WHAT WE KNOW SO FAR

So today Rick went with me to consult with the breast cancer surgeon. Perhaps I should backtrack a bit to say how I chose this surgeon. Initially when my gynecologist gave me the results of my biopsy, he gave me a list of surgeons he recommended, so my first step was to check my medical insurance provider roster and all those surgeons were on it. My next step was to talk to a friend who has had two experiences with breast cancer, one recent and one about eleven years ago. She had a different surgeon for each, but recommended both of them, Dr R and Dr K. Again they were both on the insurance roster, but only Dr R was on the list from my gynecologist. Then I called my primary care doctor, who specializes in internal medicine. He only recommended one surgeon, Dr. R, so I called to make an appointment with him. Then, I went to get my hair cut. I told my hairdresser about my diagnosis and to my surprise she asked who my surgeon would be and expressed approval when I told her. She is between my two daughters in age and told me that Dr R did her mother's breast cancer surgery about four years ago. I have researched this doctor's credentials, education, awards and recognitions and learned that he's quite renowned. All along I had also been praying that God would help me in the choice of a surgeon and I believe He did. 

Rick and I both liked the surgeon very much and felt that we had a good rapport with him. He showed us all the images from my mammograms and ultrasound and went over the pathology report from the biopsy with us. He explained everything very thoroughly in a way that answered most of our questions before we even asked them, but he also took time to answer the remaining questions we did have. 

Here's what we learned today:

My breast tissue is so dense that it's impossible to rule out the possibility of more cancer in either breast without MRI, which means I need an MRI before mastectomy can be ruled out. I'll have the MRI on Monday and the surgeon will call me when he gets the results. 

If no other tumors are found, then we'll schedule a lumpectomy. That would be done as an outpatient. The doctor would remove the tumor plus a margin of tissue around it. He would also remove one to three "sentinel" lymph nodes, more if those look suspicious for cancer. I would go home the same day. Statistically, there would be about a twenty percent chance that the margins around the tumor would not be cancer free and I'd hear from the doctor about two or three days later and would go back in to have more breast tissue removed. Lumpectomy is always followed by radiation and I'd probably start that two to four weeks after surgery.

If more cancer is found in either breast, then I'd be looking at mastectomy and reconstruction, which would not need to be followed by radiation. 

After surgery I'll be seeing an oncologist, who will have access to the pathology report on the tumor and the lymph nodes. The possibility of chemotherapy seems unlikely, but will hinge on whether cancer is found in the lymph nodes and to what extent. One thing I do know is that the tumor is ER (Estrogen Receptor) Positive, which means the drug Tamoxifen is in my future, since at the age of fifty-seven I'm still not quite postmenopausal. I'll probably be looking at five years on that or two to three years followed by two to three on another drug once I am postmenopausal.

All in all, I still think the prognosis is very good and I thank the Lord that my cancer was detected early, my tumor is small and slow growing, I have access to good medical care and I am blessed with a wonderful husband and supportive family and friends.