Author: Chantal

Surgical Consultation

Posted on by Chantal

I met with my surgeon today. I can see why everyone loves him. He is extremely good with people, which probably isn’t the norm for surgeons. Or at least, that’s what I learned from Grey’s Anatomy on TV. ?

The surgeon explained the risks and benefits of the surgery, which was pretty straight forward since I have done so much reading and research in the past week. I know that the tumour has to be removed via process called a lumpectomy. From there, they have to make sure that there is healthy tissue all around the removed tumour, which is what they call negative margins. This is determined by sending the tumour off to a lab, where they look at it under a microscope to make sure that there are no cancerous cells around the removed tumour. At the same time, they will analyze the tumour to find out if it is estrogen or progesterone positive, HER2 positive, a combination of the three, all three (triple positive), or none of the above (triple negative).

Of the tumour types, I am most worried about a triple negative breast cancer. That type of cancer does not respond to targeted therapies like trastuzamab or estrogen blockers. The only things it responds to is chemo and radiation. And if the chemo is not effective, what do you do? HER2 is a fast growing and aggressive type of tumour, but there is a drug called trastuzumab (Herceptin) that beats the crap out of it. However, you also need chemo almost 100% of the time if you have that type of tumour. I get the feeling that a HER2 positive tumour used to be especially dangerous, but isn’t quite bad these days as long as it’s caught early enough.

The surgeon plans to remove the tumour and perform a sentinel node biopsy. In this case, the word biopsy is a bit misleading. Usually, when a biopsy is performed, a sample of tissue is taken. In a sentinel node biopsy, large amounts of radioactive dye is injected into the breast. At that point, your body needs to figure out how to drain the extra fluid out, which is where lymph nodes come into play. The idea is that the first lymph nodes that take on the radioactive dye are the same ones that drain fluid from breast tissue. So, they identify those lymph nodes and remove them to analyze them for cancer.

The reason surgeons do this now is because someone figured out that there is no need to perform an axiliary node dissection to remove all lymph nodes. If the sentinel nodes are healthy, there is no reason to believe the cancer would have spread anywhere else. As a result, the other lymph nodes can be left alone. That spares people the complications of an axiliary node dissection which is 30-40%. Some of the complications are numbness in the arm, lymphedema (swelling in the arm), or weakness. Yuck.

Radiation Oncologist

Posted on by Chantal

I had an appointment with my radiation oncologist today. He explained how the treatment works in full detail, including side effects during the treatment, along with short-term and long-term effects.

Fatigue and burns to the skin are pretty much guaranteed during the treatment, and so is some damage to the lung on the affected side. The lung damage due to scar tissue is supposed to be minimal to the point where I shouldn’t notice it at all.

After the treatment, scar tissue in the treated area is also a concern. Lastly, in 30 – 40 years, I could get cancer from the radiation, such as leukemia, or even another breast cancer occurrence. It doesn’t sound wonderful, but it reduces the chance of this breast cancer coming back from 25% to 5%. So yeah, I’ll take that.

We talked about the game plan of doing chemotherapy first, followed by radiation, and further surgery to remove the first two levels of lymph nodes. I know my surgeon wanted to do the lymph node surgery first, but I thought it made more sense to do the chemo and radiation first, so that the lymph nodes have the best possible chance at being free of cancer when they are removed. That way, I can breathe easy, despite the lung damage from radiation!

Surgery Tomorrow

Posted on by Chantal

Well, it has been a crazy week and a half. I am trying to relax for bed so that I can actually sleep tonight. It’s probably not going to happen.

I’ve figured out that it’s not just the surgery that’s bothering me. Yes, my surgeon will be removing the lump, which probably won’t hurt that much. The sentinel nodes being removed might be a bit painful, but I’m sure it will be manageable.

What I hate is that this is just the start of medical appointments, procedures that will be painful and draining, and who knows what else. And I will have little control over this. On top of that, I won’t know how bad this is for up to three weeks.

Merry Christmas. ?

The ‘C’ Word

Posted on by Chantal

I got a phone call from my surgeon today. He told me that the results of my biopsy are back, and that I have breast cancer. Not only do I have cancer, but the tumour is either a high grade 2 or grade 3 which is pretty aggressive. We won’t know some of the other details for a couple of weeks while the lab analyzes the tumour.

I’m not sure that anyone can really be prepared for being told they have cancer, especially at my age. I’m not even eligible for mammograms because I am too young. Screening for breast cancer only starts at the age of 50. I work out, don’t eat junk food on a regular basis, don’t eat red meat (I know that only reduces risk of colorectal cancer and maybe a a couple of others, but whatever), and I am even careful about what I put on my skin.

I checked my risk of getting cancer, and depending on whether I am considered to be black or white, the percentage is either 0.8% or 0.9% respectively. So let’s call it 0.85%. Alas, here I am. The good news is that the surgeon wants to see me on November 30th for a consultation to remove the tumour.

In the meantime, I will try my best not to freak out too much, but I am really not good with not knowing. Christmas is right around the corner, so I am probably not going to say anything to anyone until I know what’s happening. I don’t want my family worrying like crazy if this turns out to be early stage breast cancer. Either way, it will be crappy to some extent, but I don’t want them worrying about whether or not I am going to drop dead in a few months, if it’s 99% unlikely to be the case.

Speaking of which, there is every reason to believe this was caught early. The tumour was only 1.67 cm in size. If it really is grade 3, that means it hasn’t been there long. Hopefully, it didn’t have the chance to do much damage before it was caught. We’ll see.

Oh really?