And Here We Are

Sometimes you look around and think, "How did we get here?" It's not that it's a bad place to be, it's just different from what you were planning on or expecting. Throughout my life I've been blessed with good health. My only trips to the hospital were for the births of our 5 kids. I love to exercise, go skiing in the winter and work in the yard the rest of the year.

In early September I found a lump on my right breast, not too big, just different. (I also began to notice at times that the little lump caused a dimple on the skin - something to watch for.) At Rob's suggestion I moved up my mammogram and to get it checked as soon as possible. Did you know that if you find a lump you need to tell them when you schedule a mammogram? I didn't and so when I went in for my regular screening mammogram, she said, "I can't do your mammogram, you need a diagnostic and you'll need to have your doctor order it." The next day (Sept 17) I had a diagnostic mammogram and an ultrasound. Everyone was very calm, but they did tell me I would need to get a biopsy, an MRI and schedule a consultation with a surgeon. The radiologist wanted to do the biopsy the next day, but I take aspirin for my heart, so it had to wait a week while the aspirin cleared out of my system. Everyone was very calm (this is what they do all the time), but it was clear that they were very concerned and I began to feel that cancer was a likely outcome.

The next week, Rob came in with me for the MRI and biopsy (Sept 25). He did a little work, a lot of waiting, and even managed to fit in a trip to Sportsman's Warehouse :). After the biopsy the doctor told me it did look malignant and I would need surgery (we kind of figured that out by now). The size of the lump was approx 1.5 centimeters (but it has a very irregular shape). He gave me all his phone numbers in case I had any questions and called me personally the next evening. Yes, it was malignant and it would need to come out. Thankfully, we already had an appointment with a surgeon whom our OB had recommended. That was Friday (Sept 26), now we wait till the following Monday. (This whole process has involved bursts of information followed by a quiet time to digest and accept what we have learned. This time has been a blessing to us.)

We visited with the Surgeon on Monday (Sept 29). After an initial examination, he was very impressed that I had initially found the lump. The small size and proximity to the chest wall made it a bit difficult to identify. As a stroke of luck and good timing, we were able to get on his surgery schedule for the next day (Sept 30 - no waiting there!). The goal of the surgery was to remove the tumor -along with an estimated margin of clean tissue around it. Additionally, they would inject me with a dye and radioactive agent to trace the sentinel lymph node under my arm. Rather than going in and initially removing a bunch of lymph nodes, they have found that by identifying and testing sentinel lymph node, they can potentially reduce the number of nodes they remove. During the course of the surgery, they looked at the breast tissue sample and the sentinel node to attempt to determine if they got a clear margin on the tissue and whether the sentinel node is cancerous. Unfortunately, they found a 2 mm cancerous tumor in the sentinel node, and as a result, they removed all the lymph nodes in that region.

It was a week after the surgery before we received the pathology reports (Oct 6). We met with our Surgeon to review the results of the report and examine the results of the surgery. The great news was that the cancer had not spread to any other lymph nodes. Additionally, it is not an aggressive cancer. It is classified as Stage IIA (okay news), is estrogen receptive (good news) and is her2 negative (more good news). All this leads for a very positive prognosis and optimistic outcome. The unfortunate news was that rather than a single tumor, the tissue they removed from the breast actually contained 7 tumors - a couple of which were either very near or on the margin of the tissue removed. At this point, it was recommended that we seriously consider a mastectomy.

That was a huge burst of information for us and very hard to take. Thankfully, we had some help to get through that one, and more time. Once each week IHC sponsors a Cancer Clinic. You get your own conference/exam room and during the course of a morning, they parade a whole bunch of doctors and specialists through. On October 9, we attended the clinic and met with a surgeon, plastic surgeon, radiological oncologist, medical oncologist, genetic counselor, physical therapist, dietician, patient advocate and representative of the American Cancer Society (and maybe one or two more we don't remember). While it was akin to drinking from a fire hose, it was extremely helpful as they were all familiar with my case and we had free reign to ask any questions we desired and take as much of their time as we needed. By the end of the morning, we had a much clearer understanding of what lies ahead and what is needed to get rid of this cancer that is a very unwelcome guest in my body!

Based upon all that we learned through the Cancer Clinic and prior consultations, we agreed that the mastectomy is the best course of action. While we had hoped and prayed for a different result, it was clear that this was the best course of action to maximize a positive outcome for my treatment. Because the cancer has spread into my lymphatic system, it will be necessary for me to undergo chemotherapy - Ugh! Additionally, I will likely need to undergo radiation therapy after the conclusion of the chemo. The goal of the chemo is to kill any cancer cells that might have spread into my body through the lymph system. The goal of the radiation therapy is to kill any cancerous cells that remain after the mastectomy. Of course the ultimate goal is to emerge from this process cancer free and I am prepared for whatever course of action gets me there.

In the intervening week and a half, I have been recovering from the first surgery and we have gone through the process of identifying a plastic surgeon. We have found one that we are excited about. The surgeon and the plastic surgeon will both participate in the next surgery (mastectomy) which is now scheduled for October 31st - Happy Halloween! That is the soonest we could coordinate schedules with both surgeons.

I am actually grateful for the wait time between surgeries. It is giving me time to heal and feel well again. Rob and I enjoyed a quick trip to the mountains for some 4-wheeling last week. I'm looking forward to playing in the garden a couple more times before the next surgery and winter set in. I enjoyed going to Jeremy's class for a quick, simple science lesson on chromatography of marker colors earlier this week. And, I appreciate time to be well and be with my family and friends.

So, here were are, not too much worse for all that we're starting into, full of faith and peace, and grateful for the love and support and prayers of family and friends. We'll get through this!