Monday, August 22, 2011

Bill says we got great news

Today we had our doctor’s appointment at LC to discuss my diagnosis and treatment plan. First they reviewed all my test results so far:
·         7/21 Mammogram showed micro-calcifications in varied sizes & patterns. Some clumped together, some not. Very diffuse through the right breast. Ultrasound same day showed no distinguishable lump.
·         8/3 MRI showed enhancement in area of calcifications. This means the dye they put in my blood stream lit up like a Christmas tree on the MRI where the calcifications are.
·         8/17 Two biopsies. Both sites biopsied were determined to be ductal carcinoma in situ (DCIS), high grade, hormone receptive = positive.

Then the plan: because the DCIS is over so much of the breast, a lumpectomy would leave me disfigured and it would be difficult for them to know they got it all since the calcifications are so tiny. So the only way to be sure to remove it all is a mastectomy. Because of my young age (that’s right, I’m young!) and the large size of the area with DCIS (what they biopsied was non-invasive but that’s no guarantee it all is) they will also perform a sentinel node biopsy, which removes 1 to 3 lymph nodes and biopsies them. There is a 15% chance the lymph nodes would be positive for cancer (meaning there was indeed invasive DCIS in there somewhere).

For the treatment plan we discussed today we’re assuming my lymph nodes will be negative. A lot would change treatment wise if they’re positive so… we’re going to think positive… wait, I mean…  uhhhhh  we're thinking positive that the nodes are negative!
So assuming lymph nodes = negative for cancer is pretty good news.  They said I can have reconstruction right away (I’ll post more on this another day – there are some BIG decisions to make about that and we didn’t meet with a plastic surgeon). I won’t need radiation! Chemo is totally not necessary J  and Tamoxifen (drug recommended if you are hormone receptive positive) would be my choice to possibly reduce the chance of getting cancer on the left (no thanks, menopausal side effects…   I’ll risk it).

The next step would be genetic counseling (I am YOUNG to have this and I have a daughter so I’d like to know if I am BRCA positive) and meet with a plastic surgeon. Before I book appointments – I need to get that second opinion and decide where I’m going to get treatment. DF is working on getting some preliminary data from LC and I expect them to call me tomorrow with an appointment time. I believe it’ll likely be next week as the tissue samples and other test results need to be sent to them, as they will have their pathologists look at the biopsy samples and kind of start from scratch from the films and slides.

I feel overwhelmed. My mind is spinning. Bill feels like we got great news today (no radiation! reconstruction right away!). And it is good news but… great news to me would’ve been “We made a horrible mistake and have a nice day!” I’m still wrapping my head around all this. Even now, it just seems unbelievable to me.

Yesterday’s BBQ was good. I won’t post pictures of other people’s kids but here is Cassidy in the old kiddie pool and chilling in her chair from Saturday.


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