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Category:

Questions to ask to ensure you are in good hands

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Question:  #61 9/7/2008		Q:	My mom was diagnosed with breast cancer just last week. This process seems to be going so slow. She had a mammogram a month ago. It was very suspicious and she immediately made an appointment with a general surgeon to tell her what to do next. He made her go for more testing. Then she had a biopsy two weeks ago and just got the results on 9/4. Her doctor said we can discuss this if you come in now or wait until your next appointment on 9/18! She has made an appointment for Tues 9/9 with another doctor, but this just seems to be moving so slow. The biopsy made her entire breast black. Not just brusing, but so black you could not even see her nipple. It was not normal. She called to tell the doctor who performed the biopsy that she was concerned about it because it hurt so bad and looked terrible and the nurse said she must have done something, that it wasn''t their fault. The doctor who performed the biopsy also told her it had grown since her mammogram (which was done two weeks prior). Is this normal for it to take this long. I''m really scared for her especially since it seems to be getting bigger. She can even feel that it''s larger. I am really worried.
		A:	this is a longer process than desirable. it would be highly unusual too for this to grow bigger in 2 weeks though. you didn't mention what kind it is or how large so i don't know how concerned to be about it. in general, women have time to make good decisions and ensure they are in good hands before having to embark on treatment.
Question:  #62 9/7/2008		Q:	I had breast cancer four years ago. The breast cancer I had was estrogen positive. I also had a hysterectomy with my ovaries removed. I also had a gene test done and I am positive for the brca2 gene. I started to bleeding from the vagina and have serious pain. Went to the oncologist and my vaginal wall is like paper thin. I have tried arimidex and raloxifene and they did not work. tamofin is out of the question. the doctor said to take premarin vaginally 2 to 3 times a week. Some of my other doctor are not pleased due to a second reoccurance of breast cancer. Is this a good discussion?
		A:	some oncologists do recommend and prescribe vaginal estrogen cream for such symptoms that are effecting quality of life. the absorption of estrogen is quite low and therefore some oncologists are comfortable with their patients using it.
Question:  #63 9/2/2008		Q:	I am 2 1/2 yrs out from Stage 3 BC at 42. Had an 8 cm tumor 5/17 lymphnodes positive Her2neu+ and HR+. AC Taxol ,bilateral and radiation. Finished 1 year Herceptin and on Tamoxophen. I''ve been discussing Zometa to prevent bone mets because I''ve been reading about european studies on young women show great promise. My onco says more results from studies should be out this fall and that it may be an option for me. Just wondering what you think of it and if you have had any success keeping cancer at bay with Zometa in younger women. Again thank you so much for your time. You have inspired me and others to give back and pay it forward :)
		A:	I have heard about the study with Zometa and that the results are promising so far. If it is to be used, it would be a younger woman with cancer like you had. We are not doing this study at Hopkins. ds
Question:  #64 8/26/2008		Q:	I had a fibroadenoma completely removed in February and I am going tomorrow for my 6 month mammogram which is going to be a diagnostic mammogram. The whole experience of having this lump turned my life up side down until I knew it was the fibroadenoma. So now that is has been six months and I have to get another mammogram it has brought all those horrible feelings back adn I am very nervous and my breast surgeon is not going to be able to see my for a week. So my question is my scar tissue going to cause my mammogram to be abnormal and will they be able to tell me tomorrow whter or not everything is ok. Will the radologist know that it is scar tissue? I am having the mammogram at the same hospital I had the fibroademona removed? I am just very nervous and I don''t know if my mind can go thru a week of not knowing everything is ok or not. Thak you for any advice you can give me. I am mother and I had step mother die from breast cancer at a very young age.
		A:	the radiologist will factor in that you had surgery 6 months ago and will do a mammogram that becomes your new baseline mammogram. he will be able to distinguish the scar from other structures in the breast. relax. LS
Question:  #65 8/24/2008		Q:	i forgot to ask another question. Would a mri pick up micros or papillomas or anything else going on in a prior lumpectomy area?
		A:	not usually microcalcs but sometimes papillomas. it is highly sensitive but not specific. LS
Question:  #66 8/24/2008		Q:	for someone (age 35) with dcis (cribiform)low grade er/pr positive who didnt hv radiation or tamoxifin and 1 relative (mother age 47 at dignoses) what are the chances of the cancer returning w/in 3-5 yrs? Also if mammo comes back abnormal and another picture doesnt show it can it see be a problem. I asuming they saw microscals near or in my prior lumpectomy site.
		A:	stats are that there is a 40% probability of it returning within 2 years without doing radiation. that's pretty high. your family history combined with your age makes me think about genetics so meet with a genetics counselor and consider genetic testing. if you test positive for a breast cancer gene then the risk of recurrence is much higher, and also high for the other breast as well. get digital mammography too. LS
Question:  #67 8/24/2008		Q:	i had a mammography and ultrasound 5 months ago and the technician stated that i had dense breast and they found a 2cm possible cyst in the right breast. my ob/gyn md suggested that i return for a follow up 6 month mammography and ultrasound . i am scheduled for this exam next month. at this time should i be concerned? should other follow up exams such as a mri have been done after the initial exam?
		A:	they may have already confirmed it was a cyst by its appearance. so see if they tell you that when you go next time. cysts don't do harm. sometimes they are aspirated if causing pain or blocking the view because they are large. ultrasound would confirm if cyst (liquid contents) or not. LS
Question:  #68 8/23/2008		Q:	I am taking tamoxifen and having all the symptoms of hot flushes and mood swings. I am only 27years old and completed treatment for radiation and chemo. Just wondering if I can taking livial as I read it can eliminate the symptoms
		A:	ask instead about taking effexor. ask your medical oncologist. hope you have considered genetic testing too..... LS
Question:  #69 8/23/2008		Q:	Hi Lillie, you have always been sweet about answering my questions in the past - unfortunately I have another. I am 37 and have a 1 yr old son. In June I had a small rash (size of a quarter) on the top of my breast, my doctor deemed it a Lyme rash since I had a tick bite two weeks previous and it was a "classic" ECM. I took the antibiotics and it lightened and eventually went away but the area where it was has a slight erythmea. It is so slight my breast surgeon is unconcerned but ordered a mammo/ultrasound. At this point I was still nursing once a day. The mammo came back with microcalcs that looked benign in the right (not the one of concern) and nothing on the left. I asked about an MRI and she said okay, well in between the time for the MRI I became pregnant. Needless to say, I could not have the MRI, for peace of mind. So at this point, my surgeon says we have to go with the information we have and her breast exam which she feels are normal, I will have the follow up mammo after the baby is born and we will go from there. She says we have to go with the information we have and she will do another exam in three months and possibly an ultrasound if I am still concerned. In the meantime she told me to enjoy my pregnancy because she is not worried. I am worried that this will explode into inflammatory breast cancer or something sinister. I try not to think about it but I feel I am in a bad position with the pregnancy. Are there options for me or should I just trust my surgeon, who I have found to be thorough and accomodating. She is not worried at all. She ordered the MRI at my request. I should also say I have health anxiety, which does not help one bit.
		A:	a blood test can confirm that it was lyme disease. this would give you the peace of mind you need. LS (congrats on baby too.)
Question:  #70 8/11/2008		Q:	Recently had lumpectomy 1.5cm. Grade 3. Plus 2 sentinel nodes out. Last week I had to go back in to clear a margin and have more lymph nodes out because cancer was in Sentinels. I am conerneed because I did not have a drain. The surgeon said I did not need one because I was dry. Could it be that I did not have any nodes in the bit he took out? Should I be worried?
		A:	Your pathology report will indicate the number of lymph nodes removed. It is the discretion of the surgeon whether or not to place a drain. Without a drain, there can be an increased risk of a collection of fluid called a seroma.
Question:  #71 8/11/2008		Q:	I had a Mastectomy 11/06 for stage 1 IDC and reconstruction with an expander and a silicone implant in 3/07. I opted not to have a nipple contructed, but now, would like to get a decorative tattoo to cover the scar and nipple. Do you know of any risks involved?
		A:	Commercial tattoos are not recommended with breast reconstruction as the dye used is led based. This dye could interfere with quality of potential imaging like mri. The medical tattoo is an organic substance. Breast centers are not at liberty to make a decorative tattoo as it is not a medical necessity. ds
Question:  #72 8/9/2008		Q:	I had yearly screenings for 15 years. In 2001 I received a call back for additional films. I was called in for a consultation and was told I have a few cysts in left breast 3cms and 1 small one in rt.breast.I was told nothing to worry about.My Dr''s report says PROBABLY benign(Which I never saw in 2001) 2006 I was called back for additional films and was told no malignancies.2007 No evidence of breast cancer report was sent to me. July 2008 was called back for ultrasound and more mamograms. Then A request for biopsies in both breasts. I had the procedures now I have invasive mammary carcinoma(ductal) 4.5 cm in rt breast. I have seen the surgeon and he wants chemo first to reduce size of tumor. I am scheduled next week for CT,Bone Scan,MRI,This radiolgy center has 11 offices in our city. The Dr.who gave me a clean bill of health last year did the biopsies and the Dr. who called me with the results is also an attorney. They use Cert.Techs (6 mos) as second readers.When I got this call back I asked for a MRI and was told we only can do them if we find something. Now my surgeon wants the MRI. I will not go back to this center. I am scheduled to have the MRI done at the hospital. Its a little late. I am stage IIA T2. Should I stick with the plan of chemo-Possible Lumpectomy-Chemo-Rad./atypical in left breast lumpectomy or seek second opinion.
		A:	seek a comprehensive breast center that is part of an NCI designated comprehensive cancer center. the measurement is large and usually shrinking it first is recommended to chemo first makes sense. if you can come our way, DO. 443-287-2778. mammary implies it is a mixture of ductal and lobular. getting a more accurate measurement (and getting a clip placed too) with MRI is wise.LS
Question:  #73 8/3/2008		Q:	I went to see a breast cancer surgeon last april with inverted nipple, peau de orange, swelling and redness of right breast. I had mammogram,ultrasound,and needle biopsy. I was given the results that i had chronic exzema. In august last year with no change to my breast i had a lump come up under my right arm a different surgeon ordered tests and the ultrasound followed by a biopsy of underarm found these were secondaries.They could not find the primaries did i have IBC as there was no specific mass and what test could they have done in April to rule cancer out. I had never heard of IBC until seeing it on a news report
		A:	if the lymph nodes under your arm were found to be breast cancer then your clinical presentation of the breast does match a deion of inflammatory breast cacner. a skin punch biopsy of the breast skin is how it is diagnosed. LS
Question:  #74 8/2/2008		Q:	Hi, I am very uncertain of my stage and treatment at this point. I am ER positive,large tumor removed, positive nodes in axilla, supraclavicular and mediastinal. I do not have mets to distant organs. I am on Arimidex with good response. I was told I am either IIIC or IV. I am concerned that if I am a III that there is a curative element. Maybe not, there seems to be some vagaries on the web about the mediastinal. Can you help me? My case was reviewed at Dana Farber, Connecticut and MD. Anderson. some said hormonals and MD said chemo. I am worried that I may be missing out on a cure, if possible. Is it possible to stay at regional progression with Arimicex? Thanks for your help. I need some hope.
		A:	usually mediastinal nodal involvement implies stage IV. sounds like this was the direction people were going with recommendation of hormonal therapy. its good that it is hormone receptor positive. hormonal therapy may work for quite some time. that is the goal. to treat this like a chronic disease. you've gone to two excellent institutions. as you probably know most women with stage IIIc progress to IV; not all but many. sit down and talk with your oncologist about your desire to be aggressive and see what he tells you.
Question:  #75 7/27/2008		Q:	Just went to gyno, Pap-ok/CA-125-ok but had a pelic sonogram and an endometrial biopsy-awaiting results. Said I had a thick lining of 1.8 sonograms, instead of the norm.of 4mm. I am 65, went through menopause @ 57-no symtoms, hot flashes, etc. So, therefore never took any hormones.
		A:	so this doesn't sound like a breast cancer related question but a gyn question. maybe check the hopkinsmedicine.org website for gyn. if you were ever on tamoxifen it may be side effect related but since you didn't mention that then i need to direct you to someone else to assist you.
Question:  #76 7/27/2008		Q:	Hi, I have had a lumpectomy to treat 1 cm & 3mm IDC & obtained clear margins, 0/3 nodes. It is intermediate grade,highly ER/PR +, Her 2 Neu -, OncoDX score is 12 and Ki-67 is 20%. I''m 46 & am premenapausal. Will be doing whole breast radiation - 33 treatments. My onc. is recommending that I don''t do chemo & take Tamoxifen. I know that I''m in a very favorable position with good prognostic factors & would rather not do chemo but would like to be sure that it''s the right thing to do. I have read the Ki 67 of 20% is considered boderline high & I''m wondering how much this is considered when making the recommendation for no chemo. My other concern is whether or not 46 is considered young to have breast cancer & if women are treated less aggressively at a certain age. My final question is whether or not being premenapausal is also a factor in how aggressivly to treat the cancer - is it a less positive factor to be premenpausal? Thank you for any insights you can give me!
		A:	women over 75 with other health issues are treated less aggressively in general. you are relatively young but not extremely young. many are younger than you diagnosed. the oncotypeDX factors in the Ki67 score as well. 12 is a nice low score. you have to decide how aggressive you personally want to be. some women will do chemo for 1% benefit, but not many. your situation is one that usually has a very happy ending.
Question:  #77 7/26/2008		Q:	Hello, My Mom was diagnosed with breast cancer 16 years ago. She had a mastectomy on her left side and reconstruction. They also performed radiation. She ended up hurting her hip December 2001 and we found out that she had bone cancer. She was told that there was no cure, but it could be dealt with. She has been on several medications for the last 8 years and has been living well until this April. She is now experiencing high calcium. She was going on a trial, but at the last minute she did not qualify. Now, she has good days and bad because of the calcium. She was taking Chemo and it brought the calcium down to the normal level, but she only had two treatments and then her doctor said she was too weak. They referred us to hospice after that. I needed the extra help because she doesn''t have private insurance to pay for care. My question is should I have any hope that she might get stronger and will be able to take Chemo again or is this the end? I am hoping that since she is staying with us that maybe in a month or less she can gain back some of her streath and take Chemo. Am I crazy? The doctors keep saying it is up to her and they have never told us anything negative, but her nurse keeps reminding us that there is no cure and this will just be ongoing. Last time she had Chemo was three years ago and it worked well enough to give her three more happy years. Should we be trying for this again? I am confused and torn and when I express this, they say we will see. I just have this feeling that this is not the end. I know that sounds strange, but it is a very strong feeling. Do you know of anything new for breast to bone cancer? Also, since she has been on so many estrogen blocker type meds, would it be helpful if she started the cycle over again starting with the first one she took? Have you ever heard of this and does it work? I read an article about it where a lady started back at her first drug after taking several of the others. Also, do you know what the average life expectancy is after someone is diagnosed with breast to bone cancer? I can''t find any numbers anywhere. Thank you for any help you can provide!!
		A:	the fact that the doctor enrolled her in hospice means that he completed paperwork stating that be anticipated her to die within the next 6 months and that aggressive treatment was no longer being pursued. perhaps that wasn't explained to you at the time. hospice is designed to help patients and families get closure with life, maintain quality of life for as long as possible and die with dignity. talk more to the hospice nurse about what to expect and when.
Question:  #78 7/22/2008		Q:	50 years old. Pre-menopausal. Simple mastectomy June 13. ILC 4.5 cm tumor on rt breast. SNB 3 nodes all negative. Oncotype DX score 8. All other CT, bone scans, etc negative. Onocolgist says I don''t need chemo, since the score is low, but wouldn''t be against giving me 4 doses over 12 weeks of TC chemotherapy to improve/reduce my recurrence scores from 6% to 3-4%. She says it''s my decision, but am worried about size of tumor and lobular cancers can give false negative nodes. Is skipping chemo and moving on to hormone therapy the correct option?
		A:	to decipher this truly requires a formal consultation with a medical oncologist. that is a large tumor. most people would have skipped doing the oncotypeDX and gone ahead with chemo based solely on the size of the invasive component. get a formal second opinion before deciding.
Question:  #79 7/19/2008		Q:	My question is in regard to nutrition. I''m confused about the effect of soy. I was diagnosed with infiltraing ductual carcinoma, T1 No Mx, ER+, Her2-, stage 1. I''m 55yrs. old and chose the L-mastectomy for my peace of mind. I was told to limit my soy intake to 2-3 servings per week which I''m finding to be difficult since practically everything has some sort of soy ingredient. Can you explain the how soybean, soy protein, soy oil, and soy lecithin affect my system? soybean and soy protein I know I should not have. But what of the others in small amounts? Or very close to the end of the ingredients list? Is soy referred to as any other names?
		A:	i wish i could but i can't.... research is still in the midst of deciphering this. some studies show it to be very safe and actually preventing breast cancer; other studies imply it may not. the amount of soy in prepared food products (excluding soy prepared products that are of course 100% soy) are not considered to be of concern. hopefully in the next year or so we can put this issue to bed.
Question:  #80 7/19/2008		Q:	Hi Lillie I have a quick question I was treated with mastectomy for multifocal high grade comedo and solid grade 3 dcis ER- and Pr- Her/nu +3 I never received any further treatment is this standard of care
		A:	correct. it would be unusual to recommend anything else based on this pathology. stage 0 disease. hormone receptor negative (and frankly Her2neu shouldn't have even been done.)
Question:  #81 6/29/2008		Q:	Last year (2007), I had a lumpectomy. Approximately 3 1/2 week ago I had a breast reduction to even out the breasts. I''m still in a lot of pain, is this normal? I am still not done with surgery as the ariola has to be attached. I''m at a loss trying to figure out why it was not done at the same time......is the way most surgeons do it?
		A:	usually surgeons like to wait to ensure your margins were clear and also to have radiation effects completed befoe adjusting the other side to match.
Question:  #82 6/15/2008		Q:	Lillie, Thank you so much for this site. I wish I could give you a medal for all your unselfish service to women everywhere. Here''s my situation - I''m 60 y.o., in generally good health. Family history of breast cancer in 3 paternal aunts. Mother died of pancreatic cancer at 64 y.o. I had a very small (2.5cm) borderline Phyllodes tumor removed, with a second surgery to ensure wider clear margins. Path report: 1) Negative for residual phyllodes tumor. 2) Fibrocystic changes with focus of columnar cell change and mild intraductal hyperplasia, no atypia. I consulted with an oncologist at Stanford before the 2nd surgery. He advised mammo and checkups every 6 months for the next 10 years. My doctor, a general surgeon, wants me to come back to him in 6 months for my follow up. He''s only treated 4 other PT cases, and has not followed up on any of them. He also wasn''t very familiar with the disease when I was first diagnosed. Would you recommend this course for follow up, or should I be seen by a specialist at a cancer center? Any other testing you would recommend? Thank you so much.
		A:	time to be followed by a breast specialist at a cancer center. your family history screams out genetics. pancreatic cancer is linked to breast cancer genetically too. so time to see a genetics counselor for genetic testing. if you test positive for a breast cancer gene you might want to do some preventative surgery for yourself.
Question:  #83 4/27/2008		Q:	Dear Lilly, I am so glad I got through it seems like ages since I last had to eamil you. I ws DX Nov 05, trip neg stage 1 wide matgins lumpectomy 6 rounds of 5FU Epirubisin and cytoxin did clin trials and had 34 rads. This Nov will be 3 year mak Right? Is there anything new on trip neg that I need to know? I am still being seen avery 3 months by the surgeon or oncologist. Is this typical, and age at dx was 45, now I am 48.I jusr want to make sure that I am doing everything to be informed. I jave Kaiser and they have reg mammograms, should I go somewhere to get a base for digital? If there is anything new that I need to know could you let me know. Tahnk you I hope you are doing well
		A:	good for you! getting digital mammos is smart. you should be graduating soon to be seen twice a year. more news on triple neg will come out in dec i think at the next san antonio breast cancer conference. nothing to report yet though. take care!
Question:  #84 4/7/2008		Q:	I am a high risk patient (ALH @ 46 yrs.--12/07 R breast; & sister w/ BC 2 yrs ago age 46) my lifetime risk is 45%. After my needle loc biopsy in Dec., I met w/ oncologist to determine plan for me. Tamoxifen not possible b/c of inherited blood clotting disorder; so oncologist suggested breast MRI's & mammograms (I have dense breast tissue) but she did not know "where I could get MRI or who to call" to order it. I asked breast surgeon to order MRI which was performed 1/30/08. At 3-month follow-up exam w/ BR surgeon, they seemed confused about "who had ordered the MRI and why? " & did I have the disk of MRI? They then informed me that they like to have their radiologist read the MRI's after the hospital b/c the hospital had been reading/performing MRI's for only a couple of months, & they were sometimes "missing" things. After locating my disc, they said they would call in about 1 week w/ their results--this is now 8 weeks since MRI was performed. Radiologist calls 1 week later & says I need to come in for ultrasound to check something in my left breast . I was seen that afternoon; she could not find w/ ultrasound what was seen on MRI & said come back in July for mammo. Why is ultrasound definitive when MRI is more sensitive? My sister's cancer--3 spots--were not seen on mammo, all appeared on MRI & were hard to detect w/ ultrasound. In addition, BR surgeon initially said I should come back in June for right only mammo. If I am considered high risk, why am I having to request MRI & question logic of only following R breast? Even before ALH biopsy result, I was always coming back in 6 months after annual mammo to follow calcifications, etc. on one side or other (at another facility prior to biopsy) Would a second opinion be wise & should I seek a high risk program for future care?
		A:	sounds like a second opinion would be wise. also sounds like perhaps something was seen in MRI they want to now correlate with an ultrasound.
Question:  #85 4/6/2008		Q:	Hi Lily and once again thanks for your kindness and support. I am 18 months out of stage 1 IDC. I had radiation and am on Arimidex and all is going relatively well. Everytime I have a blood test and then have my onc appt, he tells me my white blood count is on the low side ( not leukemia--he always says). Any way I can build up my white blood count such as certain foods I should be eating or is this not possible to control.
		A:	unfortunately there isn't a way through nutrition to build your white count (red count, yes but not white).your body seems to be running a "low normal."
Question:  #86 4/6/2008		Q:	Hi Lillie- I have read your past posts on DCIS with microinvasion of a focus of less than 1mm. Along with most of DCIS being Her2neu+ and the micrinvasion being Her2Neu+ too. My oncologist called the pathologist to verify the Her2Neu+ on the microinvasion. Your answers to these posts are in agreement with the many oncologists I consulted with regards to my treatment. I am T1mic and was told, with a negative sentinel node, wide margins, negative scans, and such a tiny microinvasion the treatment plan is radiation after lumpectomy. I was told the Her2 status is not important for such a tiny tiny microinvasion. The risks of chemo and/or Herceptin outweigh the benefits. I'm hormone negative so no hormone therapy and I had high grade cells. I have heard of chemo & Herceptin being given now for early stage breast cancer. How much much microinvasion usually calls for chemo & Herceptin? Also does Hercptin work without chemo? I already started radiation but still am worried...Thank you.
		A:	herceptin isn't given without chemo. it would need to be truly invasive disease-- not just microinvasion to entertain chemo.
Question:  #87 4/6/2008		Q:	Can you think of any reason a breast surgeon would recommend a 6month or 1 year follow up for mild focal epithelial atypia found on stereotactic biopsy instead of doing a open excision biopsy. There is no lump only microcalcifications. Just wondering your thoughts as your advice is to do an open excision biopsy. Thank you.
		A:	no, not really. the standard of care is to do an open excisional biopsy. if you wish to come to us just call 443-287-2778.
Question:  #88 3/29/2008		Q:	Hi. I recently went to see my breast surgeon to review the results of my biopsy and discuss the bloody nipple discharge. He has decided to do a major duct excision for the discharge Because the discharge is not always present he said the ductogram cannot be done. I am okay with that but my real concern is that my biopsy results showed mild focal epithelial atypia in the 10 o'clock outer area of my rt breast. He has decided not to do an open excisional biopsy as he felt the atypia was only mild and focal and the pathologist did not "recommend" additional tissue samples. He suggested due to no family history of BC and my age of 37 we wait and watch with yearly mamograms and exams. What are the chances that I could have some early bc in my breast with "mild/focal" atypical cells present? I want to trust my dr. but everywhere I read it says that standard of care for atypia is to do a open biopsy. Thanks.
		A:	atypia of any kind is a ticket for open excisional biopsy. consider coming to us where there are specialists in breast cancer and high risk women (which you are). 443-287-2778.
Question:  #89 3/29/2008		Q:	Hi, I'm 28 and recently diagnosed with Melanoma. I recently had a wide excision on my breast and haven't received results, my surgeon went on vacation and no one will tell me the results over the phone. The nurse I talked said that she had my results in front of her but couldn’t tell me. She went on to say, “it is what it is, there’s nothing I can do about it, and not to worry about it until my appointment”. Leading me to believe the results are positive-meaning bad! It will be 19 days when I finally have my appt, should I seek care from a different doctor?? It’s been over 2 weeks since surgery and today I started having shooting pain from the incision site to the nipple-very painful! I haven’t had any pain until now. Should I be worried? I’m currently in a master’s program and working part-time as a substitute-meaning NO INSURANCE!! I’m scared that because I’m without insurance that I’m not getting the best care. I have a cousin who is 17, stage 3 Melanoma and moving into 4. My maternal grandfather and his sister also have melanoma. Besides the melanoma, I have a strong family history of breast and colon cancer at young ages, paternal. My mother (47) is currently awaiting results concerning a lump in her breast as well as on her ovaries…with my family history; shouldn’t the doctors be more aggressive? What should I do?? Thank you for your time!!
		A:	based on your deion of the conversation it would imply that it is bad news...request to speak to the doctor covering for the doctor who is on vacation. it isn't fair for you to have to wait like this. you can always go elsewhere. the challenge is your lack of insurnace. given your medical history i'm sure you know it is a necessity for you to have insurance coverage. gone are the days of free care. your family history is compelling and warrants a genetics evaluation too.
Question:  #90 3/27/2008		Q:	I am a 41 year old Stage One IDC survivor- two years out. I have developed a rock hard pea sized lump on my wrist. I noticed it in January,and I think it has grown a little since then. It is quite prominent, and it is somewhat tender. I showed it to my family doc, who said come back in 6 months and if it's still there he will refer me to a hand specialist. I have no appointments booked with my oncologist, and being in Canada, one cannot just book an appointment with an oncologist. I am no longer considered his patient, and all my follow-up work (prescribing Tamoxifen et al) is done through my family doc. My concern is that this could be cancer. Does metastatic breast cancer ever present itself as a lump? Should I be demanding a referral to a specialist (wait time for an appointment with a specialist would likely be another 6 months- no kidding- this is Canada) or even going to see one privately in the States? Or am I being paranoid? I can never tell these days if I have crossed the line and become a full-fledged hypochondriac... some days I wonder...
		A:	the possibility of a hard pea size lump on your wrist being breast cancer would be extremely remote and unusual. i've frankly never seen breast cancer go to the wrist. remember you can develop other problems just like anyone else-- like a ganglion cyst. ask your family doctor if that is what this is.