Second Opinion Done

Today Ken and I went to meet with the breast cancer oncology specialist, Dr. Merkel of Northshore University Health System for a second opinion.  I was shocked when I saw him standing in the hall, I'd been told he had 20 years experience but he looked 30, maybe not even.  When he came into the room with Ken and I, I tried to be direct and summarize my case quickly to get three questions answered. 

The quick history I gave him: I am a 47 year old woman with a family history of breast cancer.  Healthy, physically active, I had a bilateral mastectomy after I was found to have Ductal Carcinoma in Situ, and an invasive ductal carcinoma tumor of less than 1 cm in my right breast.  After surgery the pathology showed that I was node positive with a micrometastisis in one lymph node  (according to the doctor today that happens in less than 5% of the cases with a tumor this size).  I am estrogen receptor positive.  BRCA negative (which is a genetic breast cancer test)

I have Stage 2 breast cancer.    In addition, while undergoing surgery, I was found to have additional cancer in my left breast (a different ductal invasive mass of 4 mm unrelated in pathology to the first mass) and Lobular Carcinoma in Situ in my left breast.  So I don't have "large" tumors but I have 2 primary sites and a bunch of other cancer cells.

I was advised by the team at Northwestern to have 12 weeks of chemotherapy.  Four - three week cycles of Taxotere and Cytoxan.  Commonly called T and C.  To be followed by Tamoxofin for five years.   This is under review at their breast conference meeting but this is NMH's suggestion so far.

I wanted to know three things for my second opinion:

1) Is the T and C treatment option that my doctor reccomended the best option for my particular case?
2) Is the suggested number of chemo treatments the appropriate number?
3) Would he suggest additional lymph nodes be removed?

Dr. Merkel was great.  He listened eagerly.  Spoke highly of both my surgeons and their work.  After reviewing the pathology report, a physical, and history, he reviewed the details of several of the latest studies that impacted my case and said he would suggest the same treatment that the Northwestern team prescribed.

He also reviewed studies about Tamoxofin and made suggestions for how to handle some side effects.  He spent 45 minutes with us and made me feel more confident about my choice.

I came home and took a nap. 

I spoke with the head oncology coordinator at Northwestern later in the day and told her about Dr. Merkel.  She said she was happy that I got a second opinion.  She said that it always concerned her when people didn't take the time they would research to buy a car to pick their doctor and review their care. 

So, this is one more step completed in the process.  There are a couple of more this week.  I will get the results of the breast conference review at Northwestern to see if all the doctors when they meet have additional suggestions.  I will then schedule chemotherapy to begin if they give the ok.

I'll let you know.