Forum Discussion
Nadi
10 years agoMember
Help with understanding pathology report in order to choose best type of surgery
HI ladies
Saw my surgeon yesterday and thought I was well prepared with questions and information having done background reading from BCNA website and the My Journey Kit.... but now slightly confused. I had a core needle biopsy on 15 October. Apart from 18mm, IDC with papillary features the pathology report said:
the lesional tissues are negative for hormonal receptor of ER and PR. There are no myoepithelial cells present as there are no myoepithelial markers of p63 and SMMHC positive cells seen.
The report goes on to say that it is predicted as a grade 2 tumor (which is good).
Based on my initial pathology my surgeon thinks that it is likely that it is a triple negative breast cancer. I know grade 2 is the intermediate growing kind i.e. not aggressive. But of course final pathology results will not be known until after surgery and SNB scheduled for 12 Nov.
I was given the choice of a partial mastectomy with radiation or full mastectomy. I am 47, pre menopausal and for some strange reason I have a strong psychological desire to keep my nipple so am leaning towards partial mastectomy/lumpectomy - also my private health insurance doesn't cover breast reconstruction after cancer surgery.
Now I don't know whether I should consider a full mastectomy. Just wondering if women have had similar pathology results and decided to go with partial mastectomy/lumpectomy and if they are ok.
The info on the BCNA website says there is no higher chance of recurrence for triple negative but it doesn't say whether that is for lumpectomy, full mastectomy or both. Tried a link on BCNA for triple negative support group but link appears to be broken.
Thanks for sharing any personal experiences. Any information would be appreciated.
Nadine
12 Replies
- mum2jjMember
You are funny :). When I had my original lumpectomy I was in my head in no way ready for a mastectomy. However situations and circumstances changed. I totally understand the path you took. All the best with the rest of your treatment.
Paula X
- LisaSMember
Hi. Confession time. I really was just arguing the case for lumpectomy for balance sake.
im actually having a mastectomy after I finish chemo because they found more cancer during my 2nd lumpectomy.
I still don't regret trying to save my boob. Given my age, lack of family history, size of tumour etc etc it made sense at the time.
I think that's the goal for all of us: no regrets. Some decisions are easier than others. Best of luck. L
- mum2jjMember
Hi Lisa,
I am glad you have given Nadine your pro lumpectomy side. I think it is really important to hear other people's experiences. As Lisa above has said we need to be guided by our doctors and also consider the points you have bought up. Had I not had a recurrence so soon after my initial diagnosis I would be happily traveling along with my two breasts. I do miss the sensation of my real breasts (something that isn't always made clear to us). Yes I got a tummy tuck, however that never really factored into things for me. What I would really like is to have never had this wretched disease. After my recurrence, mastectomy was my only choice. I was a little different in that my cancers were both very soon after clear mammograms. My breasts were dence and didn't image well apparently. Also m cancers were both very aggressive. I really had no choice. Don't get me wrong, I have no regrets, but I do miss my breasts.
Have a great weekend
Paula x
- LisaSMember
Seeing the pro mastectomy posts here, I thought I'd argue the pro lumpectomy case. :)
i found the lumpectomy operation to be really easy. Easier than the biopsy. I've had 2 lumpectomies and I don't regret it. My boobs still look the same. 16DD. My tumour was 18mm in the 4 o'clock position, no skin or nipple or chest wall involvement.
if you can save your boobs, I think it is worth doing a lumpectomy. Even though you have to do radiation.
Factors to consider:
#1 factor to consider is what reduces the chance of recurrence the most.
2) Mastectomy surgeries are a big deal. You can't drive for 6 weeks. Lumpectomies are day surgery.
3) radiation. Is going every day for 6 weeks a problem? Some people hate the thought of radiation.
4) does losing your boob make your feel safe or sad? Will the numbness disturb you? Will you enjoy having perky breasts? And maybe a tummy tuck thrown in?
Ultimately only you know what will give you best peace of mind.
- Robyn_WMember
Yes, had 4 rounds of docetaxel,but no radiation,because I had a mastectomy.The docetaxel was not too bad,definitely nothing like I had thought.
- Lisa_BCNAMember
Dear Nadine,
It’s Lisa from the Policy Team. It is great that you have posted on the Online Network as it can be a really good place to get support.
I just wanted to jump in and say that when making decisions about what type of surgery to have, it is best to speak to your breast surgeon and other members of your treatment team, such as your breast care nurse, as they will be able to provide you with the best information that is relevant to your individual situation.
It may be useful to speak to your surgeon a number of times to make sure that you get all of the information you need before making your decision. Some women also find it helpful to get a second opinion from another surgeon if they are not sure about the advice they have received or would like another perspective.
You may have this already, but we have developed a pathology fact sheet which provides some general information about terms and information commonly contained in pathology reports. If you'd like to have a look, you can find the fact sheet on our website here.
Best wishes,
Lisa - NadiMember
Thnx Paula The link didn't work again for me then I refreshed and now all good. I'll go over there and read.
Spoke to health insurer yesterday - have basic hospital - no cover for reconstructive surgery or plastic surgery. Just went back to the website which had another footnote that says I am covered for cancer treatment when it is part of an included service. I didn't have item number for reconstruction when I rang. May be I will give them another call.
Thnx again for sharing.
- mum2jjMember
- mum2jjMember
Hi again,
here is the triple negative link again. Give it another go. I just tried and it worked for me.
Hugs.
Paula x
- mum2jjMember
My cancer was triple negative 2.7cm. I had lumpectomy, chemo and rads. Unfortunately had a recurrence 18mths later and went on to have mastectomy. Everyone is different though, and my margin even though clear was not that big. My second cancer was about 2cm away from the lumpectomy scar. I am sure there are many ladies who have had lumpectomies and no recurrence. Are you sure about your health insurance. It is very unusual for reconstruction post mastectomy not to be covered as it is considered part of your treatment. That said there can be considerable out of pocket expenses. You are also eligible to have a reconstruction as a public patient, you just may have to wait a bit longer for it. I would let BCNA know about the link for the triple neg group being broken as I am a member of that group.
I wish you all the best. I guess just gather your info and weigh up the pros and cons. I know t his can be a confusing time.
Hugs.
Paula