The most conservative surgery

[nelly8]

Hi, I already posted a question on the last week, now I have my diagnosis after needle biopsy: infiltrating ductac carcinoma 0.7 cm. I am in Canada and here the standard option is lumpectomy and all nodes removal. Is it differen in US, I heared that it's only sentinel node removal there with blue liquid injection. Is it so? How much would cost such a surgery for Canadian paid from a pocket? Is it possible to arrange just lump removal in US? I am very conservatively oriented and will not take any chemo or hormons. Thank you for your help.

[debden]

In the spirit of sharing experiences that may be helpful, I would like to offer the following.  I had a lumpectomy with a 3cm tumor removed, 2 of 8 lymph nodes were positive for cancer, that was followed with 4 cycles of A/C, 4 of Taxol, 7 weeks of radiation and 1 year of herceptin as part of a clinical trial, I was stage II.  My experience was very positive, with few side effects and the blessing of great doctors and nurses. I did extensive research and networking among caregivers and patients. You may want to find people in your area who have been both pleased and had difficulty with treatment, then you can compare the pros and cons of the various options to the things that are most important to you, in your life, and based on your support system and resources.  Each person is so unique and so I believe that we have to support each other while not expecting that any two patients will have the same experiences.  Take Care.

[Poodah]

i am sorry to hear of your troubles.  i too had a lumpectomy five years ago, along with 4 rounds of taxol, 4 rounds of FAC and 6 weeks of radiation.  i was grossly overtreated (the result of being talked into a "study" at a major cancer hospital).  do your research!  make sure that you not only take care of the cancer, but that you think of your quality of life afterwards.  i am in constant pain, i constantly get major staph infections (in the cancer breast - due to lymph node removal), and have horrible thyroid disease due to radiation.  my children were 2 and 6 at the time.  do your homework (exactly what you are doing here :)).  these places are great for finding out what is REALLY going on out there -- not just what they tell you.  hang in there.

[SnowWoman]

Don't feel that just because your daughters are grown and "on their own" that they don't need you in their lives any longer.  My mom died in Feb. from lymphoma.  It's been a painful and difficult time since I feel like we had just really been able to build a relationship in the last 5 years since my dad died.  I'm 46 and feel cheated of the years we should have had to get to know each other better on an adult basis.

I was fortunate that my "lump" was not cancer but in the very long week that I awaited the pathology results, I had convinced myself it was.  My biggest fear was having to be dependent on others if I had to endure more surgery and chemotherapy, etc. (It was really difficult just to ask a friend to drive me home from the hospital after the biopsy.)  But know that just as you would be more than willing to do this for others, they would like to be there for you.

Look at your options and don't let the politics of medicine there make your decision.  If you don't want chemo, you might consider mastectomy as the best alternative.  Therapy may need to be a part of your treatment plan (that's where I'm headed next in my healing).  As others can tell you, breast cancer is a very treatable disease and there is good hope that you can have a "normal" fulfilling future.

[SCMom]

. Nelly, my heart just goes out to you. I just wanted you to know that I am 48, with an adult daughter, too. I am scared, also. But please do not give up! There is a wonderful online support group that you might like to check into: http://bcsupport.org. Many, many women ask questions and get support from each other, and have so many stories to share. You have my thoughts and prayers!

[nelly8]

Dear scmom, thank you for your sincerity. I am (was) healthy, wealthy and happy mother of 2 adult daughters, I am 52 now. And I doubt very much that this new life with pain, fear, treatment complications and limits all over may even be compared as 1:100 to my previous life. Probably I need a psychologist. Thank you anyway.

[seven7]

Hello,  You may have already had your lumptectomy, but I felt I has to add my thoughts.  Your tumor is very small (compared to mine, which was 5 CM)  but it is infiltrating,  as mine was.   I hope you do as your doctors suggest if they call for chemo and  radiation.  It will greatly improve your chances of staying cancer free.  And the treatments are not so bad.  I am glad I had them.   Best Wishes to You.

[SCMom]

Nelly, I just had another comment. Of course, everyone has a right to their own health care decisions, but I hope you are being very careful about informing yourself. I just went to my radiologist today, and she said that if a person has a lumpectomy only (no chemo, hormones, or radiation) there is a 25 to 30% chance of that cancer recurring. This is reduced to 6 to 8% with radiation. Hormone therapy and/or chemo, if recommended by an oncologist for your particular situation, further improve your chances of living a long, cancer-free life. Please consider your health and get the input of those loved ones in your life. My diagnosis is identical to yours, and I had lumpectomy, and am having radiation, chemo, and hormones.Many women have been through this protocol and say they would do it all again, no regrets. My chances with full treatment are 94.4% for non-recurrance. I like those odds! Please give it some thought!

[Bet63]

Hi,
I felt I should respond even though I don't have breast cancer. I am a Canadian living in the US and recently had a lumpectomy for microcalcifacations. Having to pay for medical treatment here is a new concept for me! My surgery was around $5000.(that's in US funds and when you convert Canadian money into US funds,the amount is quite a bit more) That was with no nodes removed and it was an outpatient procedure.
I hope this gives you some idea. I wish you the best of luck.
Take care.
Bet

[SCMom]

Hi! I just recently had surgery for  a .7 cm infiltrating ductal carcinoma, too! I had a lumpectomy & sentinel node. Here are the approximate Souther US (mid-size city) costs...It was done as an outpatient, no overnight hospital admission. Surgeon's bill was $3,000.                  Hospital: $4,900.    Pathology : $880.  Another $700 for Radiology, which I think was for the sentinel node. Total was about $9,500. Of course, insurance paid for most of this. If you get sentinel node, you want to make sure that your surgeon is VERY experienced in this area. You want to make sure that the sentinel node is not missed. Occasionally, the sentinel node is located in an area that can be difficult to reach, also. I hear they have good health care in Canada! I would be hesitant to have doctors "scattered about."  You may need to return to your surgeon later to have a port inserted or to follow up on a problem, or simply for post-op checks. My oncologist and radiologist also communicate with my surgeon, so I feel reassured knowing that they are all in the same city and will work "as a team" to give me the best care. Best wishes to you as you pursue your medical care!

[CCF-RN,MSN-JS]

Dear nelly8, There are some choices about the "usual" course of treatment.  Breast conserving surgery is lumpectomy, removing more of the tissue at the biopsy site to be sure of clean margins(normal tissue surrounding the cancerous area).   Checking the lymph nodes is part of the staging and involves removing the lymph nodes in the fat pad under the arm.  Radiation therapy to the remaining breast tissue will be part of that treatment choice.
Sentinel lymph node biopsy is done to check the node that would in theory be the node that if cancer had spread to the other nodes would have affected that node first.  There are questions as to whether both procedures should be done (concerns of missing a lymph node if the sentinel node only is done).  In most cases sentinel lymph node biopsy alone is reserved for very small tumors in selected individuals.  One of the reasons for checking the lymph nodes is to determine whether or not chemotherapy or hormone therapy would be recommended.  

As to the cost of the procedure we do not have the information to respond to this question.  Each institution has its own cost structure.  You may need to contact a specific hospital to obtain this information.