Doctors Recommendations

This is the summary I asked the doctor to email me concerning our visit yesterday so I could put it on my blog. It includes the terminology I wouldn't remember. Loving this surgeon right now. 

Going over and beyond.

Rebecca,

Very nice meeting you and your husband.  As we discussed, here is a summary of my recommendations and your workup thus far:

#1 Your imaging and biopsy workup thus far has demonstrated breast cancer in both breasts.  Biopsy of each of these cancers has confirmed that they are invasive ductal carcinoma, the form of breast cancer that represents approximately 75% of all breast cancers.

#2 Regarding the diagnosis of invasive ductal carcinoma, we still are awaiting additional studies that clarify the subtype of invasive ductal carcinoma.  As I mentioned to you in clinic, we are specifically awaiting the estrogen receptor status, progesterone receptor status and HER-2/neu status.  These variables are relevant as these results may affect the timing of chemotherapy.  Specifically, some patients benefit from chemotherapy administered before surgery depending on their results.

#3 Based on your young age and the fact that you have bilateral breast cancers, I would recommend bilateral mastectomy, sampling of the lymph nodes as well as a referral to a genetic counselor so that you can be screened for any possible genetic mutations.  For example, the BRCA mutation recently brought into the public eye by Angelina Jolie. 

#4 Finally, I will be making a referral to Eric Gamboa, M.D. one of our medical oncologist whom I work closely with on all of my breast cancer patients.  I talked to him last night about you and he hopes to see you this week.

Please keep in mind, that are meeting yesterday was based on incomplete information.  We are still waiting for your receptor status and HER-2/neu status as noted above.  I have a call in to the pathologist to expedite this process and I hope to have an answer for you later today.   Depending on these results, our plan may change in terms of the timing of chemotherapy.

Also, as I mentioned to you and her husband in clinic -this is not a hopeless situation.  Although the diagnosis of breast cancer is certainly a daunting one, we will be with you every step of the way and we will take very good care of you. 

Best regards,

John

John T Droesch, MD, FACS

Breast Surgeon