Monday, October 17, 2022

Breast Cancer Fight: Genetic Testing Results

I had an appointment with Dr Samuel Ow on Thu 6 Oct 2022 to go through my PET-CT scan and genetic testing results. The appointment was on-time and I saw him from about 12.15pm - 12.45pm. I note this because I usually have to wait a long time to see my doctors or get tests done haha..

I'd already been told by Dr Mikael about my PET-CT scan results but Dr Samuel went through it in slightly more detailed explanation. After all, he was the one that ordered it to be sure that there was no cancer spread, even though there was a very low risk of that at my early stage...

I asked him about brain activity masking the cancer spots in the PET-CT scans and he said that is possible, and hence why they don't usually use that to detect brain cancer, but other scans and tests instead. However, the PET-CT scans can detect abnormal swelling in the brain, which might indicate brain cancer as well to call for further tests. 

In any cases, the scans are analysed by nuclear medicine specialists who are able to read and interpret the scans properly... which is reassuring in a sense but then there was still a typo in my scan report??!

Ya, after my appointment with Dr Mikael I had a look at my scan report and noticed that it was written in 2 different sections there that was "a hypermetabolic lesion in the medial aspect of the right breast, compatible with known breast-CA". 

That didn't seem right as it should be my left breast. 

I asked Dr Samuel about it and he said that he noticed it too and brought it up with the doctor who wrote the report and they will rectify it as it is important for them to do so.

I saw that the human error likely occurred because the report was entered, co-read and approved all by the same doctor....... which really kinda defeats the purpose and system of peer review. 


note to self: never assume or take any information or reports for granted

We talked a bit about the breast reconstruction as I have some worries about it. I asked him point-blank if he thinks that the benefits of breast reconstruction outweighs the risks and he said, yes... he thinks so, especially for mental well-being as it might affect women detrimentally when they lose their breasts. 

He has not seen any patients with lymphoma caused from breast reconstruction yet, and if I do have to do radiation therapy afterwards, it may affect the tissues and implant. 

My gene testing result from Invitae Diagnostic Testing {US-based} was not out that day and we agreed to have a tele-consult on Mon 17 Oct for him to call and tell me the results. After which, it will be decided if I should remove one or both breasts... or maybe even ovaries if there was any gene mutations that might cause cancer there.

Although I was prepared to remove both breasts no matter what just for a peace of mind and he said in the US actually doctors are more inclined to remove both once there is breast cancer in even one, the doctors here do not want do overtreat and remove both breasts if not needed. 

Of course, in the future there might be a chance of breast cancer occurrence in the other breast but we should only do what is medically necessary now. There might be regret in removing both if not medically needed, and it will be even more traumatising for the body to remove and have breast reconstruction both breasts.

On Mon 17 Oct, he gave me a call around 4.30pm to tell me the good news that my genetic testing result was negative for the evaluation of 49 genes for genetic changes that are associated with genetic disorders. 

Phew! That's a big relief.

From here, we can move forward to confirm the surgery and move forward with my treatment plan. 

2-3 weeks after my surgery, I will meet him again and my chemotherapy will start 4-6 weeks later. At the very most, 8-12 weeks after surgery but no later than that. 

Dr Samuel 2nd visit cost: $99.51
Dr Samuel tele-consult cost {10 mins call}: $99.51

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Before mastectomy and breast reconstruction surgeries

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