worried

Hi Sarah,

Sorry to hear that your Mum has recently had a BC diagnosis. Its a week since you posted, have you any update on her yet?

One way to know if her BC has spread to her nodes is to do a Sentinel Node Biopsy. Some hospitals remove all underarm lymph nodes on the same side as the cancer but some offer the SNB which is basically the removal of the first one (or two) lymph nodes in the axilla (underarm). This is then tested and if it comes back clear then they know there is no cancer in the rest of the nodes. If it comes back positive, they will remove all the nodes in a later op and test them all to check the extent of the spread. Sometimes the SNB is done at the time of the lumpectomy or mastectomy and sometimes it is done prior to any breast surgery.

A couple of things to note - if her consultant said the nodes felt normal during physical examination, this is better than large nodes being palpable under the skin. Although I understand you are worried because they showed up on ultrasound. Also, the majority of people (me included) who unfortunately have their cancer spread to underarm nodes don't have further spread to other organs.

Keeping fingers crossed for you and your mum that all goes well.
Regards,

Flo.

worried

Hey sarah

Sorry to hear about your mums recent diagnosis.

It can take 10-14 days for the results of the pathology (analysis) of the tumour/lump and the nodes to come back so the doc is saying nothing as he simply does not know yet.

Once the results are clarified, your mums next course of treatment will be determined. That may be chemotherapy and / or radiation therapy. Your mum will also have other scans - bone scan and CT scan and some point in next few weeks.

Your mums primary goal now is to get over the surgery and get her head around the whole thing. Although I have not used them yet, there are cancer support services linked to some of the hospitals were your mum will be able to meet other women in her situation and also chat to trained councillors. For eg the ARC centre near the Mater Hospital in Dublin. Perhaps you can check out one neaer where your mum lives or is being treated.

By the way, I have just turned 40 and was diagnosed with BC last Dec. Initially I had a lumpectomy together with a sentinal node biopsy (Flo mentioned this) however my lumpectomy was unsuccessful in getting a good margin around the lump so I had a mastectomy on 4th Feb and all my lumph nodes removed as two were found to be positive during the sentinal node biospy. I got the results of the second surgery about 10 days later on Fri 13th Feb. Thankfully for me there were no more positived nodes and no more cancer found in the breast tissue. I am waiting to start chemo. Unfortunately I developed an infection so am waitiing for the wound to heal before embarking on the chemo part of this journey. My chemo will last 6 months and will be followed by radiation therapy.

Hope this helps, best of luck to your mum.

Please let us know how she is doing and dont hesitate to ask more questions.

L

Hi Sarah,

When did your Mum have her operation? As Linda said, it can take a while for the results of the Pathology to come back. The Pathology looks at different characteristics of the cancerous tissue removed and helps the docs decide what is the best treatment for your Mum. Only after pathology will they know exactly how many nodes were affected. And the stage and grade of her BC. The 'stage' refers to the size and spread of the tumour (see first link below for further info) and the 'grade' refers to how the cancer cells are behaving (see second link below).

http://www.cancerhelp.org.uk/help/default.asp?page=3315

http://www.cancerhelp.org.uk/help/default.asp?page=3317

The Pathology will also tell you other things, such as was the tumour Estrogen (and/or Progesterone) receptor positive? In my simple non-medical terminology, this means that cancer cells were using the hormones in yr Mum's body to grow. May sound scary but in a way its positive because there are good reliable drugs available now to treat this.

They will also test the tissue removed to see if it is 'HER2' positive. I 'think' (not sure here) that HER2 is a protein released sometimes by tumours. They are often faster growing tumours. Again, this sounds scary but there is a drug used (with great success) to treat this called Herceptin. It is not the same as chemo but it is given usually once a month by infusion (drip) for about a year after diagnosis, it is not taken in tablet form. The test for this is called an FSH test (pronounced FISH test).

You can probably learn more by doing searches on the net for Her2, Estrogen receptor positive, etc. This is just what I've learned along my cancer journey.

Stay positive. The stats nowadays show that over 80% of Breast Cancers are cured. Surgery and treatments have come a long way. In my non medical opinion, I think yr Mum was wise to have the Mastectomy. I chose not to at the time, I was 37 and not ready, but am planning on going back later this year for one.

Let us know when you get further information. I found talking to others REALLY helped me cope better.

Regards,

Flo.

worried

Hi Again Sarah,

I know its impossible but try not to worry. Even if yr Mum's nodes are positive, they have all been removed. And chemo (and radiation?) will be done on the offchance that some lingering cancer cells are trying to survive.

And yes, the waiting is probably the worst part of cancer. It was always the part that frustrated me the most - I just wanted to be DOING something all the time to beat the cancer, not sitting around waiting for something. But sometimes the time spent waiting is necessary too to help you all come to terms with, and accept, the diagnosis and to deal with with all your worries and fears. After diagnosis, sometimes it can feel (especially for the patient) like they are on an out of control roller coaster. A lot is suddenly happening and everyone else seems to be making the decisions and telling you what to do. I know I just wanted to scream 'STOP!' and try to take back some of the control of my life that I felt I was losing.

Unfortunately, on the HER2 front, there could be more waiting - Sorry!!! They will test the tissue removed for HER2 but sometimes the levels are borderline and they have to do a more detailled test (which takes longer) to determine if yr Mum would benefit from Herceptin. I know it must be very worrying to read that HER2 positive cancers are usually rare but more agressive BUT the HERCEPTIN drug has proven to be excellent in combating this. My medical oncologist (the guy who prescribes the chemo) said he believes that Herceptin is the biggest step forward made in Cancer Research in years! In fact, I have talked to some people who were actually hoping their cancer was Her2 positive because they knew there was something very effective available to treat it with.

If yr Mum is feeling up to it, try using this waiting time to take her out for nice lunches or to find and have a look at a Cancer Support Centre. I didn't find mine before I started chemo, which I regret now as I found it wonderful. A haven of peace and comfort where I could be honest with counsellors and patients about how I was feeling. And a source of wonderful massages, reflexology, relaxation therapy, wig advice and fitting, among other things.

And Action Breast Cancer also have a service which could put yr Mum in contact with other Breast Cancer survivors who she can talk to IF she wants.

Hugs to you and yr Mum,

Flo.