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Wife will have biopsy next week. Which doctor to see first?
Breast Cancer | Last Active: Oct 10 12:19pm | Replies (23)Comment receiving replies
We received the pathology report on Tuesday (10/8), 7 days after the biopsy. It shows cancer. My wife is a quiet person. and she is very calm about this, but I know she is hurting inside. She does not post anything in any social networking forums, so I am doing this to help with information gathering.
The pathology report shows:
INVASIVE DUCTAL CARCINOMA
Grade 2. BRS Score: 7/9
Size of invasive tumor: at least 0.7 cm.
Estrogen Receptor: positive
Progesterone Receptor: positive
Her2/new IHC: Negative
Ki67 proliferation rate: 30-35% (high)
AJCC pathologic T-stage: at least pT1b.
Lymphovascular invasion: Not identified
DCIS: Not identified
My wife's gynecologist suggested to start with a breast surgeon, so she has been looking for one in UCLA Santa Monica facility, their main campus for breast cancer.
It took us a day to gather the medical records from the past 2 years with CDs. We drove to Santa Monica and hand delivered those to their front desk. We have to call their scheduler today to get an appointment with one of their breast surgeons. We hope to see a doctor soon.
Replies to "We received the pathology report on Tuesday (10/8), 7 days after the biopsy. It shows cancer...."
It is definitely better to have as much information as you can get. This is a good place for information and support.
Although, as members we cannot give medical advice, or explain a plan of any kind, we can translate what terms mean and what tests are and relate what that meant for us.
Having this biopsy in hand means that she can see an oncologist and they can start formulating an individual plan for your wife based on these test results.
There will most likely be choices she will have to make based on her feelings about this. My best advice to you, is to support whatever decisions she makes. If she makes informed decisions, she will have thought it through.
Bless you for supporting her through this journey, my husband and I have been through a lot of cancer, and our marriage stronger than ever.
Can you get the gynecologist to send a referral to the university breast clinic to expedite this?
Each day after the shock of learning will have its own challenges for a while, how are you both doing today?
Hi Frank. I am 2 months post op from a bilateral mastectomy with expanders and will have my final reconstructive surgery in December. One thing I learned just recently which I thought was brilliant was to use the "voice memos" on my iPhone to record what the oncologist, surgeon and anyone else you talk to. Even when you go into an appointment feeling totally prepared, there is so much information, it's daunting. My husband was with me for all of my appointments, which I loved, but even he couldn't remember everything. Best wishes to you and your wife.
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@frank1956 from online:
"pT1b: Tumor >0.5 cm but ≤1.0 cm in greatest dimension "
It is important to know the percentage or scores for estrogen and progesterone. Higher percentages are good and anti-estrogen meds will of course work well if ER score is high.
Ductal or lobular, LCIS? No DCIS I see. Good there is no lymphovascular invasion.
Can you see the breakdown of the grade assignation? ki67% is a measure of proliferation so wondering how that higher score goes with grade 2.
I had a 20% ki67 (I speculated this was possibly due to cells growing after biopsy), grade 3, lymphovascular invasion (focal) and had a positive HER2, then equivocal, then negative and had it retested.
I had a double mastectomy, no radiation as a result. The Oncotype Dx test, which your wife will have, often guides treatment. Surprisingly, mine was low with a score of 8 which meant no benefit from chemo. I did hormonal meds for 5 years (letrozole).
ki67% is included in the Oncotype along with other measures of proliferation. As you can see, grade does not predict treatment anymore!
Once your wife has a plan it will just be one foot in front of the other and she will get it done. I am ten years out and doing fine despite my seemingly awful pathology.