Light of Day

I had two biopsies completed on 9/27. The pathology report came back yesterday, and both the “new” mass and the lymph node are positive for the same type of cancer as the original mass.

Yesterday, all I had was the pathology report, which was absolutely terrifying, because it looked like this-

*

*

 Metastatic mammary carcinoma (also known as metastatic breast cancer) is automatically Stage 4. Stage 4 is the only stage that is considered “incurable” (though not untreatable) so… it was an extremely traumatic day. I was home alone, and my panic levels rose so high that things went gray on me a few times.

HOWMEVER (< a little MFM humor there… if you know, you know)

I was able to have a teleconference call with Dr. Liu this morning, and things are looking a lot brighter than yesterday.

It is true that both biopsies were positive, but the “metastatic” part of the report did not automatically mean Stage 4 in this instance. It was specifically in regard to the fact that it is in the lymph node- therefore it has metastasized to the lymph node. “Metastatic” is not a diagnosis of the cancer, itself. There is always the possibility that things could change, but for now, there is no indication that it has spread further than the abnormal lymph node.

 Because there is now lymph node involvement, I have been re-staged from Stage 1 to Stage 2. This is not great news, but it’s way better than Stage 4! Right? RIGHT??!!!

Because of the additional mass in my right breast, I will have to have a mastectomy. The second mass is small, but all of the tissue between the 2 tumors will also have to come out, so the surgeon believes that a mastectomy would be the safest option. 

I will have to have some lymph nodes removed and biopsied, but there are conflicting ideologies on whether I should have all of the nearby lymph nodes removed, or just the few that are closest to the tumor. Dr. Liu is going to present my case to the tumor board on Tuesday, and they will weigh the pros and cons, but it will likely be my decision. I will probably only do a few lymph nodes (unless there are indications that more are involved) because I will be having radiation after surgery, anyway. Lymphedema is a condition that can occur from removing them all, and that would not be conducive to my lifestyle.

I still have to have the biopsy on my left side next week. The results from that could totally change my plan of care. I will also have a second consult with plastic surgery that day, because the mastectomy means I will have the option of reconstruction. 

Let me just make a side note here- a person’s reconstruction decisions are their own, and outside opinions are not helpful-even when they are well meaning or “fact based”. There are some possible risks associated with reconstruction. These are not entirely eliminated by choosing not to do it, and there are even a few that can occur because of not doing it! I have encountered a few people who seem to believe that reconstruction is about looking “normal” in public. That may be true for some women, and that’s also absolutely fine! For me, though, I honestly don’t care at ALL if my walking around with one boob makes other people uncomfortable! And you can BET I would come up with a bikini top with only one cup for the beach! 😆 For me, it is a psychological/trauma issue related to the cancer, itself. I’m not going to try to explain all of that in a blog post, because it’s nobody’s f-ing business. 🤷‍♀️ But I did want to address the fact that all of the aspects of this are complicated, and nobody else has the answers for what’s right for an individual who is going through it.

Anyway… sorry(ish) for the rant. Here’s a couple of pics of me and Patton to make up for it:

Ok. So Dr. Liu meets with the tumor board Tuesday. My next biopsy and plastics consult are Wednesday. I’m currently scheduled for a consultation with Dr. Joyce on 10/15. She’s the medical oncologist who will decide if I need chemo. She will also be in charge of my hormone blocking medications. And, she will be the person who decides if I should have additional imaging to see if it has spread anywhere beyond the lymph nodes. Often, they won’t do that unless they are worried about certain symptoms, but she could decide it’s a good idea. I am hopeful that we’ve already found all of it, but… who knows? It is definitely a marathon and not a sprint, and we’re just going to have to settle into a pace that reflects that.