Hi all,My wife's just been diagnosed with Invasive Ductal Carcinoma NST (Grade 2-3) ER+, PR+, HER2- with a 29mm tumour and at least 1 involved lymph node. Needless to say it's hit us like a bus and we're in that dark, foggy place pre-treatment where we have no idea what's coming up next.That said, things have, luckily, moved pretty quickly since the first GP meeting for the initial pathology referral. In the 9 days since visiting the GP, we've had imaging with a mammogram and ultrasound which indicated suspicious findings, then 2 days later a biopsy, followed a day later by the meeting at the GP to get the bad news. Since then we've had our initial meeting with the surgeon at the RBWH, Dr Wong (who seemed very capable, but if anyone else has had him as their surgeon I would still love to hear more about your experience) and some of the MDT. We have our first meeting with Medical Oncology next Friday and the 2 week follow up with the MDT the following week.During the initial discussion our doctor classified this as "Early Stage" cancer (something we're hanging hope on) and said that we would have a number of options for treatment. My wife's family has quite an extensive history of cancer (mostly breast, with some throat / ovarian), however her Mum was genetically tested years ago and is apparently BRCA negative. When asked what we would prefer as a treatment, we just said we'd rather have a double mastectomy to reduce any chances of recurrence later, however when Dr Wong came in, he had a good chat with us and asked if we were making decisions from an emotional place rather than a practical place. His suggestion is to pursue a neoadjuvent treatment course, followed by genetic testing and then surgery, which if the chemo was effective would possibly mean just a lumpectomy rather than a mastectomy as well as potentially saving some lymph nodes.Unfortunately we're very sleep deprived and still in a bit of shock so we're not sure what to do. Basically we see it one of two ways:1. Do the chemo, hope that it shrinks everything (or God-willing completely disappears it) while killing anything else that might be floating around, then do the surgery, then radiation if required.2. Go the surgery, remove everything including lymph nodes, then hit hard with chemo and radiation if needed to try and smash anything that's left.Honestly, I get the idea of "patient-centered" treatment where your opinions and wishes are taken into account, but I know if I had a client approach me as the subject matter expert for a highly technical quote on something they didn't know anything about and I asked them to tell me what they thought would be the best option, I wouldn't have a job. This sounds so dumb, but I just want to say something like "wait a second, why are you asking us what treatment should be? Aren't you the expert???" We want to be very positive and forward leaning with this journey and I feel like we have to have an element of trust in the MDT and the process, but could do with some perspective.Sorry for the wall of text, I blame the lack of sleep!George

Hi George, my surgeon was "in charge" up to the surgery discussion until the cancer history was made known and then she discussed the options with the oncology team..and it was their recommendations she finally followed (with my agreement). Your wife's family's cancer history should have an input so I would draw it up to show the oncologist..they will want to know age of initial diagnosis for family members as well as type if it has not already been done. Once the surgery is over, your wife will then be placed under an oncology team. She will see one oncologist but her case will be discussed by the oncologist team at the hospital. The surgeon's role will be essentially over although appointments for scar inspection will be ongoing (as well as scans and other tests). Try to get in contact with a McGrath Breast Cancer nurse as they can also help clarify your wife's path as you go forward. Keep reaching out to this site as well as there is lots of advice available..

Hey @Mareealso - that all makes a lot of sense. I think our confusion is really around the correct order of things. As you say, best to wait until we meet with the Oncology team and get the full picture. It very much feels that, as you've shown with your own experience, making the right choice is really important and I guess we just need as much information as possible.This waiting is doing our heads in though! I don't think my guts can take another week of it all.

Hi George, you are already on the right track by trying to find more information. I know it is challenging but think of it as a marathon race rather than a sprint and just plan for what needs to be done now. Hang in there!

Hi @arpie, Thanks for the message, we're at Narangba, North of Brisbane so the drive to the RBWH from here isn't too bad, probably 45 minutes on average, it's the parking that's the real wallet emptier so far at $40 odd a day 😕That's really helpful news about the ongoing consults over the next few years. It's great to get a real sense of what the new "normal" is going to look like for us.We actually have had a holiday to Japan in late March / April 25 basically booked and mostly paid for for months now and of course we're devastated that, depending on treatment etc, we may not be able to make the trip. That said our doctor worked out a really rough schedule and she said "don't cancel anything yet", so we're hoping that we can crush through the treatment and come out the other side ready to have that reward of an amazing holiday.We've actually just come back home from a lovely day out with the kids, we did a really energetic 9KM bush walk around the Ewan Maddock dam up on the Sunshine Coast. It was pretty hard going at spots but was lovely to be out in the fresh air. I'm convinced that, along with a great diet and positive attitude, exercise will play a key part in us having a better outcome. Rebecca is going to speak to her GP tomorrow about getting a management plan in place with a referral to a local Exercise Physiologist who can start to work with Rebecca on an exercise plan before, during and after treatment.

Hi all,Quick update. We've now seen Oncology and they were really good and answered all of our questions. We have an official staging of 2B, grade 3 Early Stage BC with only the tumour and a single lymph node being found to be active on the PET scan. They did highlight a couple of other hotspots on the scan, but said it was a low probability that these were related at this time. So, the plan is now an ACT regime starting next week, with biweekly doxorubicin / cyclophosphamide x 4, followed by 12 weekly rounds of Paclitaxel. Rebecca's Ki67 is on the high side at ~50, so we're not sure what that means for the outcome, but we're hoping that despite that, the chemo will devastate this thing and we can move onto surgery and then onto the rest of our lives.Thank you to everyone for your thoughts and prayers so far, please continue to send good vibes while we continue to fight and beat this thing ♥️George

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