Hi my dear virtual friends,I have Hormones positives and Her2 negative. Grade 3 and Stage 3(Tumor size 35 mm).Surgeon A:Treatment plan Option 1: 6 months chemo ( neoadjjuvant), if tumor size shrinks > lumpectomy. If it doesn’t shrink > mastectomy > radiotherapy (will have to take Tamoxifen/AI)option 2: mastectomy > chemo> radiotherapy (will have to take Tamoxifen/AI)Surgeon B:treatment plan: lumpectomy immediately, tablets for hormones +ve (Tamoxifen/AI) > radiotherapy > chemo (depends on outcome of lumpectomy surgery).surgeon B doesn’t see the need to do 6 months chemo to shrink the tumor. He says he will have a better idea after surgery if chemo is necessary.hubby and I are still processing all these information and have some further questions written down. Keen to hear what other questions we should be asking both surgeons, please. Sincerely value everyone’s input.XxGin

Grade 3 is rapidly aggressive growth and more likely needing chemo treatment but not sure before or after surgery. What's your likelihood of returning? Ask if they have that pathology now or if that will be available after surgery. It is another factor for your consideration. I would be concerned about reducing that likelihood too as well as addressing that grade 3 cell. Good luck.

@GinGin - what a shame they didn't both have the same opinion! grrr It just mucks with your brain a bit more than it already has! xx It is a very personal decision that only you can make - but it really is about the 'what ifs' ...... ie What if I get a recurrence ..... did I make the right treatment decision? Have you considered joining the Breast Reconstruction Group, or Flat Chat (about possibly choosing no reconstruction) - you'll be able to chat with others who may have had to make the same decision?I was lucky & just had a lumpectomy, rads & tabs - but I was fully prepared for them to go ahead with mastectomy once they started the surgery, if they thought it warranted it, as sometimes the size of the tumour 'on the screen' can be smaller than the actual size of it, once in surgery.Quite a few cancers have chemo prior to surgery, to manipulate it & hopefully make it smaller, which may mean less aggressive surgery is required ... It sounds like Surgeon A is throwing everything at it, to give you (as he sees it) the best outcome possible and his 2nd option goes for the bigger surgery but without the chemo first ..... tho Surgeon B seems quite convinced the earlier chemo isn't required .... ay yi yiI think my question to both of them would be: What would you recommend your wife/daughter if it was their biopsy results, for their best possible outcome?Have either of them mentioned a Sentinel Node Test being done? (mine was done prior to surgery [and was clear] to see if the nodes closest to the breast have been infiltrated by the cancer at all) - as this will also give them even more information to work with re the level of surgery/chemo requirement ... Hmmm, Some sites indicate that Stage 3 may have already infiltrated the nodes ..... which means it may also have escaped into the body already - which means, maybe throw the kitchen sink at it!?As @Cath62 said - it is the aggressiveness and size of the tumour that normally dictates the amount of surgery & need for chemo before and/or after surgery (or not at all.) Can you talk to your Breast Care Nurse about it? She may be able to put unbiased opinions/explanations to help you in your decision making xxtake care & all the best xx

Hi @Tarma, the trouble is,you don’t know if the chemo is working or not for sure until a few months down the track when they rescan.If it wasn’t effective then the cancer is growing and possibly spreading. If cancer returns years later it can sometimes morph into completely different pathology so the original chemo might not be the one of choice.I’ve seen that happen too. Having a mastectomy reduces your risks of a local recurrence to about 1% of coming back in that chest area.With a lumpectomy and no radiation,it’s around 30% risk and with radiation afterwards it’s drops down to around 8%. These are the stats given to me for my situation many years ago so don’t quote me but at least it’s a rough guide. Ofcourse there’s no guarantee that a cancer cell might be lurking dormant elsewhere in the body.We’ll never really have 100% peace of mind but over time,you learn to live with it and enjoy life.

My sister has found Day 3 is the tell tale as to side effects for her

Ask surgeon B if they will need to do a mastectomy if he does not have clear margins. I had neoadjuvant and the tumours shrunk to virtually nothing BUT I went ahead with the mastectomy anyway as I had a haze of cancer right across the top half of my breast additionally to three tumours so a lumpectomy was never an option. Chemo isn’t fun so both options have both negatives and positives. Sorry, not much help.

Totally confused after seeking second opinion

42 Replies

GinGin
Member
3 years ago
Hello my dear virtual support friends
Firstly, I would like to sincerely thank everyone for taking time to share your feedback/ thoughts/guidance/questions with my situation.

Updates 25 Aug: I went with B and surgery was a success. pathology results showed clear margins. My actual tumour size was doubled what the initial biopsies reported!
Next stage: Chemo (likely 6 months). Seeing the oncologist next week
@T@Tarma : I’ll be joining you in the chemo journey shortly :-:wink:

😘 💐 xx
Gin
iserbrown
Member
3 years ago
My sister has found Day 3 is the tell tale as to side effects for her
Tarma
Member
3 years ago
@GinGin I'm so pleased you're doing well 😃💌

My nasty chemo side effects 🤒🤕🤧are starting to settle a bit and im definitely feeling more positive and strong than I have been the last 4-5 days 😃

Today I'm kickin cancers butt!!

💟T.
GinGin
Member
3 years ago
Hi @Tarma, I am doing well. I had my surgery on Friday (+axillary clearance). Was discharged this morning after the drains were removed.
Seeing my surgeon this Friday ( hopefully sooner if the pathology reports are out earlier) to work on next steps, fingers crossed all the nasty stuff has been taken out!!!
I hope you are staying positive and strong! We can all beat this!
xx
Gin
Tarma
Member
3 years ago
Hey @GinGin how's things??
TonyaM
Member
3 years ago
Hi @arpie, great advice! I’ve listened to that podcast and it’s terrific for someone embarking on this crap bc journey
arpie
Member
3 years ago
@Tarma .... if you are finding yourself feeling a bit overwhelmed by it all (and it happens to us all - as we try to fully understand what is going on & we ALL tend to 'over think it'!) ....

Please ring our Helpline tomorrow & chat with our lovely ladies there ....1800 500 258

Also, consider listening to the Charlotte Tottman Podcasts (a breast cancer psychologist who was diagnosed with Breast Cancer herself) and how it affected HER just as much as it affected all of us too xx - and also changed her approach to her clients afterwards.

I've just started listening to them and they are just great. They are very easy to listen to.
(Check out Season 1 first, then, if you like, Season 2 as well - links below.)
I am sure you'll find them helpful.
https://www.bcna.org.au/understanding-breast-cancer/bcna-resources/podcasts/charlotte-tottman-podcast-series/

take care
PrisMay1
Member
3 years ago
I’ve just been through my second episode of BC and my 2 cents worth would be go with the surgeon you trust and feel most comfortable with. I’ve know my surgeon for many years now and I trust him and know he gives me the best advice for me while allowing me to make the decisions. My first surgeon basically told me what would be happening and I didn’t get much choice - although I had little awareness and little time to research myself. Plus it was quite a few years ago! Needless to say I sought another surgeon to follow up and review my annual mammograms. I wish you luck.
Tarma
Member
3 years ago
Hey @TonyaM fair point,, as I mentioned , my journey has just started and I'm learning as I go,, info from you lovely ladies who have been there done that is invaluable 😊
I'm trying hard to not let this cancer ride completely take over my life,, so far , im failing 🤣🤣
I might need to stop and fact check a little better before I post again ...
✌️&💕T
TonyaM
Member
3 years ago
Hi @Tarma, the trouble is,you don’t know if the chemo is working or not for sure until a few months down the track when they rescan.
If it wasn’t effective then the cancer is growing and possibly spreading. If cancer returns years later it can sometimes morph into completely different pathology so the original chemo might not be the one of choice.I’ve seen that happen too. Having a mastectomy reduces your risks of a local recurrence to about 1% of coming back in that chest area.
With a lumpectomy and no radiation,it’s around 30% risk and with radiation afterwards it’s drops down to around 8%. These are the stats given to me for my situation many years ago so don’t quote me but at least it’s a rough guide. Ofcourse there’s no guarantee that a cancer cell might be lurking dormant elsewhere in the body.We’ll never really have 100% peace of mind but over time,you learn to live with it and enjoy life.

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Totally confused after seeking second opinion

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