First Meeting with Dr. Robert

We met with Dr. Robert today. He is just wonderful. He started off just asking me to explain what led to this point, and then went through a detailed and logical explanation of the results and where we go from here. It seems like he covered so much, and though it was easy to follow, it’s hard to go over point by point, but here’s my best shot.

There are two levels of treatment: local and systemic. The local treatment will be taken care of with the lumpectomy and the radiation. The more tricky issue is the systemic treatment: how to destroy cancer cells that my have migrated to other parts of the body. Though the nodes were clear, there is a slight chance that it could have gotten into the blood stream. A CAT scan or bone scan could be done to check if it was elsewhere but he doubted that would reveal anything. The question therefore is whether chemo would be justified. He said that he does want to perform two tests to help make this decision: the Oncotype test and the Her2 test.

The Oncotype test will give a Recurrence Score that is categorized into one of three groups: low, intermediate, or high risk. (According to the web, if a tumor has a Recurrence Score over 31, a high-risk score, this means there's a greater chance that the breast cancer will return. If a tumor gets a Recurrence Score of 18 or less, a low-risk score, this signals a lower chance that the breast cancer will return. If the Recurrence Score is 19 to 30 then the recurrence risk is intermediate.) If the test reveals a high risk, chemo would be recommended. If low-risk, no chemo would be necessary.

He said that the Her2 results from the pathology report I already have are inconclusive, so he wants to run another test. If the results show the cancer to be aggressive, he will recommend chemo even before seeing the results from the Oncotype test.

He reviewed the MRI results and, thank God, they were good. The mammary nodes under my sternum were clear! The radiologist did notice a cyst in each breast: Bi rad category 3 ("probably benign") in the left, and category 2 ("benign") in the right. He said that radiologists are very hesitant to say that a mass they observe is "probably benign", and if they say that, it likely means it is. However, given what I have been through, he said the question was how I would live with it. I appreciated that he factored in how I would feel about having it there, without the certainty that is actually is benign. This is another decision that will need to be made in the next couple weeks, I suppose. Dr. Robert said that he would discuss with Dr. Moynihan (the surgeon) about this.

We talked about other issues, and he answered all our questions, and said that if we thought of any others, we could email him. He’ll be in Hong Kong from 1/9 to 1/26 but will hopefully have the results from the Her2 test before he leaves. He will be able to let us know the results from the Oncotype test while he’s overseas, and we’ll just go from there.

I really thank God for leading us to him. As the nurse was taking my blood pressure, etc, she asked if we were nervous and then said that we shouldn’t be, that Dr. Robert was the best. She said if she was ever to have breast cancer, he is the only doctor she would want.

Thank you Lord for taking us through another day!