and get whatever you need to make you as comfortable as possible, OK? I hope some others with more experience will respond, but I just wanted to send my best wishes to you in this part of your journey. I'm hoping all goes as well it possibly can for you and you'll soon have no evidence of disease (NED).
Hugs♥,
nc
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Avatar universal
Nylani and Bluebutterfly you guys were both one hundred percent correct exactly what you said is just what I went through and again I say thank you so much also I am sorry it took so long for me to update but it has been a long rode. I did have the mastectomy and reconstructive surgery and in the next two weeks I was told exactly what bluebutterfly2222 said one positive node was removed and they said I have to go through chemo and take tamoxifen for the next 5 years because there could be microinvasions left behind. So now I have chemo to look forward to does anyone one have any advice?
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962875 tn?1314210036
Hi Lani,

You are certainly well-informed!  As some of us have already coveyed to you privately, your knowledge, sound advice, sense of humor, personal experience, and compassion all make you a most welcome and valuable additional to the Breast Cancer Community!

You have made an important point: The psychologial impact of any particular decision should be weighed in along with the physical impact.

When I read that study, I also had mixed feelings about the recommendation. Even though  the procedure of removing a large number of lymh nodes can increase the risks for nerve damage, pain, and lymphedema while, according to this study, not adding to survival time, there is something very comforting about being able to say, "They got it all!"

After my loved one had her tumor and her one positive node removed, we felt great relief. " We knew, of course, that there could still be microinvasions that were as yet undetectable and would  have to be addressed by radiation and chemotherapy, but our level of hope was boosted by the belief that at least for now, "the enemy was vanquished!"

Warm regards,
bb
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4880072 tn?1364746026
Thanks Bluebutterfly!

Appreciate you popping in with this piece of information as my knowledge of methods used within the United States is limited.
I have been surprised to see there is quite a few differences in approach in how breast cancer is treated around the world  and I've learnt a lot from the American sites, much to the consternation I am sure of my oncologist as I love bringing him studies I find :)

I read the study you mentioned about a month after my operation and spent some considerable time thinking on whether all of my nodes should have been removed - or not, factoring in that there is no change to the statistics realting to  survival rates either way,

The answer I came to was a personal one in that though there was no change to the statistics, the sense of relief and measure of comfort I had knowing that this path of travel had been removed, was well worth it to me.

My very best wish for Angel is for her to be in a position of power to chose options that not only are medically correct, but also provide her a measure of comfort and peace

Lani :)
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962875 tn?1314210036
Hi,

Nylani has given you a wealth of excellent information and advice!

I just want to add one thing: Since you are in the United States, even if some nodes are found to be positive through the Sentinal Node procedure, it's possible your surgeon may NOT remove ALL of the the axillary nodes. I say this because "Since the mid 2000s, the American Society of Clinical Oncology has urged doctors to consider removing only the lymph nodes closest to the tumor, called sentinel lymph nodes, to see if the disease has spread beyond the breast. Even if it has, a study released in 2011 in the Journal of the American Medical Association suggested removing the lymph nodes doesn't help women live longer, as long as they are getting radiation and chemotherapy."

Like Nylani, I'll be keeping you in my thoughts and prayers.

Wishing you all the best,
bluebutterfly

Helpful - 0
4880072 tn?1364746026
Dear Angel,

I can't tell you just how happy I am to hear that I was able to help. I was unsure about giving out so much information at once, however felt it so important that you had some answers at your fingertips and to look back on if needed.

Thank you also for providing some background as to the consultation with the breast surgeon and relieved my worried mind :)
It sounds to me, that he has a good understanding of what type of cancer he is removing.
However, he is acting very appropriately by waiting for the full pathology to come through after the surgery. With this in hand, he can sit down and go through everything with you as the picture will now be clear.

I am also glad of the reason he has given you as to why the mastectomy is better in your case. This was one of the reasons that I opted for the mastectomy myself. With an invasive cancer, there is a risk in using a lumpectomy,
It isn't common, however I have had a friend of mine who had to go back a couple of times to remove more and each extra operation becomes extremely stressful for the patient. A mastectomy provides relief from all of that worry and stress.

As to your question "What is a radical modified mastectomy?"  I have taken some excepts from an excellent site called breastcancer.org to help answer it.
When you get a free moment yourself, check the site out, it places a wealth of information at your fingertips, and knowledge is power to those of us who walk this path. Just promise me you wont overdo it like I did and read too much at once - I had a headache for days :)

Mastectomy:

Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.

Modified radical mastectomy

Modified radical mastectomy involves the removal of both breast tissue and lymph nodes:
The surgeon removes the entire breast.
Axillary lymph node dissection is performed, during which levels I and II of underarm lymph nodes are removed
No muscles are removed from beneath the breast.

Who usually gets a modified radical mastectomy?

Most people with invasive breast cancer who decide to have mastectomies will receive modified radical mastectomies so that the lymph nodes can be examined. Examining the lymph nodes helps to identify whether cancer cells may have spread beyond the breast.

This discussion you may wish to check with your breast surgeon as this indicates to me, that he feels that some of your lymph nodes are compromised and is expecting to remove all of the nodes under your armpit.

I had a radical mastectomy with the axillary node dissection. When the surgeon operates, he has no way of knowing how many lymph nodes are in your armpit.
An ultrasound can't be used either as the wee things like to hide behind other tissue,
If the sentinel node biopsy comes back indicating the presence of cancer in your nodes, all the nodes will be extracted to prevent the cancer from progressing further.

If this occurs for you, know that this is a good thing. You want this cancer stopped in its tracks and removing the nodes is the way to do that very effectively.
For me, I had 16 nodes removed, 2 were positive and again, since they have been removed, it has greatly reduced any anxiety I would have had if only one or two cancerous nodes were removed with the others still left in there

Lastly, there are a couple of things I'd like to say and hope you dont mind me clucking over you like a mother hen..

There will be many appointments in the next few months. If you can, take a support person with you always, be it your partner, friend or family member as that shocked feeling tends not to go away for a while, and it's helpful to have someone there to write things down.
Another alternative is to take a tape recorder of use your mobile phone to record the sessions. I have a wonderful tape recording of my oncologist who explained how my cancer evolved - it is priceless to me and I can go back at any stage and replay it when I forget certain things

Also, people in the most unexpected places will offer you help - dont turn them down. These people are rare gifts who can really pitch in when you need it

Angel, you sound as if you have a very experienced surgeon and I have booked the 20th on my calendar. If you are able to tell me the time of the operation, I will light a candle for you and send you my very best wishes

Please stay in touch with us here so we can get to know how you are, we do care greatly and love to know the outcomes of those who write in.

All my very best wishes
Helpful - 0
Avatar universal
Nylani I just want to say thank you so much words just cannot express how much I really appreciate your help. It seems as if God sent you at t everything you said was exactly what I truly needed to hear. And you are right when the surgeon was speaking to me I was trying my best to listen but it seemed as if my I was having some sort of out of body experience. But I can tell you that I did make up my mind to have the mastectomy I have a appointment on Friday to see the breast surgeon and on March 20 I will have a radical mastectomy with sentinel node biopsy and breast reconstruction. After reading several post on this site I am ok. And to answer your questions the last time I spoke to my doctor was when he sent me to the surgeon. As for the surgeon he did give me a choice as far as the mastectomy goes but he suggested the mastectomy because he said he only wanted to do this once. As far as the type of cancer all he said was that it was large and as for chemo he said I MUST have it because of my age but he does not no what type. And yes I do have one more question   He told me I would have a mastectomy but on paper he wrote radical modified mastectomy is there a difference? once again thank you so so much and my prayers are with you as well
Helpful - 0
4880072 tn?1364746026
Hi Angel,

I haven't spoken to you before now, apologies for not popping in earlier, but I hope I can help you personally with some of your questions.
I had a left breast mastectomy in November 2012 and am currently almost through my chemotherapy treatment so I hope I can reassure you of a few things from one who has walked the path you are about to take.

Deep breath hun, let's go through a few things and hope this helps you.

Since you seem comfortable with the PET Scans and are now focusing on the mastectomy. we can start there.

Mastectomy
Your surgeon has a reasonable idea from the previous exams i.e. Ultrasound about the size of the tumor. The fact that he is suggesting a mastectomy suggests your tumor is larger in size. I am a little concerned however, that he or someone such as your primary hasn't gone through these things clearly with you,
Are you able to make another appointment and take along a support person to write things down for you?
I know that when I was told similar news to you, I was in a state of shock and half the words my surgeon said I honestly didn't remember. My husband did, however and was able to help me later on by filling in the gaps.

You have a right to know why the breast surgeon has chosen a mastectomy over a lumpectomy.
You have the right to ask about the rate of growth and the progression of the cancer.
Certain breast cancers do spread rapidly unfortunately, mine being one, but even I was given clear advice that a mastectomy would be a "better option" but if I decided to get a second opinion, a different surgeon would likely suggest to opt for a lumpectomy. Therefore, it is important this information is given to you clearly so you can make an informed choice about your own body.
If you are not given this information properly, or treated dismissively I would strongly suggest a second opinion with another breast surgeon as soon as possible.

The Sentinel Node Biopsy

During your ultrasound, an investigation would have likely been done under your armpit to check for enlarged nodes or glands. If they appear larger in size, this can indicate that the cancer has moved away from the breast and into the lymph node tissue.

Did this get discussed Angel? If not, I am again concerned that you really haven't been provided with a clear explanation which is your right to have provided to you before any procedure is performed.
Normally during surgery, there are two ways (well, now 3 which is a reverse sentinel node biopsy but lets not confuse things) to find out if the nodes are compromised.
The gentler option is the sentinel node biopsy which identifies a node close to the tumor (called the sentinel) and is injected with a radioactive dye. The surgeon then uses a device that detects radioactivity to find the sentinel node or looks for lymph nodes that are stained with the blue dye. Once the sentinel lymph node is located, the surgeon makes a small incision (about 1/2 inch) in the overlying skin and removes the node. This is then tested to see if the cells are cancerous. If so, this means that the breast cancer has moved from the primary location and into the lymph nodes.

In my case, my surgeon was experienced enough to know the enlarged nodes were cancerous, so he performed an axillary node dissection which removes all the glands that existed under my armpit.

Phew - that's a lot of information to throw at you - I apologize for the length of my post but am concerned that you didn't have this information provided to you and hope that you can follow up on this.

Good News! - yes I can tell you there is.

I chose a mastectomy and am very happy with that choice. I could have gone for a lumpectomy, but I would be always wondering if the cancer was still there in some way. A mastectomy totally freed me from that worry and was a clean, simple operation.
I was in hospital for 2 nights, and I had 2 drains inserted which led into one bag, which when I went home, I kept in a cute flowery pouch clipped at my waist.
4 days after that, my drains were removed cleanly and relatively painlessly and simple exercises at home helped restore my arm movement.

Some women do have more pain than others post mastectomy, but this is more related to an axillary node dissection as removing all the nodes interferes with the nerves which get a little annoyed at being thrown around :)

Finally, you wont get your full "Pathology Report" until after your operation. This is perfectly normal and simply due to the fact that after the operation, they now have removed the full tumor,  plus examined the nodes, and can give you the updated information as to where to from here. This is why they cant advise yet if radiation or chemotherapy is an option as they dont have all the facts.

Hang in there, you can do this!
There are many wonderful blessings in the path to come, I promise, and they come from the most unexpected places.
The most important thing to concentrate on right now - is you. Focus on yourself, this is the time to be selfish and think about what you need in the next few months.
Do you need more information? Get your second opinion. Too much information? that's ok too. Some women are happier just going with the flow.
Whatever you need or feel is going to help, you have the right to get these supports in place.

My very very best to you Angel, I do hope I havent swamped you with too much information at once, but I genuinely care about you and your upcoming operation.

Dont even hesitate to ask if there is any question you aren't sure of and on the day of your operation, I'll be right beside you in spirit to watch over you

My very best to you
Helpful - 0
587083 tn?1327120262
Hi angel,
It's hard to know for certain which patients truly "NEED"a Mastectomy and chemotherapy to prevent a recurrence of breast cancer,since no one can see the microscopic residual cancer cells that may or may not be present after mastectomy.  
There are many different factors to consider when making decisions about treating this disease.If your breast Surgeon has recommended a Mastectomy and chemo he must have his good reasons to justify it.
Breast cancer treatment is individualized based on the patient and the characteristics of the tumor.
After your operation,the surgeon will be able to fully inform you about what type of cancer you have and will plan a specific treatment for your particular case.
My thoughts and prayers are with you and I wish you a prompt recovery.I am very hopeful that everything will go well for you, and that this disease will be completely eliminated from your body,following your treatments.
Sending you my best wishes :)
Helpful - 0
Avatar universal
Thanks zouzi for your reply, the surgeons office called me on  Saturday to tell me that my scans came back good and that the surgeon was on vacation and that i should come in Tuesday which was today My surgeon scheduled me for a Mastectomy on march 20 but I am a little confused because when I asked him what type of cancer I had he said he does not know he has to do a sentinel biopsy during surgery to find out and now he is saying I WILL have chemo after but the last time he told me I would not. Does any of this sound right to you. Thanks in advance to everyone for your kind words and support also thanks again japdip for the information you provided
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587083 tn?1327120262
Hi Angel,
I am really so sorry you are going through these appointments delays! Doctors and Surgeons usually set their own office policies,but remember that "the squeaky wheel gets greased !"
Since the results are in,I would suggest to call your doctor and ask him to get things moving,or call the surgeon's office and insist on an appt,or at least to be put on the waiting list in case someone cancels.
I sure hope that very soon things will progress faster.
I wish you well and good luck!
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Avatar universal
Hello again i am really confused now not to mention a little angry. As i stated in my earlier post my surgeon sent me for two scans, one was a pelvis and the other was a bone both scans were completed one was last tuesday and the other was about a week and a half ago thursday, I contacted my surgeon today to find out my results and was told that my results were in but she was not sure when the doctor would call me to give me a appointment to come in. Also I have not heard from my primary doctor, Is this normal procedure I am trying to stay calm and patient but I feel lost and confused and the waiting is becoming unbearable.
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Avatar universal
Thanks to all of you for your kind words and support. I was just a little frustrated with my doctor I was told about this in nov this is now feb and to make matters, I was told when they did the biopsy they would remove the lump, after the surgery i was given pain medication and was told to follow up with my doctor. I called my doctor yesterday and the secretary said oh you can come in today if you like, when i got there that is when my doctor told me. I have bad news this thing is growing and I would suggest you remove the entire breast and I will get the best plastic surgeon so you will not have to walk around with one breast I agreed. As I was about to get up to leave that is when he told me about two scans I would have to take and then he said you will be fine unless the cancer spread then there would be no need to remove the breast. Now my questions are why did he leave the lump in? And is there a good chance that the cancer spread? again thanks and sorry for all the doubt and questions

  
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Avatar universal
I just wanted to add my good wishes to japdip & zouzi's. I know it's normal to feel overwhelmed but please try to remain positive and hopeful. I truly believe it has a big impact on your recovery. Believe that your doctors really do have your best interests at heart, but be sure to ask all the questions you need to have answered. Try to get support and help from family and friends, and come back here if you need to, like zouzi said. We all wish you well and do care.
Sending you a big hug from Michigan (       ),
nc
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587083 tn?1327120262
I am so sorry to hear about your diagnosis!
I really have nothing to add on Japdip's excellent information.I just wanted to wish you an uneventful surgery, prompt recovery and hoping that all your medical treatments will be completely successful.
Just know that you have come to a great site for support and information.We are here for you and will help you through your journey.
Sending you positive thoughts and best wishes..Stay strong!!
Helpful - 0
25201 tn?1255580836
So sorry to hear that you have received this diagnosis. The additional testing that may be done now I would think would be a scan of some sort to detect any questionable areas in other parts of your body. This is pretty much a routine thing and shouldn't be a problem for you. The type of surgery is usually based upon the size of the tumor, it's placement within the breast tissue. Mastectomy isn't a complicated procedure and depending on how you react to pain or discomfort can be rather simple. There may or may not be drains placed after the surgery that are usually removed 7 to 10 days after your discharge from the hospital. Although Mastectomy is sometimes done as an Outpatient procedure, most spend a night in the hospital. Some women experience pain and some do not but recovery should be rather speedy. You will be given instructions as to what you may and may not do immediately after surgery. As far as treatment following surgery, this will depend on the Pathology studies on the specimen and if cancer cells were found in the lymph nodes.You will be referred to an Oncologist either before or after surgery ... possibly both where you will be informed of the best treatment plan for your particular situation. Hope all goes well for you and please keep us posted as to your progress.   Regards ....
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Avatar universal
Hello, It have been a while since I have posted but to make a long story short I was told today after having a biopsy on feb 6 that i nave bc in my left breast and that i should have more test done to make sure it did not spread to my bones Also my surgeon recommend that I have a mastectomy
to make sure the cancer does not return can anyone explain to me exactly what i have to look forward to and will i have to go through chemo? thanks in advance
Helpful - 0
Avatar universal
Hello angel2342,

I know exactly how you feel, about being in this alone.

I am 23 years old and found a couple mobile lumps on my right breast and went to get an ultrasound to see what they are. My breast specialist said that they are benign, though she didn't do a biopsy of it. Now I'm deciding whether I should have these lumps removed now or in 6 months after going back for another ultrasound to see if the lumps get bigger.

I have not told my parents or any of my family members about any of this because I don't want them to get worried. My aunt has just been diagnosed with breast cancer (and i think it's stage 3, because the cancer is already visible on the surface of her breast?) and my mom just found a lump on her breast too (on top of a couple other sick family members) so I don't want to add to their worries.

So I do feel alone in this too, but I guess that's why this forum helps a lot in terms of giving support. So don't worry, you're not alone. :)
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Avatar universal
I just want to say thank you soooooooo much, I do understand I have to wait until my Doc confirms but I have been on pins and needles especially because I am scared to worry my friends and family members so I feel like I am in this alone, Also the fact that they sent me a letter and now I have to wait almost two weeks just for a answer and if something is wrong, all this time is wasted. Thanks again for listening to me it really means a lot
Helpful - 0
587083 tn?1327120262
Hi,
This lump sounds like it's a Fibroadenoma which is a benign growth that could present the way you are describing it.Of course there is no way of telling for sure,but your doctor will let you know, after reading your complete Ultrasound report,if the lump needs to be further investigated by having additional tests or having a biopsy to make sure what this lump represents.
I don't think you should be overly concerned about it,because not all hard lumps that form inside the breasts are cancerous and since yours is mobile,it's a good sign.
Also keep in mind that a high percentage of breast lumps are non cancerous in nature and I hope that further investigation regarding this lump,will result in benign findings.
Best wishes...

P.S.Don't worry about the technician asking if you have a family history of BC.It was just a question that routinely Radiologists/doctors ask when a lump in the breast is discovered.
Helpful - 0
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