Re: confused by surgeon feedback/please advise

[Guest guest]

Hi Belma,

Your mother and your family have been through alot in the past few weeks

and there's a huge learning curve for wrapping our minds around what the

tests and results mean. So, don't be discouraged and don't be afraid to

ask your doctor to explain again what's going on.

Was your mom's initial biopsy a needle biopsy or a lumpectomy?

A needle biopsy can identify whether cells are cancerous, but the

pathology report after the surgery can give you more information to

determine your mother's treatment. A lumpectomy also is more tissue

removed, so cancer cells that weren't detected by the needle biopsy can

be found.

The pathology report will include how large the area is (can't always be

detected via mammogram). Whether there's vascular invasion (unlikely for

DCIS), and cancer cell characteristics: is the cancer fast-growing, what

fuels its growth (esterogene, pregesterone, Her2Neu).

My pathology confirmed that I had IDC, that the one tumor they thought I

had was actually 2 small tumors, also that I had extensive DCIS, and

that I was er/pr- and Her2+.

Those high survival rates still apply, but based on the pathology report

your doctor may recommend additional treatment. Please keep us posted.

take care,

[Guest guest]

Hi Belma,

Your mother and your family have been through alot in the past few weeks

and there's a huge learning curve for wrapping our minds around what the

tests and results mean. So, don't be discouraged and don't be afraid to

ask your doctor to explain again what's going on.

Was your mom's initial biopsy a needle biopsy or a lumpectomy?

A needle biopsy can identify whether cells are cancerous, but the

pathology report after the surgery can give you more information to

determine your mother's treatment. A lumpectomy also is more tissue

removed, so cancer cells that weren't detected by the needle biopsy can

be found.

The pathology report will include how large the area is (can't always be

detected via mammogram). Whether there's vascular invasion (unlikely for

DCIS), and cancer cell characteristics: is the cancer fast-growing, what

fuels its growth (esterogene, pregesterone, Her2Neu).

My pathology confirmed that I had IDC, that the one tumor they thought I

had was actually 2 small tumors, also that I had extensive DCIS, and

that I was er/pr- and Her2+.

Those high survival rates still apply, but based on the pathology report

your doctor may recommend additional treatment. Please keep us posted.

take care,

[Guest guest]

Belma,

I'm your mother's age. The pathology report on my mastectomy speciman

confirmed the biopsy report. I think the concern is mainly about the

right side. It is possible that the biopsy may have missed something

or he may just want to prepare you for any possibility. I know when I

had my biopsy, I asked the doctor, who took it, what he thought and he

was quite frank and told me it was cancer. This was before the path

report. He could tell just by looking. Do not dispair. I was stage

2 and am doing well.

Ruth

>

> Hi All,

>

> My mom, Esma (60), was diagnosed with ductal carcinoma in situ in

the left breast 3

> weeks ago today. In the meantime, an area in the right breast was

also biopsied and

> revealed atypical tissue but no cancer. An MRI revealed no further

cause for concern.

>

> During our initial meeting with the surgeon, things sounded very

encouraging. He quoted

> high survival rates, praised early detection, and stated that she

should be able to " get back

> to normal " after surgery and radiation--with frequent monitoring, of

course.

>

> Today's surgery went well. Both the carcinoma on the left side and

atypical tissue on the

> right were removed. However, my dad and I were sort of stunned

during our post-surgical

> chat with the surgeon, when he presented us with what sounded (to,

perhaps, our

> exhauated minds!) like a bleaker picture than the original version.

He said that we would

> now wait for the pathology report to see how to proceed. We

expected that, but were

> confused when he said something to the effect, " and if the tissue on

the right side is

> cancer, then she will need more surgery " --didn't the biopsy rule

that out?? We understand

> that the tissue was atypical, but the biopsy report clearly stated

no cancer. So, what could

> this be about? He also mentioned that " this is something she's

clearly prone to " and

> repeated that several times... Tamoxifen was mentioned as a possible

follow-up

> measure. Finally, when I said, " but there's also a likelihood that

this is just what we

> originally thought--stage 0 DCIS on the left only--and that she can

then just have

> radiation and no more surgery, and plan on vigillant follow-ups? " he

did agree that

> was the most likely outcome. Still, my dad and I were both left

feeling unsettled; this all

> sounded worse than our initial consult.

>

> So... I understand these are novice questions, but it's been a

whirlwind of activity, and

> there's so much to process and absorb. We're hoping for some input

> from folks who have been through this. Do pathology reports often

revealed big surprises

> that biopsies missed? Has anyone been in a similar situation?

>

> Thanks for being there; I have really appreciated your presence

during these crazy 3

> weeks.

>

> Belma

>

[Guest guest]

Belma,

I'm your mother's age. The pathology report on my mastectomy speciman

confirmed the biopsy report. I think the concern is mainly about the

right side. It is possible that the biopsy may have missed something

or he may just want to prepare you for any possibility. I know when I

had my biopsy, I asked the doctor, who took it, what he thought and he

was quite frank and told me it was cancer. This was before the path

report. He could tell just by looking. Do not dispair. I was stage

2 and am doing well.

Ruth

>

> Hi All,

>

> My mom, Esma (60), was diagnosed with ductal carcinoma in situ in

the left breast 3

> weeks ago today. In the meantime, an area in the right breast was

also biopsied and

> revealed atypical tissue but no cancer. An MRI revealed no further

cause for concern.

>

> During our initial meeting with the surgeon, things sounded very

encouraging. He quoted

> high survival rates, praised early detection, and stated that she

should be able to " get back

> to normal " after surgery and radiation--with frequent monitoring, of

course.

>

> Today's surgery went well. Both the carcinoma on the left side and

atypical tissue on the

> right were removed. However, my dad and I were sort of stunned

during our post-surgical

> chat with the surgeon, when he presented us with what sounded (to,

perhaps, our

> exhauated minds!) like a bleaker picture than the original version.

He said that we would

> now wait for the pathology report to see how to proceed. We

expected that, but were

> confused when he said something to the effect, " and if the tissue on

the right side is

> cancer, then she will need more surgery " --didn't the biopsy rule

that out?? We understand

> that the tissue was atypical, but the biopsy report clearly stated

no cancer. So, what could

> this be about? He also mentioned that " this is something she's

clearly prone to " and

> repeated that several times... Tamoxifen was mentioned as a possible

follow-up

> measure. Finally, when I said, " but there's also a likelihood that

this is just what we

> originally thought--stage 0 DCIS on the left only--and that she can

then just have

> radiation and no more surgery, and plan on vigillant follow-ups? " he

did agree that

> was the most likely outcome. Still, my dad and I were both left

feeling unsettled; this all

> sounded worse than our initial consult.

>

> So... I understand these are novice questions, but it's been a

whirlwind of activity, and

> there's so much to process and absorb. We're hoping for some input

> from folks who have been through this. Do pathology reports often

revealed big surprises

> that biopsies missed? Has anyone been in a similar situation?

>

> Thanks for being there; I have really appreciated your presence

during these crazy 3

> weeks.

>

> Belma

>

[Guest guest]

Belma,

I'm your mother's age. The pathology report on my mastectomy speciman

confirmed the biopsy report. I think the concern is mainly about the

right side. It is possible that the biopsy may have missed something

or he may just want to prepare you for any possibility. I know when I

had my biopsy, I asked the doctor, who took it, what he thought and he

was quite frank and told me it was cancer. This was before the path

report. He could tell just by looking. Do not dispair. I was stage

2 and am doing well.

Ruth

>

> Hi All,

>

> My mom, Esma (60), was diagnosed with ductal carcinoma in situ in

the left breast 3

> weeks ago today. In the meantime, an area in the right breast was

also biopsied and

> revealed atypical tissue but no cancer. An MRI revealed no further

cause for concern.

>

> During our initial meeting with the surgeon, things sounded very

encouraging. He quoted

> high survival rates, praised early detection, and stated that she

should be able to " get back

> to normal " after surgery and radiation--with frequent monitoring, of

course.

>

> Today's surgery went well. Both the carcinoma on the left side and

atypical tissue on the

> right were removed. However, my dad and I were sort of stunned

during our post-surgical

> chat with the surgeon, when he presented us with what sounded (to,

perhaps, our

> exhauated minds!) like a bleaker picture than the original version.

He said that we would

> now wait for the pathology report to see how to proceed. We

expected that, but were

> confused when he said something to the effect, " and if the tissue on

the right side is

> cancer, then she will need more surgery " --didn't the biopsy rule

that out?? We understand

> that the tissue was atypical, but the biopsy report clearly stated

no cancer. So, what could

> this be about? He also mentioned that " this is something she's

clearly prone to " and

> repeated that several times... Tamoxifen was mentioned as a possible

follow-up

> measure. Finally, when I said, " but there's also a likelihood that

this is just what we

> originally thought--stage 0 DCIS on the left only--and that she can

then just have

> radiation and no more surgery, and plan on vigillant follow-ups? " he

did agree that

> was the most likely outcome. Still, my dad and I were both left

feeling unsettled; this all

> sounded worse than our initial consult.

>

> So... I understand these are novice questions, but it's been a

whirlwind of activity, and

> there's so much to process and absorb. We're hoping for some input

> from folks who have been through this. Do pathology reports often

revealed big surprises

> that biopsies missed? Has anyone been in a similar situation?

>

> Thanks for being there; I have really appreciated your presence

during these crazy 3

> weeks.

>

> Belma

>

[Guest guest]

Hi Belma –

When I was first diagnosed, the surgeon was very optimistic and told me that

I should be fine with a lumpectomy and radiation, however, after the

lumpectomy, they found with the pathology that my margins weren’t clear and

I would have to have a mastectomy. Even at that point, my surgeon didn’t

think I would need chemo, but after the pathology report from the

mastectomy, it was decided that radiation wouldn’t help me and I was

referred to an oncologist. I guess what I’m saying is that a biopsy doesn’t

give you the full picture. There are a number of other women in this group

that started with a lumpectomy and then had to go on for further surgery…in

my experience (now), it apparently isn’t that uncommon.

My best wishes for a speedy recovery for your mother.

confused by surgeon feedback/please advise

Hi All,

My mom, Esma (60), was diagnosed with ductal carcinoma in situ in the left

breast 3

weeks ago today. In the meantime, an area in the right breast was also

biopsied and

revealed atypical tissue but no cancer. An MRI revealed no further cause for

concern.

During our initial meeting with the surgeon, things sounded very

encouraging. He quoted

high survival rates, praised early detection, and stated that she should be

able to " get back

to normal " after surgery and radiation--with frequent monitoring, of course.

Today's surgery went well. Both the carcinoma on the left side and atypical

tissue on the

right were removed. However, my dad and I were sort of stunned during our

post-surgical

chat with the surgeon, when he presented us with what sounded (to, perhaps,

our

exhauated minds!) like a bleaker picture than the original version. He said

that we would

now wait for the pathology report to see how to proceed. We expected that,

but were

confused when he said something to the effect, " and if the tissue on the

right side is

cancer, then she will need more surgery " --didn't the biopsy rule that out??

We understand

that the tissue was atypical, but the biopsy report clearly stated no

cancer. So, what could

this be about? He also mentioned that " this is something she's clearly prone

to " and

repeated that several times... Tamoxifen was mentioned as a possible

follow-up

measure. Finally, when I said, " but there's also a likelihood that this is

just what we

originally thought--stage 0 DCIS on the left only--and that she can then

just have

radiation and no more surgery, and plan on vigillant follow-ups? " he did

agree that

was the most likely outcome. Still, my dad and I were both left feeling

unsettled; this all

sounded worse than our initial consult.

So... I understand these are novice questions, but it's been a whirlwind of

activity, and

there's so much to process and absorb. We're hoping for some input

from folks who have been through this. Do pathology reports often revealed

big surprises

that biopsies missed? Has anyone been in a similar situation?

Thanks for being there; I have really appreciated your presence during these

crazy 3

weeks.

Belma

[Guest guest]

Hi Belma –

When I was first diagnosed, the surgeon was very optimistic and told me that

I should be fine with a lumpectomy and radiation, however, after the

lumpectomy, they found with the pathology that my margins weren’t clear and

I would have to have a mastectomy. Even at that point, my surgeon didn’t

think I would need chemo, but after the pathology report from the

mastectomy, it was decided that radiation wouldn’t help me and I was

referred to an oncologist. I guess what I’m saying is that a biopsy doesn’t

give you the full picture. There are a number of other women in this group

that started with a lumpectomy and then had to go on for further surgery…in

my experience (now), it apparently isn’t that uncommon.

My best wishes for a speedy recovery for your mother.

confused by surgeon feedback/please advise

Hi All,

My mom, Esma (60), was diagnosed with ductal carcinoma in situ in the left

breast 3

weeks ago today. In the meantime, an area in the right breast was also

biopsied and

revealed atypical tissue but no cancer. An MRI revealed no further cause for

concern.

During our initial meeting with the surgeon, things sounded very

encouraging. He quoted

high survival rates, praised early detection, and stated that she should be

able to " get back

to normal " after surgery and radiation--with frequent monitoring, of course.

Today's surgery went well. Both the carcinoma on the left side and atypical

tissue on the

right were removed. However, my dad and I were sort of stunned during our

post-surgical

chat with the surgeon, when he presented us with what sounded (to, perhaps,

our

exhauated minds!) like a bleaker picture than the original version. He said

that we would

now wait for the pathology report to see how to proceed. We expected that,

but were

confused when he said something to the effect, " and if the tissue on the

right side is

cancer, then she will need more surgery " --didn't the biopsy rule that out??

We understand

that the tissue was atypical, but the biopsy report clearly stated no

cancer. So, what could

this be about? He also mentioned that " this is something she's clearly prone

to " and

repeated that several times... Tamoxifen was mentioned as a possible

follow-up

measure. Finally, when I said, " but there's also a likelihood that this is

just what we

originally thought--stage 0 DCIS on the left only--and that she can then

just have

radiation and no more surgery, and plan on vigillant follow-ups? " he did

agree that

was the most likely outcome. Still, my dad and I were both left feeling

unsettled; this all

sounded worse than our initial consult.

So... I understand these are novice questions, but it's been a whirlwind of

activity, and

there's so much to process and absorb. We're hoping for some input

from folks who have been through this. Do pathology reports often revealed

big surprises

that biopsies missed? Has anyone been in a similar situation?

Thanks for being there; I have really appreciated your presence during these

crazy 3

weeks.

Belma

[Guest guest]

Hi Belma –

When I was first diagnosed, the surgeon was very optimistic and told me that

I should be fine with a lumpectomy and radiation, however, after the

lumpectomy, they found with the pathology that my margins weren’t clear and

I would have to have a mastectomy. Even at that point, my surgeon didn’t

think I would need chemo, but after the pathology report from the

mastectomy, it was decided that radiation wouldn’t help me and I was

referred to an oncologist. I guess what I’m saying is that a biopsy doesn’t

give you the full picture. There are a number of other women in this group

that started with a lumpectomy and then had to go on for further surgery…in

my experience (now), it apparently isn’t that uncommon.

My best wishes for a speedy recovery for your mother.

confused by surgeon feedback/please advise

Hi All,

My mom, Esma (60), was diagnosed with ductal carcinoma in situ in the left

breast 3

weeks ago today. In the meantime, an area in the right breast was also

biopsied and

revealed atypical tissue but no cancer. An MRI revealed no further cause for

concern.

During our initial meeting with the surgeon, things sounded very

encouraging. He quoted

high survival rates, praised early detection, and stated that she should be

able to " get back

to normal " after surgery and radiation--with frequent monitoring, of course.

Today's surgery went well. Both the carcinoma on the left side and atypical

tissue on the

right were removed. However, my dad and I were sort of stunned during our

post-surgical

chat with the surgeon, when he presented us with what sounded (to, perhaps,

our

exhauated minds!) like a bleaker picture than the original version. He said

that we would

now wait for the pathology report to see how to proceed. We expected that,

but were

confused when he said something to the effect, " and if the tissue on the

right side is

cancer, then she will need more surgery " --didn't the biopsy rule that out??

We understand

that the tissue was atypical, but the biopsy report clearly stated no

cancer. So, what could

this be about? He also mentioned that " this is something she's clearly prone

to " and

repeated that several times... Tamoxifen was mentioned as a possible

follow-up

measure. Finally, when I said, " but there's also a likelihood that this is

just what we

originally thought--stage 0 DCIS on the left only--and that she can then

just have

radiation and no more surgery, and plan on vigillant follow-ups? " he did

agree that

was the most likely outcome. Still, my dad and I were both left feeling

unsettled; this all

sounded worse than our initial consult.

So... I understand these are novice questions, but it's been a whirlwind of

activity, and

there's so much to process and absorb. We're hoping for some input

from folks who have been through this. Do pathology reports often revealed

big surprises

that biopsies missed? Has anyone been in a similar situation?

Thanks for being there; I have really appreciated your presence during these

crazy 3

weeks.

Belma

[Guest guest]

Belma,

Biopsies don't tell everything. They have to see how the margins are and also if

it is fast growing. I know there are other things but just woke up and I am not

fully awake. I will keep you all in my prayers.

Hugs

nne

Breast Cancer Patients Soul Mates for Life

http://www.geocities.com/chucky5741/breastcancerpatients.html

BreastCancerStories.com

http://www.breastcancerstories.com/content/view/433/161/

Angel Feather Loomer

www.angelfeatherloomer.blogspot.com

Check out my other ornaments at

www.geocities.com/chucky5741/bcornament.html

Lots of info and gifts at:

www.cancerclub.com

confused by surgeon feedback/please advise

Hi All,

My mom, Esma (60), was diagnosed with ductal carcinoma in situ in the left

breast 3

weeks ago today. In the meantime, an area in the right breast was also

biopsied and

revealed atypical tissue but no cancer. An MRI revealed no further cause for

concern.

During our initial meeting with the surgeon, things sounded very encouraging.

He quoted

high survival rates, praised early detection, and stated that she should be

able to " get back

to normal " after surgery and radiation--with frequent monitoring, of course.

Today's surgery went well. Both the carcinoma on the left side and atypical

tissue on the

right were removed. However, my dad and I were sort of stunned during our

post-surgical

chat with the surgeon, when he presented us with what sounded (to, perhaps,

our

exhauated minds!) like a bleaker picture than the original version. He said

that we would

now wait for the pathology report to see how to proceed. We expected that, but

were

confused when he said something to the effect, " and if the tissue on the right

side is

cancer, then she will need more surgery " --didn't the biopsy rule that out?? We

understand

that the tissue was atypical, but the biopsy report clearly stated no cancer.

So, what could

this be about? He also mentioned that " this is something she's clearly prone

to " and

repeated that several times... Tamoxifen was mentioned as a possible follow-up

measure. Finally, when I said, " but there's also a likelihood that this is

just what we

originally thought--stage 0 DCIS on the left only--and that she can then just

have

radiation and no more surgery, and plan on vigillant follow-ups? " he did agree

that

was the most likely outcome. Still, my dad and I were both left feeling

unsettled; this all

sounded worse than our initial consult.

So... I understand these are novice questions, but it's been a whirlwind of

activity, and

there's so much to process and absorb. We're hoping for some input

from folks who have been through this. Do pathology reports often revealed big

surprises

that biopsies missed? Has anyone been in a similar situation?

Thanks for being there; I have really appreciated your presence during these

crazy 3

weeks.

Belma

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[Guest guest]

they can also determine the er/pr status; her2/neu

status...a biopsy can tell whether the cells extracted

are cancerous...after lumpectomy, they can detrmine

exact tumor size; whether there's metastasis, and the

other histologic factors.

marisa

--- & nne Svihlik

wrote:

> Belma,

> Biopsies don't tell everything. They have to see how

> the margins are and also if it is fast growing. I

> know there are other things but just woke up and I

> am not fully awake. I will keep you all in my

> prayers.

> Hugs

> nne

> Breast Cancer Patients Soul Mates for Life

>

http://www.geocities.com/chucky5741/breastcancerpatients.html

> BreastCancerStories.com

>

http://www.breastcancerstories.com/content/view/433/161/

> Angel Feather Loomer

> www.angelfeatherloomer.blogspot.com

> Check out my other ornaments at

> www.geocities.com/chucky5741/bcornament.html

> Lots of info and gifts at:

> www.cancerclub.com

> confused by surgeon

> feedback/please advise

>

>

> Hi All,

>

> My mom, Esma (60), was diagnosed with ductal

> carcinoma in situ in the left breast 3

> weeks ago today. In the meantime, an area in the

> right breast was also biopsied and

> revealed atypical tissue but no cancer. An MRI

> revealed no further cause for concern.

>

> During our initial meeting with the surgeon,

> things sounded very encouraging. He quoted

> high survival rates, praised early detection, and

> stated that she should be able to " get back

> to normal " after surgery and radiation--with

> frequent monitoring, of course.

>

> Today's surgery went well. Both the carcinoma on

> the left side and atypical tissue on the

> right were removed. However, my dad and I were

> sort of stunned during our post-surgical

> chat with the surgeon, when he presented us with

> what sounded (to, perhaps, our

> exhauated minds!) like a bleaker picture than the

> original version. He said that we would

> now wait for the pathology report to see how to

> proceed. We expected that, but were

> confused when he said something to the effect,

> " and if the tissue on the right side is

> cancer, then she will need more surgery " --didn't

> the biopsy rule that out?? We understand

> that the tissue was atypical, but the biopsy

> report clearly stated no cancer. So, what could

> this be about? He also mentioned that " this is

> something she's clearly prone to " and

> repeated that several times... Tamoxifen was

> mentioned as a possible follow-up

> measure. Finally, when I said, " but there's also a

> likelihood that this is just what we

> originally thought--stage 0 DCIS on the left

> only--and that she can then just have

> radiation and no more surgery, and plan on

> vigillant follow-ups? " he did agree that

> was the most likely outcome. Still, my dad and I

> were both left feeling unsettled; this all

> sounded worse than our initial consult.

>

> So... I understand these are novice questions, but

> it's been a whirlwind of activity, and

> there's so much to process and absorb. We're

> hoping for some input

> from folks who have been through this. Do

> pathology reports often revealed big surprises

> that biopsies missed? Has anyone been in a similar

> situation?

>

> Thanks for being there; I have really appreciated

> your presence during these crazy 3

> weeks.

>

> Belma

>

>

>

>

>

>

>

------------------------------------------------------------------------------

>

>

> No virus found in this incoming message.

> Checked by AVG Free Edition.

> Version: 7.1.405 / Virus Database: 268.12.3/447 -

> Release Date: 9/13/2006

>

>

> [Non-text portions of this message have been

> removed]

>

>

__________________________________________________

[Guest guest]

I'm in exactly the same spot your mother is - just had my lumpectomy Wed, and am

waiting for the final path report.

Initially I was diagnosed, via a mammotome (needle) biopsy, with DCIS, stage 0,

non-invasive cancer - 1 spot in 1 breast. My oncologist made it clear though

that it was only a preliminary diagnosis, not the final conclusion. The

confusion arises because the needle biopsy only takes a tiny amount out, and

when they take the entire thing (hopefully) out, they can find other spots that

the mammogram/needle missed; or they can find other kinds of cancer cells (ie

invasive) mixed in with the non-invasive cells. Also, because DCIS cannot be

seen by the naked eye, and grows through the ducts (which spread like tree roots

throughout the breast), it can be difficult to get it all out the first time.

They may have to go back and do a second lumpectomy to take more tissue out and

get " clean margins " (margins with no cancer cells at all). Essentially the

final pathology report looks at the whole picture vs. just a tiny portion of it.

My oncologist was very upbeat and positive about my diagnosis also, but he

clearly stated that if the final path report showed any different diagnosis,

then we would have to " erase everyting he'd said " and start planning out a

different treatment regimen.

I would call the surgeon and ask specifically if he saw something that alerted

him to the possibility of more cancer during the surgery, or if that is just his

usual spiel after surgery. As far as being " prone to it " , well, they've said

that to me since my first (benign) lumpectomy at age 22. Basically, in my case,

it seems to mean that I have dense, fibrosystotic breast tissue - not

necessarily that I have cancer.

Hope this helps,

May both of us be blessed that our diagnosis does not change!