Treatment plan questions following my wife's recent diagnosis?

Does she also have the stage of the cancer? As she is having radiation, I know I had surgery and the three sentinel lymph nodes were taken then. Mine were clear.
Is she assigned an oncologist? I was given a choice to get Surgery or to go to City of Hope to be treated. At COH, I accepted a genetic test they offered. So much is based on the stage and the other statistics you offered. Her cancer may be very small with a lumpectomy and radiation offered. I was 60 at diagnosis.

Is there a plan to have hormone therapy at any point? Some women find higher survival rates by getting a hysterectomy after surgery ... probably not post menopausal. Hormone receptor positive is a good thing... I don't have that luxury and have limited treatments. Go at it head on and educate yourself until you're sick of education.

Don't know the Stage, we probably need to ask more questions. No Oncologist assigned. She was referred to the Surgeon by her Gynecologist. Fairly small hospital. I suggested we go out of town to get a 2nd opinion, but she so far isn't interested in that. Thanks.

Hi,
It is important to now how to keep this from reocurring. That is why knowing stage is very important. Some people need to take medicine after surgery to keep the cancer from coming back.
Take care to you both and I hope all goes well for her.

I lived in a small northern Idaho town when I was diagnosed with triple negative breast cancer. As a part time care giver, I’d seen too many people fall between medical cracks because of every reason in the world.
I was in wa. State with a recognized hospital and program within 2 weeks… quick proper treatment continues to be essential to hopefully beating recurrence and spreading.
Idaho is known for the worst insurance and hospital care in the country… hope you don’t fall in the cracks.

I had lumpectomy and reconstruction( so both breast look the same). I also had 3 lymph nodes removed ( mine were negative), I did have a marker inserted at time of biopsy too. A lot of time they will not know how many radiation treatments you will need until the pathology report comes back. They should do an onco test - with pathology. My IDC was too small to do one but the onco test will tell more information. Keep a notebook/journal. They may want to give her AI drugs. This is another story. Good luck with all.

Sorry for your wife’s diagnosis. This site is an enormously valuable resource.

My care team involves an oncologist, a breast surgeon and a plastic surgeon. All bring different expertise to the table.

Cancer is no joke. You want the A team.

Again, sorry for your wife’s diagnosis. Best wishes as you navigate the journey.

My case is similar to your wife. I’m 73 years old. IDC 5mm nodule. I did not have DCIS (I think that DCIS is cancer cells that have not broken through the ducts but I’m not sure). Hormone positive. I saw surgeon first and had a lumpectomy (with radiation). I chose that because my nodule was very small and it would be less invasive than mastectomy. The process was: surgeon, then radiation, then oncologist. I initially thought it was strange not to see oncologist first, but it worked out fine. I had 2 incisions - 1 for cancer nodule and 1 under my arm for lymph nodes. They inject dye the day before which helps them identify potential cancer in nodes. They removed sentinel (closest to the breast) and maybe 1 other. Biopsied those plus 7 others in armpit and all came back clear. 2-3 months later I had radiation - 16 treatments. That was fine - some fatigue and like a sunburn on my breast. I then met the oncologist after radiation was completed. There’s a test from the samples they obtain called an Oncoscore. A number between 1-100 will indicate whether chemotherapy is recommended. Anything above 26, they recommend chemo. I was lucky - mine was very low, so I didn’t have chemo. It will also show her reoccurance %.
The oncologist will discuss and prescribe “hormone blockers” (aka aromatase inhibitors) to be taken from 5-10 years depending on case. There are 3 different types of hormone blockers so she will be able to switch to a different hormone blocker if the current one is causing too many side effects. Good luck to you and your wife. It’s great that you’re seeking information on her behalf!! It’s scary. My wonderful husband has been so supportive and so I’m sure she will appreciate your help! There is so much to learn and it helps if 2 people can absorb it all.

I'm so glad your wife has you in her corner. I was also hormone positive, HER2 negative. For me, the time between dx and surgery was frightening because I had way more questions/uncertainty than answers. The period between seeing the report in MyChart to meeting with the surgeon was 6 days and I spent most of that time googling (not the best idea:-)) and reading everything I could get my hands on. All things cancer took up most of my head space during that time.
My first meeting was with the surgeon who went through my biopsy report with me and at that time learned my staging. I elected to go with a lumpectomy, followed by radiation and 5 years hormone therapy. I just wanted the cancer out asap and felt comfortable with the surgeon so I scheduled the first available surgery date and elected not to get a second opinion.
My clip was placed the day before surgery to help the surgeon pinpoint the exact location of the tumor. I reported for surgery at 6am and was home by 1pm in a compression bra. She removed the sentinel node during surgery and it was clear so no need to remove addl nodes. I then waited almost a couple of weeks for the pathology report and was relieved and felt very lucky to learn that my margins were clear and the tumor was removed in its entirety.
The surgeon assigned the oncologist she felt best would suit me and I met with the oncologist about 4 weeks post surgery. The onc went through the surgery pathology report with me along with the breast cancer recurrence risk calculator. For ex if I only had the lumpectomy and no radiation and no drug therapy my risk for recurrence would be such and such or if I only had the lumpectomy and radiation but no drug therapy my risk would be this percentage and so on.
My cancer was early stage and along with some other criteria I was a candidate for APBI (abbreviated partial breast irradiation) which is a course of radiation 1x/day for 5 days. I know there's all sorts of opinions on this but the research is there and I felt more than comfortable with this decision. I had some fatigue but overall minimal side effects for which I felt very fortunate. I was proactive with keeping my schedule very light that week, staying well hydrated, using calendula cream on the treated area, etc...generally just being kind to myself:-)
Approx 6 weeks post radiation my drug therapy started. I've been lucky in that my side effects haven't been so bad but I know that's different for everyone. Your wife's oncologist is the one to help navigate that.
It's been 18 mo since my surgery and I meet with my breast surgeon every 6 months for a breast exam and check in. I also meet with the oncologist for follow up and check in but as long as everything continues to go smoothly I'll meet with them one more time and then I'll be on a yearly appt basis.
Cancer turned my life upside down and it was all I thought about for a long period of time. It's still in the back of my mind but thanks to the support of my husband and the friends/family I chose to share with along with my breast oncology surgeon, radiation oncologist and oncologist (my team!) I'm doing really well.
Nobody chooses this journey but this forum is a wealth of information and beyond helpful - you and your wife are not alone.

I'm 77,76 when diagnosed in May 2024. I had DCIS stage 2 with 2 lumps. I'm ER positive and had 6 nodes taken ,2 were pos.I chose not to have radiation, but I take Anastrozole.My onco number was 19,which is good. I see my Oncologist at the end of the month. I'm at ease with all of it because I read a lot. BC is almost common now( 1 in 8 women) and highly curable so take a deep breath.The worst part is living from now on with the thought of it coming back. Even if it does it could likely be the same scenario and have to go though the whole thing again. Good Luck There are a lot of us out who have been though it . It is not a death sentence by a long shot.