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Treatment plan questions following my wife's recent diagnosis?
Wife (age72 in good health) was diagnosed with breast cancer (DCIS, Hormone Receptor Positive, IDC)? a few weeks ago after an imaging test and a needle Biopsy. They put a couple of chips/markers? in her, then her doctor referred her to a General Surgeon. The Surgeon gave her 2 options: a Mastectomy or a Lumpectomy followed by 5 weeks of radiation (to be determined by another doctor at the hospital).
She chose the lumpectomy and the radiation. He also said he would make a separate incision to sample a lymph node.
Is there something else she may not be considering in this treatment plan? We are both less than knowledgeable about all this. Thanks for any feedback.
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P.S. I had a lumpectomy
I'm 58 years old and was diagnosed with ER+/HER2- breast cancer exactly one year ago. I chose unilateral mastectomy due to the size of my small breast vs. the size of the tumor (which ended up being quite large at 70mm). Because of the size of my tumor and that I had a small bit of cancer in my lymph nodes, I received 5 weeks of radiation after the mastecomy. Now am on aromotase inhibitors and a targeted therapy (protein inhibitor - basically chemo-in-a-pill). I found the more I read on my own, the more confident I felt about any treatments and playing a role in the decision-making. "Dr. Susan Love's Breast Book" was a great resource for me - it is full of information and the studies to back it up. Dr. Love is pretty no-nonsense and the book includes not only the science of breast cancer but pulls in anectodal information from her patients on how they feel, etc. It's a beast of a book at around 600 pages, but I read the whole thing. At times it put my mind at ease and at times helped me develop questions for my oncologist. Best of luck to your wife and to you. Keep charging onward!
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1 ReactionIt's surprising that Idaho is the worst insurance and hospital care in US. What state is the best insurance and hospital in US ? Do you have a list?
The latest research talks about women over 65 omitting radiology with early-stage breast cancer. Has your wife had an MRI? The doctor should be able to see if nodes are involved or use a dye and not cut to see if there are nodes involved. Get a second opinion, this doesn't sound right for DCIS.
https://www.health.harvard.edu/blog/when-can-women-with-early-stage-breast-cancer-skip-radiation-after-lumpectomy-202209152816#:~:text=Questions%20to%20ask%20your%20cancer,long%2Dterm%20side%20effects.%22
Several others have provided similar advice. You need to get a copy of the biopsy report as well as any imaging or lab work that is done, including the surgical report after surgery. Start a notebook. Note questions for your next meeting.
A second opinion is always good as a part of the diagnosis and surgery as well as for radiation. When time comes for radiation ask how the heart will be protected during radiation.
I would highly recommend a breast cancer surgeon vs a general surgeon. There are things that can be done during the surgery to ensure that the breast shape is retained once the tumor is removed. Best of luck.
https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475
https://www.cancer.org/cancer/diagnosis-staging/tests/biopsy-and-cytology-tests/understanding-your-pathology-report/breast-pathology/breast-cancer-pathology.html
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1 ReactionMassachusetts is rated the best health care in the country, and Minnesota is rated second. M. D. Anderson in Houston is rated the number one breast cancer care worldwide. The second breast cancer care center worldwide is in Paris, France. France is rated the best health care in the world.
A family friend, who is a doctor at M.D. Anderson checked on me the day after my surgery. My surgeon never called. M.D. Anderson's oncologists work with their patients two weeks after surgery to make a plan with them, not in a vacuum.
Thank you for your information. From my experience, Usually Oncologists in Top ranked cancer center are more experienced. I diagnosed cancer stage four about 8 months ago. My oncologist in a local hospital made a plan of chemotherapy only without being aware of what kind of cancer I have (there are multiple kinds, the related treatments are different). With her treatment plan, I probably am dying. Fortunately I did some research and visited other oncologists to figure out what kind of cancer I have and what treatment I shall have, so that I can survive until now. From this case, I learned that never reply on a doctor who does not care about patients or not good on her job. After visiting some doctors, I can easily tell if a doctor is a good one and if she/he cares about patients.
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1 ReactionI would think she should see an actual "breast surgeon" as well as a plastic surgeon. For me I would never let a general surgeon operate on me unless it were an emergency situation. And depending on where her tumor is if it's in the left breast there is a danger for heart damage from radiation. Take a look at statistics, algorithms, and calculators that are all available online for patients to use to determine the best treatment plans. Best wishes to you and your wife, it's a scary time and tricky to navigate.
Always get a second opinion if you think the first isn't right.
That is right. However, my insurance was HMO which does not allow me to visit more than one oncologist. I had to request a referral to another oncologist but I did not know if it will be approved, since not all referrals will be approved. Fortunately my request was approved due to my insistence.