Grade 3 Invasive Ductal carcinoma

Hi  and a very warm welcome to the forum if this is your first post, and apologies for my bad memory if it’s not. A welcome hug regardless, don’t think any of us get enough hugs atm.... 

Sorry you’ve had such a confusing and distressing time regarding your treatment. You have such a lot to contend with anyway, without a shock cancer diagnosis and then such chopping and changing regarding your treatment plan. Very frightening and confusing. 

Finding positives: sounds like the medics are being very thorough, and that they feel that this is the best and safest course of action for now. I wish I could remember where I read it, but I do remember reading about a significant size of tumour reducing amazingly, simply with letrozole. It’s become more common during Covid, I believe, to use it as neo adjuvant therapy (I think I’ve got that right) ie before any proposed surgery, to shrink the tumour and of course to prevent further growth. 

Desperately hard though it must be, it sounds like you’ll have to trust that they really have your best interests at heart and that popping this pill will give you the best chance at the moment. You could also phone the helpline here to talk to someone about it all. 

Keep posting, rant and rave if you need to, let us know how you are getting on. Sending love and a big virtual hug, HFxx

Hi  and welcome.  During the first wave of covid lots of women were given Letrozole for a few months before surgery,  and as HappyFeet1 said,  it can shrink ER+ tumours. I'm guessing that the reason they have changed the plan is mostly  covid and partly your heart issues after an assessment for surgery? If that's the case are there any things that you can do to help improve that in the meantime (like changing diet to low histamine, intermittent fasting etc?). Maybe give your breast cancer nurse a call and ask the reasons for your change of plan. Chemo is usually given first with HER2+ women so that the treatment for that can be given as well.  It's usually surgery first with ER+ women.  I know that chemo is a strain on the heart,  and my oncologist gives 12 x Paclitaxel only (no EC/FEC which are likely to affect it) to ER+ women who have  health issues or are elderly,  but also that the drugs given with the  chrmo for HER2+ can affect the heart.

If you're not happy with their decision then please get a second opinion,  or go to PALS, as it's your life,  and you want to be sure it's the  best choice. I was diagnosed at a breast one-stop-clinic which wasn't  in a hospital. I was given the  choice of which hospital I wanted as I'm in London.  I originally chose UCH ad its very good,  then switched the next morning to a smaller local one.  I'm so glad I did as I looked at the data and UCH is so popular it is slower to treat/ operate. Ironically my surgeon and oncologist both split their time between the two hospitals so I could have had then at UCH anyway!

I'm sure that your team have your best interests in their plan,  but for peace of mind I'd ask for their reasons in more detail.  Let us know how you get on:) x

Hi

Another warm welcome to the community from me. 

HappyFeet1 and Londonmumof2 have given you some excellent advice already. It does sound as though you have a lot going on and your oncology team will be weighing up the benefits and risks of giving you surgery and chemo.

We have had people on here who have only been given hormone therapy - such as Letrozole- as treatment and had significant shrinkage and success. It often takes longer than chemo and I think it's a good sign that they are reviewing your plan after a time. I had ER+ cancer and was given chemo first as a way of shrinking the tumour in hope of a less drastic surgery but then more tumours were found so that wasn't possible - I still had chemo first though which took 6 months - neo-adjuvant treatment is often used as an option.

My consultant was very keen on telling me all about risks and he wouldn't even drain a seroma (swelling) I had after surgery because he said every time a needle went into me there was a risk of infection and he didn't want to take that risk. Procedures are so commonplace now that we forget there are risks associated with everything and chemo is a risk to everyone health problems or not.

it sounds like your team are being cautious, which is much better than being reckless but I agree that if they can't give you a satisfactory explanation then you do have the right to a second opinion. If you have other consultants for your other health issues, have you spoken to them about it? They might be better placed to explain the risks to you.

I can completely understand that you feel your ability to fight has been taken away - and it's awful to feel powerless. Are they going to review your Letrozole before the 6 months with a scan? that might be something useful to you if you can see the results of your treatment. I can completely understand them wanting to wait for Covid to be less of a threat as it sounds like you are especially vulnerable. Are you able to schedule another chat with them? Once you've had some time to absorb this new change of plan then maybe make a list of your questions and fears and ask for another consult. 

I feel like I've thrown a lot of questions at you and that wasn't really my intention - what I wanted to do was say that I think there are definitely positives and that you are not powerless. We will all be here, beside you every step of the way.

R