I had decided before I left for my visit with the surgeon yesterday that my post here afterwards would be 'short & sweet'... I'm not sure this will be either?! My mind has done 'flip flops' since this all started and when I woke up yesterday I was convinced that I had one more day surgery ahead of me (one lumpectomy and one excisional biopsy... both on my left breast)... then a few weeks of radiation... followed up by a couple of years of taking Tamoxifen... and Bob would be my Uncle... Turns out Bob isn't even remotely related to me...
The good news remains that there was no Cancer found in my most recent biopsy. And since the area in question has already been excised... there is nothing more to do on the right side at this time. Other good news is that the incision is healing really well and I was told that even though it's still quite painful that there's nothing to be concerned about. Now if the rest of my body is still up for it... I can start Running again :)
The bad news is... I have several strikes against me regarding my left breast:
(1) I have DCIS as well as ALH (in two opposite areas)
(2) I cannot and will never be able to have an MRI for follow up (that means that if anything suspicious shows up on a mammogram in the future should I opt for the breast conserving surgery, I will once again be subjected to biopsies to study the area(s)
(3) I have Cancer on both sides of my family (my Father's side is riddled with it) including Breast Cancer on both sides.
(4) If I opted for conservation and there was reason to have the breast removed in the future, there is a high possibility I would no longer be a good candidate for reconstruction due to damage to skin cells from the radiation.
Dr. Lee asked if I had gone to see the Geneticist and plastic surgeon she had recommended. We spoke at length about the genetic testing and she strongly suggested I go to meet with Dr. Resta to learn more about the process and to find out if I would be a good candidate for the BRCA testing. About the point in the conversation that she mentioned the possibility of having to have my Ovaries removed... I think my muddled brain went in to a conservation mode of its own. But I do understand that the gene testing can help in answering some very difficult questions.
I asked Dr. Lee to 'pretend this is your Sister you're talking to' and she replied by saying "I wouldn't tell my Sister she 'needed' to have a mastectomy... but I would tell her that I thought it was the best treatment in her case".
This morning things look different to me... though I'm doing my damnedest to try to keep a positive spin on all of this... It could certainly be worse... If You're still here to say it could be worse... that's enough proof to make it so... And so the beat goes on... and I will arrange to meet the Geneticist and then the Plastic Surgeon... and we'll take things from there...
*The rest of this is mostly for Rebecca, my dear friend who regularly takes time from studying to be a doctor at Stanford... to check in to see how I'm doing* :) Pathology reports so far...
So far I have had 3 biopsies, 2 x stereotactic needle guided @ 12 and 6 o'clock on my left breast and one wire guided (3 wires) excisory on my right.
Right Breast = Breast Tissue:
- apocrine metaplasia and columnar cell change, cysts, focal florid usual type epithelial hyperplasia, nodular and sclerosing adenosis, and fibroadenosis;
-scattered foci of atypical lobular hyperplasia;
-microcalcifications associated with columnar cell change
-no evedince of DCIS or invasive carcinoma
12 o'clock on Left Breast = Breast parenchyma with:
- atypical lobular hyperplasia
- fibrosystic without atypia, columnar cell change without atypia, cyst formation, apocrine metaplasia, duct ectasia and sclerosing adenosis.
- Targeted calcifications associated with complex sclerosing lesions, columnar cell change, benign epithelium, and atypical lobular hyperplasia (ALH in block designated "No calcifications").
- No evedince of in situ or infiltrating carcinoma.
6 o'clock Left Breast = stereotactic guided core biopsy:
-Ductal Carcinom in-situ identified, cribiform and solid types, intermediate to high nuclear grade with associated microcalcifications; no necrosis identified
-Adjecent foci of flat epithelial atypia (columnar cell hyperplasia with atypia) and atypical ductal hyperplasia focally with associated microcalcifications.
- No invasive carcinoma identified.
- Small benign intraductal papilloma with associated florid ductal epitelial hyperplasia of the usual type.
- remaining breast tissue showing fibrocystic changes wiht stromal fibrosis, adenosis, cysts, focal apocrine microcalcifications associated with benign breast epithelium (adenosis) noted.
- Additional Findings:
ER: 90% of tumor cells positive for DCIS
PR: 0% of tumor cells positive for DCIS
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