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Old 06-27-2012, 05:22 PM   #1
dawny
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Now DCIS - may have had it for 12 years!

Hi all
I found a new lymph node lump a few months ago, watched and waited for a while, decided to get it out, so I had a Node dissection with only 1/11 nodes affected, which is great (!) and only a couple of days before surgery the BS found another lump in the same breast, so she took that too, as well as the area my primary lump was. This came back as DCIS. So now I have to decide what to do about that. My BS is on holidays , so yesterday i went to another BS just to check everything was healing ok. He came into the room and said "I haven't seen you for 12 years" I was wracking my brain, thinking "have I met you before?" and then I remembered that when I was pregnant with my first child, I had some bleeding from the nipple. I was sent this BS, he had a look and did some reading, and said that it was a rare thing, but sometimes just happens during pregnancy. He didnt do a mammo or anything else. That was the end of that, no more symptoms, new baby, life was good. Now he thinks maybe I had DCIS back 12 years ago, and it developed into stage 1V invasive cancer last year. He can't be sure of that, of course, but talked about writing a paper, so other BS can keep an eye out for it. Now I am beating myself up over it, why didn't I go back after having my son to get it checked out again?. Obviously I wasn't thinking about cancer back then. Anyway, now I have to decide what to do next, if it has been there that long and already turned invasive, shall i just have a mastectomy? I now wish I had that last week, I am still recovering from that surgers, I don't like the thought of going straight back in! I am such a wimp, I hated all the drainage tubes, and blood! My other option is to wait and have a mastectomy if it goes astray again.

Any suggestions?

Thank you for listening to me go on and on!

Dawn
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Dx May 27 2011, age 43
Stage 1V 3.6cm breast lump, spot on lungs, nodes chest + neck
HER2+ ER/PR-
Abraxane weekly - 16 weeks
Herceptin every third week
September 26 2011 N.E.D!
Herceptin ongoing
8th Dec 2011 Brain MRI - clear
20th Dec 2011 bone/cat scan clear still NED
April 2012 scans show axillary node lump - ? what to do...
June 2012 Axillary node dissection 1/11 nodes affected, a wide local excision shows DCIS. Now what to do again? Watch and scan 3 monthly
April 2013, two spots in nodes to chest wall, start TDM1 (Kadcycla) as part of clinical trial
July 2013 stable
Oct 2013 progression off TDM-1 (Kadcycla)
Nov 2013 radiation to lymph nodes in sternum
Dec 2013. Mastectomy right side, pathology shows tumour was HER-2 negative, no wonder TDM-1 (Kadcycla) didn’t work!
April 2014 NED. On Herceptin only
August 2014 NED. On Herceptin only
March 2015. NED. On Herceptin only
September 2015 NED on Herceptin only
March 2016. Pulmonary embolism, Clexane injections daily forever. Still NED On Herceptin only
Nov 2016. Bone Mets in ribs - Radiation. Don’t know if bone Mets are er-/pr-/HER2+ or triple negative.
Can’t give self injections on to tablets (Xarelto) for blood clots.
2017 NED - On Herceptin only
2018 NED - On Herceptin only
2019 NED - On Herceptin only
2020 NED - On Herceptin only
2021 NED - On Herceptin only
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Old 06-27-2012, 06:06 PM   #2
LeahM
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Re: Now DCIS - may have had it for 12 years!

Hi Dawn,

I can't help you to decide what to do next, it's such a personal experience, but I can tell you this:

The literature I rec'd about breast cancer said that it takes 9 years for 100 billion cells to reach a 1cm size, and another 2 years for that tumor to be palpable to the touch. My tumor was .8x.3cm and was not palpable.

Please don't beat yourself up with the "what if's" from 12 years ago. Now is the time to just move forward and plan your attack. Nothing you can do about the past.

I wish you all the best
Leah
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April 20, 2012: Dx Invasive Ductal Carcinoma
April 25, 2012: ER+(5%), PR-, HER2+++
May 10, 2012: BRCA 1,2 Negative
May 23, 2012: MUGA Scan EF 70%
May 31, 2012: B/L Mastectomy. 2/2 nodes removed and CLEAR!! Power Port placed. 2 Drains. 2 Expanders placed
June 5, 2012: Drains OUT! Ahhhh..
June 12, 2012: Final Pathology Report, .8x.3cm tumor. Micromets to 1 node .35mm under cytokeratin staining. Stage 2A. Onc says "you are lucky to have found this early"
July 10, 2012: Started 6 rounds of TCH with weekly H
Sept 5, 2012: MUGA 65%
Sept 20, 2012: CAT scan of brain clear!
Oct 23, 2012: LAST TC! AMEN! Continue Herceptin every three weeks until July 2013.
Nov 19, 2012: Port out!
Dec 5, 2012: Started radiation
Dec. 10, 2012: MUGA 65%
Dec. 13, 2012: Turned 40. BEST BIRTHDAY EVER!
Jan 23, 2013: Last radiation. Told I am NED. Continue Herceptin every three weeks till July 2013.
Jan 29, 2013: Begin 5 years of Tamoxifen.
Feb 28, 2013: CT Scan with Contrast of lungs. 5mm and 4mm nodules of unknown origin. Rescan in 3 months.
Mar 6, 2013: EF 60%
May 8, 2013: Exanders out, implants implanted...abd. lipo and fat moved up. Girls are looking good!
June 3, 2013: CT Scan with Contrast of lungs. Previous nodules gone. New nodules (2mm and 3mm) found. Rescan in 3 months. So sorry I opened this can of worms...
June 11, 2013: EF 60%
June 25, 2013: Last Herceptin. wow...
Aug 20, 2013: Tumor markers within normal limits. Xray to sore left ribs shows no disease or fractures.
Sept 9, 2013: CT of lungs shows no disease. Closing this can of worms and moving on.
Nov 20, 2013: Tumor markers within normal limits. Severe Vit D deficiency, started on prescription Vit. D. Blaming chemo for this.
Feb 2014: Tumor markers within normal limits.
May 2014: Tumor markers within normal limits. Graduated to twice yearly onc appts.
Oct 2014: Tumor markers within normal limits.
May 2015: Tumor markers WNL. Bone density scan fine. Bone scan and xray of ribs shows "something" 4th right rib. Could be healed fracture but if it is healed why does it hurt?
Nov 2015: Tumor markers WNL. Follow up bone scan clear.
Feb 2016: Syncope! WTF? Dizzy too. Brain scan clear, ECHO EF 60%, Halter Monitor shows heart is fine. Viral? I will never know.
June 2016: Tumor markers WNL.
Oct 2016: Stabbing pain right eye. Long story short, trigeminal neuralgia.
Nov 2016 Brain MRI clear.
Jan 2017: Tumor markers WNL, still getting weird pain right rib area, and sometimes right upper chest. Xray x2, Bone Scan, Breast MRI all clear. Scar tissue? Rads. I may never know.
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Old 06-27-2012, 09:11 PM   #3
Jackie07
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Re: Now DCIS - may have had it for 12 years!

When I was first diagnosed in 2003, also at 43 years old, my tumor was 1.2 cm with a super fast mitotic rate. The surgeon estimated the tumor had been growing for 2 1/2 years (coincided with the time when I was being 'poisoned' at work.)

Sounded like that doctor might be saying that the stage IV you've been through had originated 12 years ago. Be sure to get a copy of his writing when it's published. It may help you understand more about the course of your treatment.

DCIS is the precursor of invasive cancer. Your doctor might need to choose something different as the previous treatment had not been able to prevent it from forming.

Current understanding of angiogenesis - that more blood vessels will form when there's damage to the tissues/blood vessels - makes doctors think twice before suggesting surgeries for stage IV patients. You might want to seek a 2nd, 3rd opinion if you are not comfortable with your doctor's advice.
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Old 06-28-2012, 12:50 AM   #4
Mandamoo
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Re: Now DCIS - may have had it for 12 years!

Oh Dawny - don't blame yourself - we can't undo the past.
I can't see much reason for surgery. I had a mastectomy thinking I was stage 2b but in the wait for chemo after surgery and node dissection I metastasized. I look back at my mastectomy and see it as a complete waste of time and mourn my breast even more though it was the right decision at the time. We were not to know what was going to happen. I would get a few opinions but I would think as you are on treatment all the time there wouldn't be any advantage to surgery and I would be concerned about what is floating around while recovering from surgery and as Jackie says also how many blood vessels are forming while recovering.
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22 February 2011 - Diagnosed Early Breast Cancer IDBC Stage2b (ER/PR -ve, Her2+ve +++) - 38 years old
(L) skin sparing mastectomy with tissue expander, axilla clearance (2/14 affected) clear margins.
Fec*3, Taxotere and herceptin*2 - stopped due to secondary diagnosis

June 24 2011 Stage IV - Skin met, axilla node, multiple lung lesions

Bolero3 trial - Navelbine, Hereptin weekly, daily Everolimus/Placebo
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August 2012 (turn 40!) tykerb and herceptin (denied compassionate use of TDM1) while holidaying in Italy!
September 2012 - January 2013 TDM1 as part of the Th3resa trial - lymph nodes resolved, lungs slowly progressing.
January 2013 - herceptin, carboplatin and Perjeta (compassionate access)
April 2013 - Some progression in lungs and lymph nodes - Abraxane, Herceptin and Perjeta
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Old 06-28-2012, 11:59 PM   #5
dawny
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Re: Now DCIS - may have had it for 12 years!

Thanks LeahH. Jackie and Amanda. I thought that I would not have surgery for Stage 1V, but I got to thinking that if I could remove that one axillay node, maybe I could get back to NED. I also wondered about the effect surgery would have, but I have already had surgery now on the axillary nodes. Just need to decide on the DCIS, mx, or watch and wait.

Thanks ladies!

Dawn
__________________
Dx May 27 2011, age 43
Stage 1V 3.6cm breast lump, spot on lungs, nodes chest + neck
HER2+ ER/PR-
Abraxane weekly - 16 weeks
Herceptin every third week
September 26 2011 N.E.D!
Herceptin ongoing
8th Dec 2011 Brain MRI - clear
20th Dec 2011 bone/cat scan clear still NED
April 2012 scans show axillary node lump - ? what to do...
June 2012 Axillary node dissection 1/11 nodes affected, a wide local excision shows DCIS. Now what to do again? Watch and scan 3 monthly
April 2013, two spots in nodes to chest wall, start TDM1 (Kadcycla) as part of clinical trial
July 2013 stable
Oct 2013 progression off TDM-1 (Kadcycla)
Nov 2013 radiation to lymph nodes in sternum
Dec 2013. Mastectomy right side, pathology shows tumour was HER-2 negative, no wonder TDM-1 (Kadcycla) didn’t work!
April 2014 NED. On Herceptin only
August 2014 NED. On Herceptin only
March 2015. NED. On Herceptin only
September 2015 NED on Herceptin only
March 2016. Pulmonary embolism, Clexane injections daily forever. Still NED On Herceptin only
Nov 2016. Bone Mets in ribs - Radiation. Don’t know if bone Mets are er-/pr-/HER2+ or triple negative.
Can’t give self injections on to tablets (Xarelto) for blood clots.
2017 NED - On Herceptin only
2018 NED - On Herceptin only
2019 NED - On Herceptin only
2020 NED - On Herceptin only
2021 NED - On Herceptin only
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