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Old 10-27-2014, 01:02 PM   #1
LaDonna28
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Posts: 78
Appointments for expanders and insurance

Does anyone know if the appts. to get the expanders filled are considered appts at the dr. office which requires co-pays?
And how often do you have to go?
Has anyone had a lumpectomy only and then decided after the fact to have a mastectomy?
Did the insurance cover this without any issues?

I am still weighing all my options for surgery still. I have 2 more TCHP treatments to go. The 4th treatment kicked my butt and am still dealing with nerve pain and facial twitches almost 3 weeks out.....
Thanks for any info or feedback!
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Steriactic biopsy July 2011 for microcalicificarions - negative
Mammogram 2012, 2013 no change
Mammogram July 8, 2014, more microcalcifications and mass (10mm per radiologist)
Diagnostic Mammogram July 10, 2014
Steriactic Biopsy July 15, 2014
July 21 given diagnosis DCIS and IDC upper, Outer quadrant of right breast
ER Pos >95%. PR Pos 90%, HER-2-neu positive (score +3) Grade 3
Breast surgeon on July 29, 2014 says 2 cm
MRI states only mild to moderate bilateral physiologic background parenchymal enhancement with uptake on intermammary nodes
BRCA tests all negative :)
August 8 port placement. Lung partially collapsed. On oxygen until further notice
August 9, '14 started TCPH therapy with nuelasta shots. 6 cycles @ 3 weeks
5th treatment T and C dosages lowered due to bad neuropathy
6th and last TCPH changed to PH only for Dec 1st
Lumpectomy and node biopsy Dec 2
100% complete response from TCPH neoadjuvent therapy: tumor completely gone-dead cells only. Node completely free of ANY cells. Staged at 0! Margins clear from 4mm-10mm from dead cells.
2 week period following surgery went in for draining of Hematoma that filled surgery void area in breast 3 times
Continued with Herceptin only December 22, 2014 @ 3 weeks until ???
Started radiation Jan. 7, 2015 plan is for 16-20 rads
january 25th 2015 last radiation completed. Stopped at 16 due to Seroma (void in breast is filled with fluid)
January 30 Tamoxifan started
Still on oxygen, tamoxifen side effects kicking my butt. Seeing a gastro dr. due to a lot of stomach issues.
July 2015 - 3D mammogram nervous as all hell - but came back clean!!!! YEAAH
March 2016 - only using oxygen at night! Stomach issues better and trying to wean off the heartburn meds. Am hoping to get reconstructive done Jan 2017.
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Old 10-27-2014, 04:25 PM   #2
Nurse4u2day
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Re: Appointments for expanders and insurance

The fills vary per doctor. As for insurance my policy is that if for the fills I see my actual Doctor then I still have to pay the co pay for each visit. As for lumpectomy if you have that first and later you and your doctor decide base on pathology report that a mastectomy is preferable then yes your insurance should cover that as well. Insurance can be weird, when I called my insurance I told them I had cancer in left breast only but wanted to know if they would cover a bilateral mastectomy there response was NO we don't do phropyhalactic ( pay) my surgeon said that was nonsense! He did the Bmx and they covered it 100%. I don't know what insurance code he used but they paid.
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]11/13 Dx IDC left breast
11/19/2013 Inflammatory Breast Cancer stage 3c grade 2 Er- Pr- her2+++
Node involvement suspected based on CT
12/13 port placed
12/13 neoadjuvant DD AC xs 4 rounds started
02/14 taxol/herceptin started every week xs 12 rounds
Herceptin for 1 year
Ki67=23%
BRCA1&2 negative
5/06/14 last round taxol/herceptin. Chemo done!!!
5/07/14 clear CT scan
6/11/14 Bilateral Mastectomy Done
6/15/14 8mm tumor post chemo. Removed by bmx
6/15/14 lymph nodes 0/9
6/15/14 officially Cancer Free
7/11/14 emergency surgery to left breast . Wound refused to heal and broke open. New TE placed
7/28/14 emergency medical procedure now to right breast( post op 6 weeks mastectomy ) wound opens.
8/25/14 - 10/07/14 Radiation
11/24/14 CT of Brain clear
01/23/15 One year Herceptin Complete
02/04/15 Diep done
5/01/15 1 year Ct scan- mass in thymus
6/23/15 repeat CT mass in thymus still present
6/30/15 biopsy thymus 7/03/15 mass Benign! Diagnoses Thymic hyperplasia rebound ( chemo at fault, no long term health effects)
7/08/15 phase 2 diep
11/23/15 phase 2b ( reconstructive surgery with lipo)
03/05/18 Vinnie Myer 3 D nipple tattoos complete.
11/19/2018 5 years since Dx of IBC stage 3c remain NED.
11/19/21- 8 years today I officially remain NED and in 12 days I will be having a lymphnode transfer to help decrease some mild lymphedema! Still working, living life and soon to see a day I thought never would happen and that’s becoming a grandparent June 22nd.
11/19/2023 - 10 years since diagnosis and I remain NED
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Old 10-28-2014, 12:23 PM   #3
jaykay
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Re: Appointments for expanders and insurance

Regarding the fills - in my case, they were part of the first part of the reconstruction cost and I don't recall paying any co-pays for visits to the plastic surgeon to get them filled. Part 1 being the expanders after the bmx. Part 2 was separate and the actual exchange surgery a year later (expanders for implants)
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March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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