Hi Bundychick, I may be wrong, but I gather from your post that you have not yet had surgery, and that the results you have so far are from your GP as result of an ultrasound and mammogram, or possibly a biopsy either FNA or core biopsy. The process of learning exactly what you are dealing with when you have breast cancer is often a gradual one, and the decisions about what treatment/s is/are best for you cannot be made until most of the information is available.
For me the process was very confusing, and I wondered if it would help if I told you what I learnt about how the process works?
I found a lump and saw my GP who refered me to radiology. You may have gone for a breastscreen to get to this same point.
The first step, Radiology supplies a radiographer's interpretation of signs of malignancy in the ultrasound and/or the mammogram. For me the very experienced radiologist saw on the Mammogram the tell-tale specific kind of calcification that went with Ductal In Situ Carcinoma, plus on the ultrasound the white spiky "hedgehog" shape of an Invasive Ductal Carcinoma, both in my left breast, and no signs in my right breast. She said there was no radiographical symptoms of lymph node involvement but warned me that this would only be certain a week after surgery from the pathology report on the removed lymph node/s.
She took a fine-needle aspiration, which found malignant cells proving it was cancer, but gave no further information about the cancer.
I saw my GP at this stage, and,like yours, she said that I would need surgery, and that they might then give me a pill called Tamaxofen for five years. However, at that time, there was not enough information to really have any idea what treatment would be recommended.She referred me to Peter Willsher at the Mount in Perth, an excellent surgeon who then took over guiding me through the process.
The next step can be a core biopsy, which can supply a bit more about the cancer, eg if it is estrogen receptor positive(ER+), progesterore receptor positive(PR+), HER2 Receptor positive, and what grade the cancer is (how aggressive/fast growing/keen to spread) it is. This is often not done if you are going straight to surgery, but is done if you are going to have chemo before surgery, known as neo-adjuvant chemotherapy which can be done to shrink a tumour before surgery.
If you only have a Ductal Carcinoma In Situ, they may or may not do surgery, and may or may not offer other treatment, I am not sure of current practice
I had to wait for my post-surgery pathology results to learn any of this information about my cancer.. Surgeons remove the tumor in a mastectomy or lumpectomy, and also usually remove the lymph node that first receives the lymph flowing from the tumor area( (the sentinel node), and check that out at the start of surgery. If it is apparently clear, they leave the rest of your lymph nodes in. They do detailed microscopic checks later on the sentinel node, and if there is microscopic cancer in it, they generally give you radiotherapy on the underarm lymph node area some weeks after surgery.
I had a bone scan and a scan of my trunk to ensure there were no obvious metastases, and by choice I had them before surgery.
About a week after surgery, you get your pathology report. It tells of which sorts of receptors are positive or negative, what the sentinel node showed, what grade and stage the cancer is, if they got clear margins around the tumor/s they removed, plus a number of other things. If you had a lumpectomy you will almost certainly then have radiation to the breast area over the following weeks. If your sentinel node was not clear, you will probably have radiotherapy to the underarm area or another operation to remove the lymph nodes.
Then you are referred to a Medical Oncologist to help decide the best treatment if they suggest Chemotherapy for you. If you have HER2Positive tumor, you will probably have treatment with Herceptin, an amazing new targetted drug, or one of its family of drugs, generally with chemo. if you are ERpositive, you may be given Tamaxofen for 5yrs, or some other hormone treatment. If you are negative for all receptors, they will probably go for chemotherapy of some sort.
It is a confusing process, but this may give you some idea of the roadmap you may be looking at, so you don't get as confused as I did. Hope this helps.
