Diagnosed today - after routine mammogram. What are my options?

Evening Mary,

My diagnosis was a bit out of the blue with no other symptoms in terms that hubby found a lump, nurse found a different lump and at my clinic appt it turned out there was 3 lumps in my breast and 1 in my lymph node.

I'm 44 and have dense breasts. I had an MRI to ascertain whether my lumps were linked which at it turns out they were linked by basically 10 cm of cancerous tissue. 

My care has been second to none and my consultant is the clinicial lead at my hospital and also does private work across the road. She also previous worked at the Royal Marsden. My friend had worked under her and said she's good and precise 

My dressing is still on so I haven't been able to see the actual scar but the white dressing covering the scar is literally 1 cm wide. So I'm hopeful for a neat job. 

I'm down in Dorset but I'm sure there are a couple of ladies who are Gloucester/Cheltenham based (my parents live in Cirencester and my sister works at Gloucester) - Claud I think?

Hope this helps xx

Hi 

I feel we are at the same hospital from your comments  I too am a Dorset girl! 

Xx

I did wonder with your name choice. 

Thanks for your message. I'm so sorry that you have had the same news as me so recently, but it's comforting to know I am not alone.

Yes, the next steps are to get the pathology results. I would like to see them ahead of my meeting with the surgeon so i can digest them and ask some sensible questions. You're right - it is like being hit by a truck - and one you didn't see coming at all.

Jurassicgirl is really pleased with her surgeon - I hope you and I will each have one who tells us it's 100% sortable!

Hi VWgirl

Thanks so much for your reply.

I asked about the MRI as I have dense breasts too, and I wonder whether without it I may have more than the "lump" they have found. As I understand it, lumps are difficult to see in dense breasts because of a sort of "white- out" effect. I will need to ask again.

Good luck for when you take the dressing off - sounds as if that tiny dressing can't be hiding anything too awful!

And if there are any ladies who are familiar with the set up in Cheltenham, I would really like their views on their experience, and any dos or don'ts that might help.

Hi Mary, 

I'm sorry to hear of your diagnosis. I too, was recalled after a routine mammogram. I had a large area of high grade DCIS and had a mastectomy and full immediate reconstruction by DIEP (fat from tummy area). I had it all done on the NHS and it all happened within 6 weeks of the initial diagnosis. I remember going to my results appointment the week after Autumn half-term and had the main op at the very beginning of December. Things couldn't have moved much quicker as before the main surgery I had to have numerous appointments with 2 teams - cancer and cosmetic, CT scans and a small op to check if there was any lymph node involvement - fortunately none. 

At the main op in December - which was a whole day in theatre (8 hour op) - I had 2 teams operating on me. There were 3 consultant surgeons plus a registrar surgeon, a consultant anaesthetist, a second anaesthetist plus a teams of nurses etc. I had to go into a critical care bed for 3 days after surgery with my own dedicated nurse as my observations had to be checked hourly. Can you imagine the cost if you had to pay for it  - and that is just for the surgery itself let alone all the appointments and treatment prior to this stage and the subsequent treatment thereafter. 

 I have had an amazing cosmetic surgeon who did the DIEP part of the surgery and who has done subsequent cosmetic tweaks. I had mine done at a big London hospital and had my own room etc. I couldn't fault the care nor can I fault the cosmetic reconstruction which is absolutely amazing. My new breast looks and feels very natural.

The only thing is with the follow up cosmetic surgery, which has involved liposuction and refill etc plus nipple recon etc - you do have to go on the waiting list and if you went privately at this stage you maybe treated more quickly. However, this is a minor point. 

At your results appointment your care plan and timescale will be discussed. A cancer diagnosis is very stressful but soon you should have something to focus on and know a little more where you stand. Take care.Xxxxx

Dear Moresleep

That is So useful. I'm delighted that you have been looked after so well and that the op was successful. I had no idea that there were so many people involved in your care - it really is encouraging.

In a way, you are answering one of my questions - should I get a referral to a London hospital, which under the NHS I believe I can? Your post tells me it might be a good idea.

Until I get my pathology results back, I don't know exactly what will need to be done ; one thing I'm fairly sure about is that Gloucestershire is unlikely to have that level of resources! I went to the GP this morning to try to get some information / advice but I am no further forward.

Without this forum and the support of other women I would be completely lost.

Thanks again xx

Hi Mary

I had all my treatment at Cheltenham and personally, I couldn’t fault it. My surgeon was Miss Massey. She was very straight with me, said it was almost certainly cancer as soon as she felt my lump. Had mammogram, ultrasound and biopsies after seeing her. I was at Breast Clinic for 3 hours that first time. A CT scan was arranged before the biopsy results were back. I had chemo, followed by surgery and radiotherapy. 
Everything went very quickly for me to the point where I had first chemo infusion before MRI and getting marker clips inserted. With all my chemo appointments, the letter with the next date arrived within 3 days so I was in no doubt about what was happening next. I had my pre chemo blood tests at my GP and then, after the first one, telephone appointments with the oncologist. 
I only had a lumpectomy so no reconstruction needed. The scar is very neat, especially considering the size of lump removed. 
Although I hope never to go through all that again, I would feel very confident about going to Cheltenham. 
Best of luck for your results. It’s always difficult waiting so take care of yourself. 
Alison

I was lucky as DCIS is very easily dealt with as it had remained in the ducts, no lymph node involvement - no radiography or any chemo treatment required. However, my area of DCIS was quite large and it was high grade hence the breast cancer team wanted to do a mastectomy. The reconstruction by DEIP is a long and highly specialised surgery involving microsurgery to connect the blood vessels and not every hospital nor cosmetic surgeon can perform it. I live in London - my cancer care was/is dealt with by Kings College Hospital and the cosmetic side was/is dealt with by a team at St Thomas'. The Kings' breast cancer surgeon went to St Thomas' to do his part in the operation and then the 3 cosmetic surgeons plus team did their magic. It wasn't a unique situation and the two hospitals co-ordinated it all. I believe both Bristol and Birmingham hospitals have the expertise to do DIEPs if needed. 

Once you have your pathology results the oncologist will go through the proposed care plan. I was told pretty early on that a lumpectomy wouldn't work for me as I wouldn't be happy with the cosmetic result, and so was sent to see a plastics consultant at St Thomas' and it all went from there. My GP has never been involved in any of this, I'm not sure how much they can advise on something so specialised. Also, any decision between a lumpectomy and mastectomy (if given the choice) and whether to have reconstruction or not is also quite a personal thing. Ask loads of questions when you see the oncologist. I went more than once to Kings to discuss the treatment plan and more than once to St Thomas' to discuss the DIEP. However, this was before Covid.....

Good luck!!!Xxxxx