One of the hardest parts about this whole process is undoubtedly the WAITING. From the minute you're diagnosed all you can think about is cancer coursing through your whole body, ready to drop you dead any minute. Is it in my other breast? Has it spread anywhere else? What if it takes weeks to get a surgery date? Am I going to live to see my kids next birthdays? The unanswered questions are killer.
We had our first consult with the surgeon today who was able to give us at least a start of a game plan. We spent three hours with her. Thank God John was with me taking notes because after hearing the words "surgery" and "chemo" and "radiation" I felt like I was ready to slide out of my seat onto the floor. One piece of good news is that the MRI showed no traces of cancer in the left breast, and contrary to what I would have expected, breast cancer doesn't jump from breast to breast (unless you have a certain BRCA gene which is hereditary) so I don't have any higher chance of developing it on the other side than the general population would. I will have to undergo genetic testing for the BRCA mutation, but with no signs of breast cancer in our family it's not expected to come back positive - but keep your fingers crossed.
From the results that did come back, I have three, possibly four, small cancerous lumps that are spread far enough apart that my surgeon is recommending a mastectomy. I guess there are basically two choices when it comes to surgery - a lumpectomy with radiation or a full mastectomy. Because my lumps are spread out she would have to take about 1/3 of my breast anyway, so I really wouldn't be gaining anything cosmetically. From what I understand, the survival rates for lumpectomy vs mastectomy are the same, but the local recurrence rate for a lumpectomy is higher (something like 8-12% for lumpectomy vs 2-4% for mastectomy). To me, if I'm not gaining anything cosmetically, then why go through the added risk of recurrence and the possibility that I'd have to get a mastectomy further down the road anyway? Not an easy decision, but it seems to make the most sense, in my case anyway. I've read that a lot of women with the BRCA gene, like Christina Applegate for example, are deciding to have proactive double mastectomies even when only one breast is affected. A courageous and aggressive stance, one I'm glad I don't have to agonize over, at least for now.
In addition to the mastectomy, my surgeon will be doing a sentinel lymph node biopsy to determine if cancer has spread outside of the breast. If the sentinel node comes back negative then the cancer is contained and there will be no need for radiation. If the node is positive, she will have to do an axillary node dissection where several lymph nodes are removed and then sent for further testing, and I will have to undergo radiation after the chemo. The removal of all these nodes can cause a scary condition called lymphedema which can cause all kinds of nasty life-long side effects like swelling in the arm, infections, aching, tightness, etc... but really I'm more concerned that the presence of cancer in the nodes means it's spread elsewhere in the body via the lymphatic system. Surgery is really the key to staging which will give us the big picture as to the aggressiveness, scope, size and general bad-ass nature of the beast we're dealing with. Luckily for me, we were able to arrange a surgery date for January 30th - not bad considering all the schedules that have to be coordinated - but still, 3 more weeks of waiting...
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