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|Questions to ask to ensure you are in good hands
Questions on what to ask to make sure your in good hands.
|Asked||Publicly Submitted Question|
|2/9/2012||Hi Lily, I wrote to you once before and truly grateful for your advise. |
I have had a mammogram in mid August 2011 that showed area of calcification 4x6 cm in my right breast, then in mid September I was diagnosed with breast cancer. I started chemo in mid October for T3 triple positive tumor. After reading your answer you wrote to me back in November I had pushed for and finally had an MRI done in December, that was in the middle of my chemo I will type the report here it reads:
Right Breast "There is approximately 2.2 x 2.0 x 0.9 cm mass with abnormal malignant type enhancement in the 9 O'clock position. There is also abnormal enhancement extending anteriorly and inferiorly for approximately 3.0 cm also indicating malignant involvement. No other morphological or kinetic abnormalities in the right breast.
No axillary or internal mammary adenopathy.
Left breast: There is 0.4cm non enhancing nodule with 2 adjacent smaller nodules at about 2 o'clock position not considered significant and could be intrmammary lymph nodes or cysts filled with debris. There is a 0.4cm non enhancing high T2 signal intensity nodule at 12 o'cols position consistent with a cyst.No other morphological or kinetic abnormalities in the right breast. No axillary or internal mammary adenopathy.
I also had a chest and abdominal CT scan done about the same time as MRI and it was clear. "The chest and abdomen do not demonstrate any evidence of metastases"
I had finished chemo 2 weeks ago. I have done well with chemo no major problems. Right now I am waiting for mastectomy, I can still feel the mass in my right breast but much smaller,(i think)
I am scheduled to continue with herceptin for a year and will be starting hormonal therapy soon.
A month ago I have gone to a bigger cancer center for a consultation about type of surgery,and inquired about new drug pretuzumab, it is not available here in Canada yet?
I also inquired if I could have a mastectomy with a tissue expander as a first part of reconstruction as you would do in your center, but because I would need radiation immediate reconstruction was not recommended for me here and because of high reacurance rates for my stage.
However right now I'm leaning towards having by lateral mastectomy because of those cysts in the left breast , not sure yet.
My question now is about right breast should I have axillary lymph nodes also removed with mastectomy ??? I have two opinions one is to have a simple mastectomy and was told there is no point or benefit in removing lymph nodes now because I already had chemo, the other is that removing lymph nodes is just standard of care and it should be done. note The lymph nodes were not tested before chemo.
What would be your advise? Also What is normal waiting time to have a surgery after chemo?
Thank you for reading my post and your advise...
|Replied||JHU's Breast Center Reply|
|2/9/2012||Glad to see chemo working!! usually sentinel node would be done, even though chemo may have erased any cancer previously there, it would be good to know that no disease is present now. that will be important for planning your radiation treatments. putting in a tissue expander as a space holder for now with mastectomy will work letting that tissue expander take the radiation hit. then down the road look at diep flap reconstruction long after the dust settles. be well dear. L|
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