To Cut or Not to Cut?
That is the question. I'm open to possible answers.
I had my meeting with my oncologist this afternoon to go over my pathology report and discuss treatment options. Overall the information the report gives us is positive. But they didn't change their minds on the whole having cancer thing. There is no spread to the lymph nodes and the cancer is in the low-mid part of the spectrum as far as aggressiveness/growth rate. Still a Stage I cancer.
This, however, is where her agreement with the surgeon ends. Her take is that the tumor is 2.4 cm, which was its gross measurement, as opposed to the 1.8 cm that the surgeon suggested. She says the 1.8 measurement comes after too much handling and mashing and manipulating to be reliable, so as a rule they go with the gross measurement. That part doesn't change anything really.
While technically the margins were "clean" they are a little too close for her comfort. She prefers a margin that is 0.5 cm from any cancer. My report shows that on one edge the margin is 0.4 cm and another edge is less than 0.1 cm. She recommends that I have a re-excision to remove more tissue. I could have another lumpectomy, but I'm also a good candidate for a mastectomy because of reasons which I wasn't able to absorb after she started talking about more surgery.
She is now consulting with the radiation oncologist to get her opinion on the margins. Since the radiation is designed to treat anything that could be lingering in the breast, she's the doctor who will have to deal with this directly and her opinion is important. If they agree that more surgery is needed, I guess I'll have to talk to the surgeon again.
I'm not jumping up and down at the prospect of more surgery, but I'd much rather have more surgery than have cancer again in a few years. I'm hoping that all three doctors can come to some sort of agreement, because I really like all three of them and don't want to be in a position where they can't agree and I have to pick one over another.
Once we got past all of that, we were on to talk of chemo. I will have 4 courses of AC (Adriamycin/Cytoxan). I will receive one treatment every three weeks, so chemo will take twelve weeks. I have some more information to read about these drugs to really get a handle of what I'm in for. If I don't have any more surgery, this will start probably the week after Easter. If I have more surgery, probably 3 weeks after that.
I have a prescription for a "cranial prosthesis" so now I can go wig shopping and insurance will have to pick up some of the cost. She said the incision which I was so upset about last night was healing nicely, so looks like all that crying was for nothing.
So now, more waiting. I will wait to hear tomorrow what the radiation oncologist thinks I should do and we'll go from there.
I had my meeting with my oncologist this afternoon to go over my pathology report and discuss treatment options. Overall the information the report gives us is positive. But they didn't change their minds on the whole having cancer thing. There is no spread to the lymph nodes and the cancer is in the low-mid part of the spectrum as far as aggressiveness/growth rate. Still a Stage I cancer.
This, however, is where her agreement with the surgeon ends. Her take is that the tumor is 2.4 cm, which was its gross measurement, as opposed to the 1.8 cm that the surgeon suggested. She says the 1.8 measurement comes after too much handling and mashing and manipulating to be reliable, so as a rule they go with the gross measurement. That part doesn't change anything really.
While technically the margins were "clean" they are a little too close for her comfort. She prefers a margin that is 0.5 cm from any cancer. My report shows that on one edge the margin is 0.4 cm and another edge is less than 0.1 cm. She recommends that I have a re-excision to remove more tissue. I could have another lumpectomy, but I'm also a good candidate for a mastectomy because of reasons which I wasn't able to absorb after she started talking about more surgery.
She is now consulting with the radiation oncologist to get her opinion on the margins. Since the radiation is designed to treat anything that could be lingering in the breast, she's the doctor who will have to deal with this directly and her opinion is important. If they agree that more surgery is needed, I guess I'll have to talk to the surgeon again.
I'm not jumping up and down at the prospect of more surgery, but I'd much rather have more surgery than have cancer again in a few years. I'm hoping that all three doctors can come to some sort of agreement, because I really like all three of them and don't want to be in a position where they can't agree and I have to pick one over another.
Once we got past all of that, we were on to talk of chemo. I will have 4 courses of AC (Adriamycin/Cytoxan). I will receive one treatment every three weeks, so chemo will take twelve weeks. I have some more information to read about these drugs to really get a handle of what I'm in for. If I don't have any more surgery, this will start probably the week after Easter. If I have more surgery, probably 3 weeks after that.
I have a prescription for a "cranial prosthesis" so now I can go wig shopping and insurance will have to pick up some of the cost. She said the incision which I was so upset about last night was healing nicely, so looks like all that crying was for nothing.
So now, more waiting. I will wait to hear tomorrow what the radiation oncologist thinks I should do and we'll go from there.
Comments
I have another thought on helping you make the decision on more surgery. I had an even smaller tumor, 0.8 cm, albeit grade 3. I did the lumpectomy and node biopsy in May, then chemo in the summer and then had a bilateral mastectomy and reconstruction in September. Part of what guided my decision to do so were the odds quoted to me by the genetic counselor of getting ANOTHER breast cancer in the future. Not a recurrence of this one, but starting all over with a new primary in a breast again, even if I did not have one of the known genetic mutations. Didn't like what I was told, so that was that.
Just more food for thought!
I'm rooting for ya!
Love and hugs (many big ones...the kind you hate! ha!!),
Suzan