2nd Opinion Schedule

I am currently in the middle of a two-week effort to gather information and opinions from 4 additional oncologists and 1 more pathologist.

1)   This week — I conversed via email with the lead author on the aforementioned Kaiser study [1].  Dr. Fehrenbacher, a medical oncologist at Kaiser Vallejo, provided me with more specific data from his research so I can better evaluate the odds of recurrence for my situation.  He also recommended closer pathological scrutiny of my DCIS lesion to more exhaustively screen for any other invasive cancer that might be lurking in the 5.5 x 4.0 x 1.8 cm mass.  The discovery of any additional, larger invasive tumors would materially change my adjuvant treatment plan.  (Currently, my primary medical oncologist recommends no adjuvant treatment, based on the 3mm invasive component and cancer free lymph nodes.).  Dr. Fehrenbacher emphasized the need for further surgery to remove extra skin close to original location of tumor in order to create wider clear margins and deemphasized the call for prophylactic contralateral (left) mastectomy.

2)   Next week ??? — waiting on 3rd Kaiser pathologist to look over breast tissue.

3)   Next week ??? —  anticipating recommendation via email from Stanford medical oncologist specializing in breast cancer in response to my case synopsis which I submitted this week.

4)   Tues., 7/12 — seeing medical oncologist at Kaiser Walnut Creek for opinion on adjuvant therapy.

5)   Wed., 7/13 — meeting with medical oncologist (Her2 specialist) at UCSF for opinion on adjuvant therapy, especially Herceptin.

6)   Fri., 7/15 — conversing with genetic counselor and geneticist at Kaiser San Jose to review family cancer history, discuss genetic testing, and submit blood sample for BRCA 1 & 2 mutation testing.

7)   September ??? — hearing from surgery scheduling dept. hopefully next week.  As of right now, it appears surgery might possibly take place in September.  As with the originally planned surgery, calendars for both the breast surgeon and  plastic surgeon need to be coordinated for what will be an approximately 623 minute surgery.  Any chemo or Herceptin therapy would further delay this surgery for reconstruction and additional skin removal (to remove close margin).

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