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08-17-2008, 01:35 PM
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#1
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Senior Member
Join Date: Jan 2007
Posts: 368
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Risk assessment
What do you think when you have 2 widely different risk of recurrence assessments from 2 different medical professionals?
I asked a prominent Breast CA nurse specialist from John's Hopkins what my risk of recurrence was and was told it was high. My own Onc (not specializing in BC), given the same info, says slight.
I know neither can ultimately know what will happen, but the huge difference is un-nerving, to say the least.
__________________
12/12/06- IDC Stage III, 4x A/C, 35 rads, Herceptin 1 year
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08-17-2008, 04:54 PM
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#2
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Senior Member
Join Date: Jan 2008
Location: Oregon City
Posts: 856
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It could be they are both referring to the same data and they both perceive that same data differently.
Say for example, your risk of recurrence is 20%, based on HER2 status, pathology reports, and your tumor's response to drugs. The nurse, who is used to normal recurrence rates of 5 to 10% would think your risk is high. Compared to normal rates, she would be correct. The doctor looks at your recurrence rate of 20%, and even though it is higher than normal, there is still an 80% chance that there will be no recurrence.
This is one of the truly frustrating aspects of dealing with medical personal. High and slight don't have much meaning unless you know where perspective is from.
__________________
This happened to Colleen:
Diagnosed in September 2007
ER-/PR-/HER2 Neu+++ 2.1 cm x .9 cm spicluted tumor with three fingers, Stage 2B
Sentinal node biopsy and lymph node removal with 3/18 positive in October 2007
4 TAC infusions
lumpectomy March 2008, bad margins
Re-excision on June 3rd, 2008 with clean margins
Fitted for compression sleeve July 16, 2008
Started the first of two TCH infusions August 14, 2008
Done with chemo and now a member of the blue dot club 9/17/08
Starting radiation October 1, 2008
life is still on hold
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08-17-2008, 06:27 PM
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#3
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Senior Member
Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
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I agree with Lee. After surgery I went to two different oncologists (Herceptin wasn't available then) and one waffled on my future and the other said, no problem - you'll beat this.
I guess its about being wrong. The first one was afraid that if he said I would recur and didn't, its a better situation for him. And the second one knows the chance is there but low and wants to give hope and optimism so says no problem and if I recur, she made a mistake. That takes guts.
You'll be fine. You risk is lower than you think. Its just the nurse is afraid to make a mistake that has bad consequences and your doctor isn't. That's her problem and it shouldn't make you worry.
__________________
Kind regards
Becky
Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia
NED 18 years!
Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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08-17-2008, 07:48 PM
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#4
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Senior Member
Join Date: Jul 2007
Location: Canada
Posts: 2,193
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Hi Brenda
My oncologist told me that someone with my dx. has a 90%
chance of not recurring and a 10% chance of recurring. He
then told me that he did not know which group I would be in.
I don't think anyone knows.
__________________
PinkGirl
Dx Aug/05 at age 51
2cm. Stage 2A, Grade 3
ER+/PR-
Her2 +++
Sept 7/05 Mastectomy
4 FAC, 4 Taxol, no radiation
1 year of Herceptin
Tamoxifen for approx. 4 months,
Arimidex for 5 years
Prophylactic mastectomy June 22/09
" I yam what I yam." - Popeye
My Photo Album
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08-17-2008, 08:02 PM
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#5
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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Pink Girl, you have a very sage oncologist there!
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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08-18-2008, 12:08 AM
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#6
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Senior Member
Join Date: Oct 2005
Location: southern california
Posts: 287
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No one knows for sure. I guess if you believe that GOD knows all of our paths, he is the only one that would know, and know why! Before I had cancer, I had many personal challenges, and then there was cancer! I thought that at some point my plate had to be full and there could be nothing added to it. Personally I was wrong. I think that there is no rhime or reason that we can detect for who recurs and who doesn't. Either you recur or you don't. That makes 2 catagories 100% that you didn't recure or 100% that you did. All we can do is not obcess about it and be thankful and find the joy in every day we have ahead of us.
Last edited by Alice; 08-18-2008 at 12:11 AM..
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