My Breast Cancer and its History: Summary

 
 

 

 

 

 

 

 

 

 

last update Nov. 29, 2016

Copyright © Nov. 2004

Erika Rusterholz

Medical Support:

PD Dr. Mathias Fehr

PD Dr. Christoph Rageth

 

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INFOS for PHYSICIANS

 

 

Anamnesis / Details of the Documentation

  

Breast cancer: History in brief

 

Family Anamnesis

Mother: Little is known about the state of her health during her life (died 1981 after a cerebral hemorage, 71 years old).

Sister of the mother: Breast cancer, died 78 years old.

 

Personal Anamnesis

Nulligravida - Menarche approx. with 11/12 years - Menopause with 51 ½-years -

16 years with Kliogest (estrogen-replacement therapy) - no sisters and brothers.

Before the surgery: 49 kg, 154 cm tall, 68 years old.

Thrombosis in the right leg after hip joint prosthesis in November 1999.

 

 

In July of 2003, a hard thickening in the left breast in the upper outer quadrant was palpable, and at the end of August of 2003, the familydoctor was consulted. His opinion: "firm parts in the gland tissue often occur when women get older".

 

At the end of October of 2003, again a visit to the familydoctor, now the resistance is a pea-sized lump. The doctor arranges a mammography for November 11th, 2003:

Findings: Sonography shows an echo-poor, irregularly limited lump with a diameter of 1 cm, absolutely malignom suspicious.

Two ultrasound-guided core biopsies: fibro-lipomatous tissue, no malignancy.

Declaration of the radiologist: "Suspected malignant lump, must be removed".

 

At the beginning of December of 2003: Referral by the family doctor to the gynecologist at the nearest hospital for further examination.

His findings on December 18th, 2003: 2 x 1 cm lump in the upper outer quadrant in the left breast, well relocatable. He suggests: "Lumpectomy in the left breast with excision of the microcalcifications in the right breast, after preoperative marking at the right".

 

Patient goes for a second opinion to another surgeon on December 29th, 2003.

His suggestion: "Open excision of the lesion with frozen section and eventually axillary lymphnode dissection".

Already the next day the registration for the hospital arrived. Patient was uncertain, did not accept this.

 

At New Year's the patient read in the InterNet about "breast lump" and informed herself about lump excision on an outpatient basis. Found an article from the KSW (Cantonal Hospital in Winterthur) about Mammotome Breast Biopsy and inquired there on January 2nd, 2004.

Answer: at the KSW not possible, should consult the USZ (University Hospital in Zürich) or Breast-Center Dr. Rageth.

Immediately consulted the breast center: Beginning of the clarifying examinations on January 5th, 2004.

 

 

Lectures and publications for Physicians / Specialists

 

over 60 lectures are inserted in "Ärzteinformation" in the German version of this homepage:

 

 

 

Published June 27, 2011

in Annals of Oncology 22

St.Gallen International Expert Consensus on the Primary Therapy

of Early Breast Cancer 2011 - Strategies for subtypes

 

Published April 19, 2013

in Breast Care

St. Gallen Consensus 2013: Optimizing and Personalizing Primary Curative Therapy of Breast Cancer Worldwide (Prof. Dr. Hans-Joerg Senn)

 

Published April 26, 2013

in Breast Care

St. Gallen 2013: Brief Preliminary Summary of the Consensus Discussion

(Prof. Dr. N. Harbeck, Prof. Dr. Ch. Thomssen, Prof. Dr. M. Gnant)

 

Contents of

 

 

Mammograms of the lump at the left, of November 2003

Mammograms of microcalcifications at the right, of 1996 - 2003

Wrong diagnosis of the lump, November 2003, after Trucut® biopsy

in Case History

New evaluation of the lump in the left breast in January of 2004

Ultrasound-guided, vacuum-assisted biopsy VacuFlash® of the lump left

Appearance of the breast 3 days after biopsy

Hematoma: Appearance 20 days after biopsy

Diagnosis of the lump at the left: invasive-ductal carcinoma

Ultrasound-guided Truecut® biopsy of the microcalcifications right: ADH

Ultrasound-guided Truecut® biopsy of the axilla lymphnode left: benign

Mammograms of the microcalcifications right of January 2004

Stereotactic Mammotome® biopsy on the right of the none-palpable microcalcifications

Diagnosis microcalcifications right: LCIS and seat of invasive-ductal carcinoma

in Clarifications

Preparation for the Sentinel Node Biopsy (SLNB)

Diagnoses segmentectomy of the left and of the right breast

Skeleton scintigraphy

Questions/thoughts of the patient (before surgery/in the hospital/after leaving the hospital)

Tight Top for the stabilization of the breast after surgery

Seroma: Appearance 8 days after surgery

Specific ointment for the refinement of the cicatrices

Scar corrections on right breast (with hyaluronic acid, with liposuction) in German only

Silicone mammary implants - documentation in German language with pictures

in Surgery

Planning of the radiotherapy

Time schedule for radiotherapy

Appearance before the last day of the radiotherapy with 46 Gy

Appearance 4 days after radiotherapy: Use of Dermovate NN cream

Appearance 2 weeks after radiotherapy: Use of Solcoseryl gel

Appearance 4 weeks after radiotherapy and comparison (before/after surgery)

Appearance 3 months after end of the radiotherapy

Hormonal therapy with aromatase inhibitor

in Therapy adjuvant

3 Months after radiotherapy: Sonographic pictures with tissue structure

3 Months after radiotherapy: Mammograms at 6 ½ months after surgery

15 Months after radiotherapy: Sonographic pictures and Mammograms

Why no longer an aromatase inhibitor - instead Livial/Liviella

Details of all further aftercare terms up to today (2016)

 

in Aftercare

Personal (appearance/changing mood/future/thoughts)

Summary (tips)

in Reflections

Definitions regarding breast cancer are explained

in Question/Answer