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Posted 12/15/2006 4:52 PM (GMT 0)
I've been diagnosed today and am still in shock.  I know almost nothing about breast cancer.  Everyone on this board seems to be very well informed so I wonder if anyone could possibly answer my questions.  I did ask my surgeon but haven't retained everything that he said and it's now evening here in the UK so probably will not get to talk to anyone about this until Monday.

The lab report from my biopsy says:

invasive adenocarcinoma ductal and probably grade 3

(tubules = 3, pleomorphism = 3 mitoses = 2 score 8)

there is no obvious lymphovascular invasion, calcification or DCIS.  code B5b

ER = 4 + 2 = 6

what does this mean?  I think it's a pretty bad one  isn't it?

 they plan to remove the lump and approx 1cm of surrounding tissue next week and recommend sentinel lymph node biopsy.  then if they find that it has not spread further  they will recommend radiotherapy.

I asked why not do an axillary lymph node dissection straightaway to save having possibly having that done in a few weeks.  the surgeon says it is my decision.

does anyone have an opinion about this - ie if having the axillary node biopsy straightaway would make any difference to the eventual outcome.

I understand it can leave you with a permanently numb arm, swelling etc.

Any information gratefully received.

 

Posted 12/15/2006 8:48 PM (GMT 0)
I'm not an expert on path reports, but we do have some ladies with excellent skills in that area. I do know, however, that some of the info is not that bad...and the grade, well, that can be an indication of the agressiveness of the cancer, but not always.

Sentinel Node Biopsies are deemed reliable indicators of lymphatic invasion. Again, I 'm no expert, but they are pretty standard with the procedure your doctor is recommending.

You will have better information following your next procedure, and your doctor will be able to steer you better at that time.

I can imagine that you are in shock right now! We all were right after diagnosis, and sometimes, it takes awhile to sink in. Between now and the next procedure, you will no doubt become a "mini-expert" on breast cancer if you visit this board often!

I am 12 years out from diagnosis, so things have changed alot in those years (ie...they didn't have sentinel node biopsies back then!) But trust me, there is life after breast cancer, although you may not feel that way now!

So... I suggest you write down questions you want to ask your doctor, take someone with you to appointments (and ask them to write down answers for you, if you want), and tell us a bit about yourself. Where you are in life (age, menopausal status, family history, etc) can sometimes have a make a big difference in how questions are answered.

Hugs...
BEV
Posted 12/15/2006 9:43 PM (GMT 0)
Hello Bev and thank you for your very helpful and supportive reply.

Well I'm 60 years old, post menopausal, never married and no children.  There's been no cancer in my immmediate family.  My father lived to the age of 87 and my mother is still alive at the age of 93.

I retired from full time work earlier this year. These days I just do a bit of ESOL teaching a couple of days a week.  It's very ironic that this comes at a time when I was just really enjoying life and finding the time to do things I've been wanting to do for years (travel, learning 3 languages, Salsa dancing etc.)

I live alone which I usually like but I feel a bit isolated at the moment.  I've got good friends and neighbours but I'm very pleased to have found this board.

Best wishes to everyone

Anthi

Posted 12/15/2006 11:57 PM (GMT 0)
Hi Anthi and welcome! I presume you live or once lived in the UK or Australia, based on some of your words? We have had people from New Zealand and all over the world at one time or another.

Sorry you had to be here, but all is not lost! This is definitely a shock and a frightening time. Read and research in moderation, you don't want to scare yourself, but take in what you can and take breaks when you need to. No reason you can't do all those things you wanted to do, travel may wait, but the others are great hobbies and no dx has to stand in your way!

Grade 3 is the worst of the scale (mine was a 3 too), it just means that the cells were more rapidly growing and dividing. I am a 7 year survivor, so it is not a death sentence by any means!

I definitely agree to do the SNB first. I had the same concern, why not just do it all now and get it over with. But if the nodes are negative from the SNB, then you will surely be saving yourself a great deal of pain and greatly reducing your chance for lymphedema complications.

Make a list of your questions and consider taking a tape recorder in to the doctor's appointments while you ar getting the consults, you'll be able to go back later and listen closely and rewind and take notes as you need.

Radiation therapy is usually pretty easy to tolerate. Don't be surprised if they mention chemo too...it will depend on the node status and the size of your tumor, among other things. No vascular lymphatic invasion is a good thing. Not sure about a score of 6, but being positive for ER/PR status is a good thing too. There are more treatment options available.

Hang in there! Find things to keep you busy and when things get overwhelming, allow yourself to cry and then know it will get better...

Lori
Posted 12/16/2006 4:58 PM (GMT 0)

Dear Lori

Many thanks for your very helpful reply and the advice about the SNB. 

I wonder if you could tell me a bit more about what treatment you eventually had after the lumpectomy and SNB.  My tumour is 12mm and feels quite big to me.  I found it myself i.e. not via a mammogram.  How does that compare?

Yes I live in the UK but have travelled all over the world as an air stewardess and also lived and worked in Greece for 3 years so my language may reflect this.  I'm a teacher by profession but wanted to see the world as well.

I've been rather worried about my 93 year old mother. She lives alone and is reasonably well but has severe short term memory loss.   She lives about 3 hours drive away from me and I was planning to go for Christmas but the timing of my op next week will mean that I can't.  My only sister lives in St Paul Minnesota but she has been great and has already organised a flight  so that she can come to the Uk and be with mother for Christmas. I haven't told mother yet - it would upset her but also I'm not sure she would remember with her memory problem  ! It's a difficult situation. 

Once  again many thanks for your support. Best wishes

Anthi

Posted 12/16/2006 6:39 PM (GMT 0)
Hi Anthi-
Now I see that you mentioned the UK in your first post, sorry for duplicating that. I'm in Michigan, and I think most or all of us at the moment are in the US...but that is the great thing about a board like this, that it does not matter where we are!

I had a 2.5 cm tumor, grade III, ER/PR+, diagnosed 11/30/99, a week before turning 31. I had my diagnosis from the lumpectomy and then had a re-excision to clean 1 margin and do the SNB. Then I did 4 cycles of chemo (nodes were negative) and radiation to the breast. Not that I would want to do it all again, but it was very do-able and I was very fortunate in how well I tolerated the treatments. You can ask 100 of us for our experiences with chemo and rads, and we'll probably have 50 different stories...there is no way to tell how you will do based on our experiences, but there is every reason to think that you'll do just great!

There is a very good chance you can still visit your mother after surgery. You may not have full use of the arm, but you should be able to get out and about just fine. There may be no need to tell your mother if the news is upsetting. I never told my grandmothers, who were in Florida. It would have killed them. By the time they saw me again, I looked just the same and we felt right about protecting them from the news.

Still plan on doing the exciting things you want to, travel may wait a few months, but plan for a great trip and you can definitely work on learning new languages in the mean time.

Hang in there!
Lori
Posted 12/16/2006 7:21 PM (GMT 0)

Hello Lori and thank you again.  that is an idea - I mean not telling my Mother,  but I think in our situation it wouldn't work as I see her probably  more often than you were seeing your grandmothers as I assume that you lost your hair from the chemo?

does that always happen - I mean hair loss?  What about these cold caps I have heard about ? Do they work?  If not how long does hair take to regrow?  I have no idea about these things.

In fact - I must confess - that I'm very relieved not to have to go to Mother at Christmas.  She is lovely but her deafness and short term memory problems mean that any sort of communication is difficult to say the least.  I  manage - by shouting every word - to stagger through a conversation, but then 5 minutes later she's forgotten we've had the conversation so I have to live through the whole thing again !  It's very very hard work and very stressful and I really couldn't cope at the moment so I shall be immensely relieved to leave it all to my sister.

thanks for your advice about continuing my languages. I shall certainly do so.  I speak French and Greek to quite a good  standard and was intending to spend some time in each country to become fluent.  As you say - that will have to wait -  but I shall carry on reading and doing my conversation classes.  Also I've just started beginner level Italian which is great. Hope this cancer doesn't make my brain go soft.

You were very young to have breast cancer. do you have children?  but how wonderfully positive you sound.  thank you so much

Best wishes

Anthi

Posted 12/17/2006 4:02 AM (GMT 0)
Anthi-
Yes I lost my hair. Last chemo was April 11, I was wig-free by the first week in July. I probably could have gone free sooner, but was too short to make a part in it, even with hair product and I felt like a little boy. Yes I was young, unfortunately it happens to gals in their 20's too. Luckily I have been cancer free ever since. No kids, but just married in September, so we'll see what the future holds!
As for telling your mother or not, perhaps you can wait till you know what treatments you'll need. If it is just rads, she may not need to know. And with chemo, if you wore a wig, she may also never know. Your call though..

Cool about the languages, I always wished I could speak another language but never was interested to learn one. Shame on me I guess.

As for the cold caps, when I did chemo I asked about it and was told not to use one because it was not tested enough...but also the point of chemo is to kill any cancer cells that are out there...and the cold cap can interfere with its ability to work on that scalp area. Be sure to ask your doctor before doing anything though! It would also depend on what kind of chemo you do, but most of us lost our hair.
Keep a list of questions for the doctor and consider taking a tape recorde to your appointments. And be sure to take care of yourself with something good like chocolate or a massage!
Lori
Posted 12/17/2006 11:12 AM (GMT 0)
Hello and once again many thanks for the useful info.

Congratulations on your recent marriage.   That's great.

Well tomorrow I should hear from my surgeon that my lumpectomy is arranged - hopefully for Wednesday.  I shall be very relieved to get that over even though I realise it's only the first stage of what could turn out to be a long business.

Take care and best wishes

Anthi

Posted 12/17/2006 11:39 PM (GMT 0)
Hi, Anthi...I'm so glad Lori answered your post! She is a great source of information. It sounds like you have lived a very exciting life, lady!

And I agree with Lori. I would at least wait to tell your mom til you know exactly what is going on. With a lumpectomy and sentinel node...you should be up to visiting your mom for Christmas. If you had to have further surgery...well, I can't imagine that it would be taking place before Christmas.

I remember I had a breast reduction surgery (on remaining breast) the day before Thanksgiving, which is more complicated than a lumpectomy, and cooked dinner for 12 the next day!

Just a question... being 60, were you on hormone replacement therapy? And if you were, did they tell you to discontinue it? Since you were ER+, just want to be sure they have that base covered.

Hope they get your surgery scheduled for Wednesday, as you hoped.

Take care...
Hugs...
BEV
Posted 12/18/2006 1:34 AM (GMT 0)
Lori, Thanks so much for being there. I am so glad you were able to answer her questions. You really are a special lady. We all remember that awful time and I don't know what we would do without you. Hugs Joyce
Posted 12/18/2006 3:16 AM (GMT 0)
Hi Anthi! I am so sorry that you are having to face all of this right now. There is no good time to hear this news but it is esp hard during the holidays.

Having hosted a bc board in the past, that dealt w/ many women from the UK, I understand that the medical system and treatments are somewhat different than what we have here in the USA. My understanding is that many times you are not able to chose your surgeon, etc.

I do agree w/ what the others have told you. Get you a notebook and keep it w/ you at all times. Write down any and all questions that you might have, no matter how silly they might seem. Take them w/ you to your appointment and make sure that your physician/surgeon answers each and every one of them where you can understand what he/she is saying. Also, please, please take one or two good friends w/ you. You will be given so much information that you won't remember it all. Havintg someone else there will provide you w/ another set of ears as well as someone else to write down the answers to your questions. Take the tape recorder also.

One question I would ask is why they are not recommending a mastectomy? If the cells are aggressive, I would want to know why th ey are just suggesting a lumpectomy. Also, you might want to ask about having both removed. Makes living w/ the cancer easier. I didn't have both breasts removed and I am sorry. Plan to have the other one removed as soon as possible.

You will be able to continue doing whatever you feel like doing. You may have to adjust some things but you will know how your body will react as you take each step in this journey.

The one thing that I want you to remember is that BC IS NOT A DEATH SENTENCE. It is a managable disease.

Come here anytime. We will be here to hold  your hand, give you hugs, whatever you need as you start and go thru this journey.

Hugs...Deb

Posted 12/18/2006 11:26 AM (GMT 0)
Dear Everyone

Many thanks for your replies. 

Yes Bev I had been on HRT for over 10 years because I had an early menopause. One of the first things I said when I got my diagnosis was 'I think I'd better take off my HRT patch don't you !'.   And I took it off as soon as I got home.

Deb - mastectomy hasn't been mentioned.  I realise that it might come to that in the future.  However my breast surgeon - who I have known for more than 10 years as I have had many many benign breast problems - is always very careful to be as reassuring and positive as possible. When he gave me my diagnosis he did his best to suggest that lumpectomy, SNB and possibly radiotherapy would fix the problem.  I asked loads of questions and he said that I really should take one stage at a time and not look too far into the future.  (Naturally I can't help thinking about what might happen). 

But your question suggests that they always suggest a mastectomy in the case of aggressive cells? Have other people found that to be the case ?

Yes you are right.  Many people in the UK have to rely on the National Health Service for treatment.  But more and more people these days are paying for private health cover because  of not only  the long waiting lists in NHS hospitals and the fact that you cannot choose your surgeon but also because many NHS hospitals are filthy and there are many cases of MRSA !

I used to have corporate private health cover provided by my company and when I finished full time work last January decided to take out a private policy - thank goodness -  as I really couldn't imagine being without it.   So when I found this lump I was able to get an appointment with Mr K - my surgeon very quickly.  Mr K is very skilful and removed a 30 gm cyst 10 years ago from which I have no scar at all.  He is also a very compassionate man and seems to understand how terrifying all this is.  And I should be going into a nice - clean, efficient - small private hospital.

I am still waiting to get my surgery date confirmed.  I am sure you all understand how I feel.  Knowing that the cancer is still inside me and possibly spreading day by day is ghastly.  It also feels twice as big since my biopsy.    I had a wide core needle - I think it is called - biopsy a week ago. The complete lower half of my breast is black with enormous bruises  - which does not matter at all - they will heal, but I once read something suggesting that disturbing the tumour with a biopsy can make it spread further.  I don't know if that is just an 'old wives' tale' or based on fact.

My state of shock on Friday has now been replaced by a condition of terror and my hands are shaking slightly all the time !   But all  your replies and support  are helping enormously.  thank you all so much for taking the time to write - especially at this busy time of year.

Anthi

Posted 12/18/2006 2:08 PM (GMT 0)

Good MorningAnthi! Wow, I am so glad to hear that you have a private insurance policy. I can remember the many horror stories I heard from women in the UK about the long wait and never being able to see the same dr.

You will be going thru a wide range of emotions over the next few weeks. Almost like what a person that has lost a loved one experiences. I can remember being in disbelief, then fear, depression, anger, disbelief and finally acceptance. Just go w/ how you are feeling. If you are really nervous, don't hesitate to ask your dr for something to help you stay calm.

One thing that will help you get thru this right now is to laugh. Watch comedies on tv or go to funny movies. Don't watch anything that is depressing. When I would get down during treatment, I would watch reruns of the Carol Burnett show and found myself laughing so hard that I cried. Felt 1000% better afterwards.

Hang in there and remember we are here for you.

Hugs...Deb

Posted 12/18/2006 3:21 PM (GMT 0)
Hello Debs and thank you again

Surgery is confirmed for 12.00 on Wednesday.  I have just had a phone conversation with Mr K my surgeon and we have more or less decided to go for full axillary node clearance.  I know that this is a worse operation to recover from and can give you problems but I asked him what he would say if it was his wife  and he advised me to have that done. 

He is quite concerned about how quickly this tumour is growing since it didn't appear on my last ultrasound in February this year.  He also said that most of his patients who who find their own lumps i.e. not found on mammogram -   do have positive sentinel node biopsies and have to go back in for the second op.   Christmas in between that would add one more week to the wait . 

So I think I'll go for that one.  Oh dear. 

Take care

Anthi

Posted 12/18/2006 5:25 PM (GMT 0)

Hi Anthi-

I would not fit the mold your doctor describes, I found my lump myself and had negative nodes. Due to my age (and therefore dense breasts) it did not show on the mammogram. That is the thing about statistics and patterns...they just try to predict what might happen, but no one can say for sure. You are just you and not a number.

As for the type of breast surgery, my suggestion at this point is to go with the lumpectomy and get it out. Then once you have the path report you will know more regarding size and location and can then make a calm and educated decision regarding whether to do a mastectomy or not.

In some cases, they say there is equal survival rate for a lumpectomy vs a mastectomy. Not true in all cases. But it is a very individual decision and not one to rush into.

When you make any decisions, go with your gut and don't look back!We'll be with you on Wed to hold your hand...

Lori

Posted 12/18/2006 10:06 PM (GMT 0)
Hello Lori.  Yes I thought about you while I was talking to the consultant and remembered what you said which certainly doesn't fit any pattern -  your story is really encouraging.

Mastectomy has not even been mentioned so far and hopefully it never will be.  Wednesday is to be lumpectomy and axillary node dissection.

Life since diagnosis has been very busy with loads of phone calls, visits and emails from well wishers.  Tomorrow I plan to clean my apartment and leave things well organised for when I get back from hospital.

It's good to know that people are thinking about me.

Take care everyone

Anthi

 

Posted 12/18/2006 11:42 PM (GMT 0)
Dear Anthi...glad you got your surgery date! And I hope you get good results on your path report. Have you given any more thought to going to your Mom's for Christmas?

It sounds like your Dr. K has a good head on his shoulders. As Lori says, her tumor was a grade 3, and she only had a lumpectomy; so it is not uncommon to start there. The question becomes getting clean margins that are free of cancer. When I had my mastectomy, I had two tumors, I was small, and I wouldn't have had enough boob left after removing the tumors and enough tissue to get clean margins, so lumpectomy was not even an option for me. So just be aware that you may lose more tissue than you had anticipated. I had a friend who lost a third of her breast by doing a lumpectomy. You can always have the other breast reduced to "match." (At least you can here in the US...there is a law that says they have to give you matching "headlights" now...wasn't that way when I had my mastectomy).

I'm glad you got off the HRT. Are you having to deal with menopausal symptoms again?

Well, good luck with your surgery. Let us know how it goes!

BEV
Posted 12/19/2006 4:24 AM (GMT 0)

Hi Anthi

I just had to drop in and say hello. I have been reading thru your posts and they sound so much like all of ours did when we were first diagnosed. I had so many questions for the ladies here that I flt like I was a pesky child. You will get lots of great advice and a whole lot of hugs from our ladies. I don't know what I would jave done without them.

I wanted to touch on the hair loss issue. I was totally freaked out about loosing my hair, I was told at first that I would be having a lumpectomy and then radiation but the tumor was larger than they anticipated so I had 6 months of chemo and 2 months of radiation. I hated the thought of loosing my hair and having to wear a wig. I can tell you looking back on it it was not nearly as bad as I thought it would be. I wore my wig only for work and went bal at home. I wore baseball caps to the store or shopping. I can honestly tell you it is not that bad. I enjoyed the fact that getting ready took almost no time at all. I had no hair, lashes or brows all I wore was a little eye liner. It felt great and I loved having the extra time every morning. I can only tell you how I took this experience and almost all of the ladies here felt the same way.

For now you have enough on your plate to think about, come here and "talk" anytime. We are always here to listento anything you have to say. You will even find that many of us have had pity parties when we are having a bad day, so feel free to vent.

Take care,

L&H

Bernadette

Posted 12/19/2006 12:52 PM (GMT 0)
Hello again and many thanks for the messages.

Bev I haven't started getting menopausal symptoms yet but I remember when I first started HRT it took about a month to kick in so perhaps the same happens in reverse.   I don't know. My main reason for taking it in the first place was hot flushes - about 100 a day - dreadful  - with great rivers of sweat running down my body - not a pleasant sight and very nasty to experience !  And I understand that one gets those symptoms from drugs like Tamoxifen so I guess that may be something else to look forward to !  

Thanks also for the warning about the change in my breast size after surgery.  It's going to be frightening looking at myself for the first time afterwards.

Bernadette many thanks for your input re hair loss.   Yes you are right it would certainly save all that time washing and blow drying each morning !  I assume it would also save having to shave one's legs ?

You are right, the issue of hair loss does worry me a lot but I'm trying to feel as positive about all this as I can.  I'm still shaking but I have loads to do today so I need to keep busy and that's good.  I have bought some rather nice red satin pyjamas for the hospital - I thought red would be a good cheerful colour.

Thank you everyone for your messages and support.  I am so pleased I found this message board.
Anthi

Posted 12/21/2006 2:53 AM (GMT 0)

Forgive me for intruding on your forum. I had UC (ulcerative colitis) for 8 years (now symptom and med free) and realized that UC symptoms are, as well as many of our diseases, the result of a fungus. Throughout my research of mycology, I have come across articles that I have passed on to others, not to persuade them of anything, but to give them another view point. It is with this in mind that I leave a link to an article that may or may not interest you. The author has co-written a "huge" book about cancer, "The Germ That Causes Cancer" with a doctor. The research is undeniably accurate and hard to dispute that fungi and mycotoxins do cause cancer. If nothing else, please note that both cancer cells and fungi must have sugar in order to survive. Also, both respond to antifungal medicines. Some cancers have gone into remission or reduced in size when an antifungal medicine was used to treat a co-existing infection. Both will die in the absence of sugar. It matters not to me what you think of this research. However, if I had cancer, I would certainly be open to any and all facts/opinions that came my way. As an aside, I've heard that Beta glucan can help with negative symptoms of radiation therapy. May be worth looking into as well?

The link takes you to a website. Look for the title: "The Role Of Fungus In Cancer" It also has a link to the book I mentioned. I've seen it on Amazon as well.

http://www.knowthecause.com/sciencefungus.php

I don't mean to in any way to belittle your disease. I have friends that are battling this disease. It breaks my heart to see them suffer. Maybe even one out there can benefit from this knowledge. I don't know...I haven't lived it myself. Take care...

Posted 12/21/2006 3:59 AM (GMT 0)

Kim: I am glad that you have found info that you feel will help you deal w/ your illness. The problem that I have w/ books on topics such as this is that there are no clinical trials that have proven them to be useful in the cure of cancer. There are many, many books and theories and alternative therapies that claim to be able to cure cancer. Each of the women on this board is fighting for their lives. Each has faith in the oncologist, surgeon and medical dr that they have chosen as well as the course of treatment that has been chosen.. Our journey is a difficult one both mentally and physically.

I personally don't appreciate someone coming here and telling me that the treatments that I have endured for over 5 years are not what I needed. That something that will kill a fungus will kill my cancer cells. I am sure that if this was true, tests would have been done by now and one of our members would have reported on this.

Thank you for taking the time to post. I wish you well in your journey but please keep these crazy, off the wall ideas to yourself.

Deb

Posted 12/21/2006 1:50 PM (GMT 0)

Deb,

It was not my intention to make anyone feel this way. After reading about several studies, one such as the JAMA (2004) that published a study that the use of antibiotics (fungal toxins) is associated with increased risk of incident and fatal breast cancer (one of many such findings in the aforementioned book), it made sense to me that there MAY be a link there. I am certainly NOT saying ALL cancer is a fungus. For me, the documentation provided in this book is substantive. I apologize for any ill feelings and will keep my comments for the UC forum. Sorry... 

Kim

Posted 12/21/2006 3:04 PM (GMT 0)
Kim, if this works for you, that is great.  My biggest problem with the "sugar" theory for disease is that, the minute we put any type of food in the mouth, our saliva begins to break it down into sugars that our body can use for fuel.  While fungi and cancer may need sugar to survive, people survive on it, too.  Our bodies are made to be sugar factories! 

There have been many studies done to try to link diet and cancer, breast cancer included.  If there were proof out there, I would be the first to be on my daughters to change their diets.  Personally, I worry more about my daughter who eats that nasty artificial sweetener than the one who chooses sugar as her sweetener.

I hope you continue to be symptom and med free, and your diet continues to work for you, and thanks for sharing.

But I am curious as to why you chose to share under a reply to an obvious newcomer's post, rather than just creating a new post to share with everyone???

BEV

Posted 12/21/2006 7:43 PM (GMT 0)
Alas, I only respond because you asked me a question and I didn't want to appear rude. Those who know me from the UC forum know that I only share my opinion when others ask advice. The heading of this posting was "...advice needed". I just gave my 2 cents worth, that's all, like everyone else. I don't intend to scream it from the rooftops, coming across as a "snakeoil salesman" :) I always sit by and respond to those seeking help, rather than some "know-it-all." There are enough of those in the world. As for the "sugar" theory, it is not sugar in fruits and veggies that is the concern. They are very much needed, especially the veggies. It is the refined/processed sugars (a grain) and other grains (wheat, corn, etc.)that are commonly contaminated with fungal toxins, like aflatoxin, a carcinogen. When you eat these foods you are at risk of ingesting fungus. Dr. A.V. Constantini, former of the WHO believes that multiple cancers are caused by fungi and mycotoxins. By eliminating those foods as well as reducing foods high in sugar, you starve the fungus, literally. That's all...
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