oestrogen and DCIS

@arpie regarding the margins I will ask oncologist team when I see him.
My surgeon have checked my wound and she said is good. I have seen my GP yesterday and mentioned about feeling warm and he gave me prescription for antibiotics just incase i need it. I just take it without waiting the infection appeared.
I remember my sister in law had ovary surgery and no antibiotic taken and she had infection, come out yellow blood/pus, the infection went so bad and she had to have another surgery to clean that. I don't want to take that risk. hope I am doing the right things having this antibiotics.
The gene testing is not the Braca (BRCA1 and BRCA2) testing, this is another new gene research "HBOC", I am afraid of the consequences/result, I am not ready to face the result for myself and my children, this causes another stressful/depressing for my family. 
You right, my auntie she is vegetarian and had breast cancer, she said stressful caused this cancer. she is good now, it has been 7 years cancer gone. I love to have some weight from you if you can transfer :)

@StrongCoffee thank you for the info regarding genomic testing. I never know if there are many type of genomic testing, will ask my oncologist regarding this test. so this depends on cancer pathology result not the biopsy result/MRI result?
What is ablation ?
I am also worry when taking this tamoxifen since I have cyst in my uterus, will discuss this with oncologist, not sure this will affect my uterus or not...
I also feel pain and hard at my nipple( breast that has surgery) not sure due to the surgery or because of my ovulation days...
Thank you for the link @iserbrown. I have  printed and bring this as my guidance when meeting with oncologist team.

Thank you so much all for your help and valuable information, really appreciate it.

Many thanks,

I had the genomic testing. Mine was Endopredict and it cost $3000. It will probably depend on the final 'grade' of your cancer once all the pathology is in. It is only recommended for grade 1-2, HER-negative, 0-3 lymph nodes involved and a Ki67 under 10. So it could be it's not grade 3 as first thought or your Ki67 may be very low.

As I chose a mastectomy rather than a lumpectomy (breast conserving surgery), I did not need radiotherapy. My endopredict came back low. So also wasn't recommended for chemo. From memory, scientific evidence supports starting chemo within 3 months of surgery.

It's fantastic that your nodes are clear! It will take a while for that area to stop being sore. I have the mesh holding my implant in place stitched to that area as well and, after 6 months, it's still sensitive to touch.

I can't remember if I was on antibiotics. If so, it was just for the first few days after surgery. The warmth definitely sound like something something your GP to look at sooner rather than later, as it's a high chance it's being caused by infection. I had pains, twinges (especially after a few weeks when nerves started reconnecting), tenderness and phantom pains in my non-existent nipple. But never warmth.

I'm on tamoxifen as I'm pre-menopausal. I don't find the side effects too bad. I take it in the morning as I feel agitated for the first 6 hours (so caused insomnia at night). Vitamin B12 is helping that. And I'm taking magnesium for leg cramps/aches from it. I have inflammatory arthritis/spondylitis, so I can't say if it's giving me bone/joint aches as I already had them! After almost 6 months I'm noticing some issues like UTI-type symptoms that would be caused by it. On the plus side, it has stopped my perimenopause hot flashes and made my skin produce oil again like when I was younger. It doesn't stop estrogen, it blocks the receptors. What they've found is is had an anti-esteogenic effect on some parts of the body and an estrogen-like impact on others, such as the uterus. It can increase menstrual bleeding, but I've had an ablation in 2020 so it's not an issue for me.

Great that your nodes are clear, @Della  ..... did he say if the 'margins were clear'?  Maybe ask the Onc when you see them.  They will have access to your Pathology report too.  Fingers crossed you don't need the chemo - but they Onc will explain all that to you .... 

Re Genomic Testing - I didn't have it done, but we did have it done earlier this year for my husband's cancer - to see if there were any mutations in his cancer that may enable more specific targeting with his chemo.  Ask them the cost (as it can be a tad expensive.)  Do you have children?  The Braca Gene test is to see if you may have it & may pass it on to them - if 'yes', they could be tested too, if they wanted to find out.  I don't have children, so didn't need that. 

Re the copy of the results - when all your pathology results are 'in' .... ask for a copy of your pathology from your surgeon (or ask your breast care nurse to grab one for you!)   It is good to have for your own records.  Your Surgeon will also report back to your GP - so ask THEM for a copy of the surgeon's report too ....  I just grab copies of whatever I see!!  After you see the Onc, they will report back to your surgeon AND GP ..... lots of reports!!

The lymph node removal pain under your armpit can take a couple of months to settle .... mine did.  It was also a tad 'numb' after that as well.  I can't remember if I was Antibiotics - usually only if your wound goes red/sore, I think.  Your surgeon should have checked your wound at the appt on Wed?  Did he?  If you are concerned at it being warm (which can be an indication of infection) either get checked out by your breast care nurse, or see your GP - don't put it off.

Re food .... just go back to eating whatever you enjoy & like - just with moderation.  There is no rhyme nor reason for you getting BC in the first place - so you can't really blame your food habits on a 'guess' ..... vegans get BC, meat eaters get it - my husband was an incredibly fit triathlete who never ate any 'wrong foods' or drank booze & ended up with stomach cancer!  So .. it is all just TOTALLY unfair!  Don't deny yourself food that you like & enjoy.  Specially if you can't afford to lose weight!  (I'd give you some of mine, if I could!  ;) )

 Take care, keep busy doing what you love ..... try not to overthink the whole thing. xx

Hi all,

Thank you so much for sharing me these valuable knowledges.
The pathology not complete yet when I saw my surgeon last Wednesday 27 Oct 21. Surgeon mentioned my lymph nodes clear. but I am at borderline to have chemo and rad, heard this "chemo" make me scare. have to wait their meeting between surgeon, oncologist, rad. 
Are the treatments can be more than one option ? and I can choose which the best for me? 
 
The surgeon mentioned about Genomic essay testing, have you guys ever take this testing ? 
and also gene testing related to research ?

@arpie you mentioned about a copy of record of the result, may I know what kind of result they would give to me? this result from the surgeon or from oncologist team? is this related to the cancer pathology and lymph node ? is this some kind of report with the details what have been done in my surgery? I am sorry to ask you many details.

@StrongCoffee, I have oncologist booked on 17th nov. I am not quite sure how long we have to wait from surgery to the treatment(chemo/rad). Hope the cancer does not grow so quickly.

@iserbrown, regarding the tablet, surgeon also mentioned that after chemo/rad I have to take tablet at least 5 years. If I not wrong the nurse mentioned it might be temoxifen (hope pronounce correctly) since I am 50 years not menopause yet and this tablet will stop oestrogen production. Have you take the same tablet ? 

I am still feel pain under my armpit where the lymph nodes taken (surgeon said 2 lymph nodes taken)
do you guys take antibiotics for this surgery ? do you feel warm sometimes after the surgery ? 

I have so many questions in my mind about whats gonna be my next step, hope I am strong to handle it since I have been avoiding many nice food (ice cream, chocolate, cake, fried chicken) due to this cancer. mostly eat fruit and vegetables, sometimes chicken(corn chicken) and make me lost my weight... which is not good. I am already small...


many thanks,

I had Surgeon review and then he sent me to the Medical Oncologist on the same day.
I also knew my pathology results prior to leaving Hospital so the review was to check on healing and discussing next steps. 
It's all a little daunting as you come to grips with names of treatment and or medication that were not part of our everyday prior.
Having someone with you is a good thing!  I can remember my Breast Surgeon, when I first met him and he diagnosed me saying you'll be my patient for the next 10 years.  I missed the next sentence or two as I tried to absorb the 10 years!
Take care 

@Della  Your surgeon should discuss your 'team' with you on Wed (if not, ask him about it!!) - which usually involves an Oncologist and Radiation Oncologist - even if you don't need chemo, the oncologist will be in charge of your ongoing hormone suppression treatment too.  You may (or may not) need radiation - but may still have at least one appt with them, to discuss why (or why not) you may need it  ..... it all depends on your pathology report.   

You will continue to see your surgeon on a yearly basis for up to 5 years, as well as your Onc and/or Rad Onc (if you have rads.)

They will all be doing their best for YOU ..... so try not to stress too much about it .... once you have your treatment plan, usually, it is a big weight off your shoulders xx

take care  and all the best for Wed xx

Hi @StrongCoffee, I have not have oncology appointment booked yet, this situation is new, I don't know the process ?
Can you tell me how usually the process ?
I have my surgery last Wednesday and this Wed I have appointment review with my surgery doctor, not sure what is next ?
So, after this, there will be another oncology team instead of my surgery doctor ?
is the process different between public and private hospital ?

Hi @arpie thank you for the hint. I will empty my mobile phone for recording.
I hope my 'game plan' is easy and I am strong to face it.
 
Many Thanks

@Della - with a bit of luck, they'll have your pathology results ready for your next appointment .... mine took a full 2 weeks to 'come back' tho .... Try & keep as busy as you can (relevant to your pain levels & any restriction in movemnt ...). Make sure you are given a copy of the results for your own records - and I Definitely suggest you record this appt on your phone as You MAY want to go over it again later (or not ....) 'Cos it CAN be difficult to 'hear it all' even tho you see their lips moving!!   

Take a sensible, trusted friend with you as well, as an extra set of ears. My sister-in-law was a wonderful asset at my post op appt!!  She asked more questions than me!  LOL

Once you've got your 'game plan', I think you will feel much more settled xx

All the best, take care xx

I can't remember exactly how long. I had a follow up with the surgeon in their private practise a few days before my follow up appointment at the hospital and he had the results already. I think that was about 2 weeks later. It's so tough as the waiting just keeps going! Do you have an oncology appointment booked in with the Hospital?