Alrighty people, I’ve had my first visit with a surgeon. Here is the update.
First, I really liked the surgeon. She was super nice, compassionate and thorough. She told me I was going to be fine. She said that young mothers tend to handle treatment the best because they don’t have time to focus on themselves with little kids jumping all over them. She doesn’t see anything to indicate that it’s spread and thinks we have caught it pretty early. Hooray!
We got the pathology report and this tumor really is quite the little overachiever. I explained earlier that being grade 3 is determined by looking at 3 different areas, scoring each 1-3 and the cumulative score determines the grade. Grade 3 is a total score of 8 or 9 so there was a chance that one of the areas only scored a 2 and wasn’t as bad. Nope. All 3’s. Because something isn’t worth doing if it isn’t done right! They got the hormone receptor test back – normally a tumor is basically “fed” by a hormone and it will test as a positive on the hormone receptor test for that. Mine came up negative for all – so it is called a triple negative. Triple negative tumors are basically the crazy type of cancer. We don’t know what is feeding it and prognosis is generally not as good – relapse is more of a concern. BUT, they respond well to chemo which is good – especially since that’s the only treatment we have since it won’t respond to hormone therapy, etc. So based on this test result I need to have chemo without question and I need to start it pretty fast.
Outside of chemo, I do have options which is great. And gives me lots to think about. Here they are:
1. Lumpectomy with radiation therapy – healing time would be less, this is an outpatient procedure with bed rest for a week and light activity the following week. Then chemo would start. Radiation would start about 6 months later and would be every day for 7 weeks.
2. Mastectomy (single or double) – More surgery and longer recovery time, reconstruction process of about 6 months, 2 night hospital stay. Perks are no recurrence of breast cancer and no radiation unless it is found in lymph nodes.
3. Lumpectomy first, start chemo faster, then do a mastectomy after. I had never thought of this option. She said that most people get what they’re going to get right off the bat though.
I am being scheduled for multiple appointments ASAP – her nurse is scheduling them for me and calling me with all the information, isn’t that lovely? First will be genetic counseling to see if I carry the “breast cancer gene” and an MRI to see if there are any other areas in my breasts. Positive results on these tests will obviously change my options. If I test positive for the cancer gene, they would do a bilateral mastectomy and she said I would need to think about removing my ovaries once I finish treatment. If the MRI shows more cancer then that would remove options as well. So we will see what they show. She did say that there is the definite possibility of additional cancer genes that we have not yet recognized and based on my age and everything she has to think that there is something going on that I would come up with this super aggressive tumor.
I am also having appointments scheduled with the oncologist, radiologist and plastic surgeon to really hear the details about what my future holds.
Whatever surgery we do, they will remove the sentinel node and send it for testing. If there are cancer cells, then they will go back in to remove more lymph nodes.
So, I should start getting calls tomorrow with my appointment schedule and she expects me to have seen everyone within the next week. She said that surgery is usually happening two weeks after the initial meeting so things will go quickly. If we do move forward as I’ve thought with the bilateral mastectomy, she will coordinate her schedule with the plastic surgeon so it may take a little longer. Things should move quickly though.
So really, mostly good news today. I’m not thrilled about the triple negative but what can I do? If anything, that makes me feel more like I need to do the full deal. Early recurrence rates are definitely high. That obviously scares me. I’ll update again in the morning when I’ve had time to do more research and let the feelings sink in. Tonight I’ve got a girl’s night! Margaritas!!!