More Information

Before I forget, I wanted to go over the information we got from talking to the doctor this afternoon. One good thing was that the Dr. tape recorded the appointment and let me have the tape, so I can listen to it again if I forget some of the things she said.

First of all the pathology report. Dr. L is pretty sure she got the entire tumor. She even took some "margins" because she was concerned as soon as she saw it. The tumor measured 1.6 cm, so she was really impressed that I found it. She said most patients don't feel a lump until it is between 3 to 5 cm. It was a Invasive Ductal tumor, meaning it started in a milk duct and then broke out of it. It was a Stage 3 tumor, meaning it was very aggressive and fast growing. Her thoughts were that it couldn't have been there more than a couple of months. She also said she doesn't think I would have found it if I had been breastfeeding, because my breasts would have been much more full and lumpy anyway.

Because, I am so young, Dr. L wants to pursue a very aggressive treatment plan. She said she is sure that the cancer we have found is gone. As far as we know, I no longer have any cancer in my body. However, if a couple of cells had broken off before removal and got into my blood stream or lymph nodes, they could take years to develop into another cancer. Fifteen or twenty years from now I could find a lump/spot on my lung, liver, or even brain. Twenty years from now, I will only be 46 years old. She said if I were 65, they would probably just say the cancer is gone, maybe do some radiation and be done. If 20 years later (at 85) something showed up, we'd deal with it then. However, they don't want to have to deal with a reoccurrence. I'd like to stay healthy for another 50 or 60 years.

So here's the plan:
Step 1 - Testing. First an MRI. This will allow them to look at the rest of my right breast and look at the left breast to be sure there isn't anything else in my breasts. They got me in right after the appointment for the MRI. Next, I have a mammogram scheduled for Tuesday. (I'm expecting that to be plenty painful on my fresh incision.) Friday morning Dr. L will be meeting with a team of about 20 doctors that meet weekly to discuss new cancer diagnosis patients. They will look over my ultrasound, pathology slides, MRI and mammogram information and agree with a game plan for treatment. Friday afternoon, I will meet with Dr. L again to go over the results of the new tests and confirm our next plan.

Step 2- Surgery. Dr. L wants to go back in and do "Sentinel Lymph Node Mapping." This will probably be in early October. Basically she will go in and use some dye at the tumor location and determine which are the main 3-5 lymph nodes that could have been affected by the cancer. They will remove those lymph nodes (from my armpit) and send them off to be tested. They'll get the results in about 10 minutes and then if they are clear, they'll close me back up and I'll go home. If they detect any cancer, they'll remove 10-20 lymph nodes at that time. Also during this surgery she may go back into the original site and remove some more tissue. Apparently some of the margins were only 1mm, so she might want to take out more tissue just to be safe.

Step 3 - Estrogen Sensitivity. At some point (I can't remember when) they will test the tumor to see if it was sensitive to estrogen and thus affected by my hormones. If it is, they will have me take a medication (pill) once a day for 5 years.

Step 4 - Chemotherapy. Regardless of the results of the lymph node surgery. I will be having chemo. This will start about a month after the surgery. Again, they want to be sure they kill everything, so I won't have as much of a chance of developing other cancer down the road. I will have probably 4 to 8 cycles. Most likely it will be a cycle every 2 to 3 weeks.

Step 5 - Radiation. Once the chemothereapy is completed. They will do radiation treatment at the tumor site. I will have to go in 5 days a week for a 5 to 10 minute session for 7 weeks.

Step 6 - Monitoring. I will be seeing Dr. L at least every 6 months until everything is complete. Then she will see me annually forever. I'm guessing I may have frequent mammograms too.

The hardest part of the whole appointment for me was when I asked about having more children. Eric and I had been planning on starting again in March. That's not going to happen. I will not be able to get pregnant while I am taking any of the medications. So if I have to take the pill for estrogen sensitive cancer, I will have to wait at least 5 years to get pregnant again. The doctor assured me, I'll only be 31 and perfectly cabable of having a baby, but that sort of squashes the idea of having my children 2 years apart or even considering being a surrogate. She seemed fairly sure that I'd be taking this pill, so we didn't ask how that timetable changes if I don't. I guess we'll cross that bridge when the time comes.

Sometimes your plans have to change. Funny how everytime I come up with a plan, God reminds me that I'm not in control of my life. I have to trust that he'll take care of me. I also thank God that I already have Grace. We'll deal with this now and when the time comes we'll decide if we want to attempt to have another child (6 years later) or if one is enough.

I'll leave you with a verse my Mom gave me today.
Jeremiah 29:11-13 "For I know the plans I have for you," declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future. Then you will call upon me and come and pray to me, and I will listen to you. You will seek me and find me when you seek me with all your heart."