I was diagnosed on March 17th, prescribed Femara straight away and it was explained that it would help to shrink the tumor. I had a WLI and SNB on April 18th, the surgeon popped along the next day and said that as far as he was concerned it hadn’t spread and I could go home, and to go back to see him in 2 weeks which is this Thursday coming. So off I trotted home with more Femara and some paracetemol and a leaflet of exercises.
Has anyone, any idea what happens next please.
You will probably get your full results, and the treatment plan for what happens next.
Things they will (or might) tell you:
Grade. You may already have an idea of this, but it can happen that a tumour is upgraded once it’s been removed. After the biopsy I had I was told it was Grade 2 but after surgery it turned out to be Grade 3.
Size. Scans give a good idea of size, but only once it’s been removed can they say accurately how big it was.
Nodes. Confirmation of what your surgeon said, that your nodes are clear and that it hasn’t spread. I can’t remember if you had OSNA (a test where they check nodes while you’re still under) but if not, they send the nodes off for microscopic examination and will tell you the final results at your follow-up.
Margins. When they remove a tumour they like to have some clear healthy tissue all around the tumour to give more certainty that they’ve removed everything cancerous. Up to 20% of people don’t get clear margins and end up having to have another go at getting everything out. It’s not a big op but does get you back in The Waiting Room, so I’ve got things crossed that your margins are clear. Because they can’t see DCIS by eye, they have to check the margins under the microscope and this can take a little while to do.
Hormone status. By the sound of it you already know whether your tumour responds to hormone treatment as you’re on Femara, but they might give you a “score” out of 8 to say just how receptive it is.
HER2 status. If you are HER2 positive, your tumour would also respond to Herceptin. If you’re not, then Herceptin wouldn’t do anything at all for you. That’s an interesting one to know as Herceptin is usually given in conjunction with chemo, whatever grade the tumour is.
TREATMENT PLAN. You may be told there and then what the treatment plan is, or at least what the LIKELY treatment plan is, ans may be given another appointment to see your oncologist who will take over the next stage of your treatment (margins allowing. If they’re not clear you’ll probably be given another date for surgery.) Or you might meet your oncologist too, it depends on how your hospital does things.
In the meantime write down any questions you might have in a notebook so you don’t forget to ask them when you have your appointment.
Best of luck, and I hope you enjoy the weekend in the meantime, if you can. Fingers crossed for you.
CM
x
Thanks CM for that well informed guide hun you are certainly very knowledgeable.
I’ll write down all the subsections you have given and will note his responses etc to it all.
Thank you again you have put my mind at rest for the time being.
Dear saphy,
You may also find the BCC publication “Understanding your Pathology Report” helpful. I have attached the link:
breastcancercare.org.uk/upload/pdf/pathology___feb_08_0.pdf
Very best wishes
Janet
BCC Facilitator