Results from the Tumor Board 6/5

Well, I spoke with Rick Jervis (PA-C) who is a friend and advocate for me as well as a PA in my family doctor's office. He attended the tumor board meeting where Dr. Luke Dreisbach (my oncologist which means main cancer doctor) submitted my case. The tumor board is sort of a round table discussion of cancer cases, where mine was one of four cases to be reviewed this past week. The general consensus was that they liked what Dr. Luke was doing in terms of the chemotherapy course of treatment. They were very concerned about my inkling to have the surgery done elsewhere because of anything they might possibly have to deal with post-surgery. My response to that, however, is that it's probably easier for the doctors at Eisenhower to just work with each other, maybe they just want more control over the whole treatment process and complications that might arise. I understand that. I've been told that breast surgery isn't that difficult. Nonetheless, I would like a specialist to do the breast surgery, and he (Dr. Wagman) is at City of Hope, a National Cancer Center. I don't fell compelled to change that choice at this point.
One interesting development was the suggestion to test for the BRCA gene mutation, since if I were to test positive for this, it would indicate that I might develop other cancers in the future (based on correlational studies only). There is a significant connection between breast cancer and ovarian cancer. In women whose pedigree (funny to talk about for humans, huh, but that the term they use...) is of Ashkenazi Jewish descent, 1 in 40 carries this mutation. Due to the fact that I am 75% ashkenazi Jew, and I have breast cancer at a very young age, they are suggesting that I have the testing to just further define the course of treatment. There is a history of cancer in my family but it is completely unrelated to breast cancer. At any rate, the field of genetic counseling is fairly new and is at times inconclusive. However, if I do turn out to be a carrier, that means that we may consider some different options surgically speaking, like maybe a mastectomy instead, (since the probability of developing another cancer in the same breast would be high and it is harder to operate on radiated skin, which I was planning to have after the lumpectomy and radiation this November) and possibly the removal of the ovaries as well. I'm going to wait and talk to my Oncologist on Monday when I see him right before my next chemo treatment and ask him what he thinks. Meanwhile, I have spoken with a genetics counselor from City of Hope and she said she would help me get the ball rolling from a distance, since this kind of testing takes time to get the results back and is done in stages since each stage is more expensive than the prior one. So, after I talk with Dr. Dreisbach, we'll go from there.
Regarding surgery, most of the doctors present agreed with the suggestion to do the lumpectomy with radiation following, with the exception of one doctor suggesting bilateral (removal of both) mastectomy. I'm sticking with the lumpectomy idea unless the results of the BRCA discussion and testing lead me to think otherwise.
Overall, the results of the tumor board confirmed the confidence I already feel in Dr. Luke Dreisbach as my Oncologist. I thnk he is fantastic and would recommend him to treat anyone.