Patience, The Results and a Partial Plan

In case there has ever been any doubt, patience is not amongst the virtues I possess. 


It has been a long week waiting for the biopsy results and the phone call that would give us our game plan for treatment.  When the pathology report was not back late Friday afternoon, I was sure we'd be waiting through the weekend for the results.  However, the truly awesome Dr. Neumayer, called late last night and we discussed the report with us over the phone.  I think she gets my type 'A' personality.  

As expected, the 3.4 centimeter mass detected in the MRI is invasive cancer.  To our surprise, it was Invasive Ductal Carcinoma with Lobular tendencies.  What?  In all our reading, we've not come across this particular diagnosis and based on the previous pathology report, we thought it was Invasive Lobular Carcinoma.  Dr. Neumayer thinks its fascinating.  In the end, it doesn't matter what it is called as the beginning of the treatment plan is the same.  

The pathology report still showed a strong hormone receptor result which is great news.  The hormone treatment (Tamoxifen) for 5 years will produce great results.  Dr. N offered us a clinical trial which was designed to track if women, who take the treatment before surgery and see a positive impact on tumor size, stick with the full 5 years of treatment. We agreed and will start that at least 7 days before surgery. 

Another change from the last pathology report to this one was the HER2 result.  It is now 'borderline' and will be sent for some extended testing.  This is the 'accelerant' which, when positive, causes cancer to grow like gas on a fire.  If that comes back positive, chemotherapy will be necessary. 

So - the beginnings of a plan!  We are scheduled for surgery on October 12th.  They'll verify that Dr. Agerwal (plastic surgeon) is available but that is our date right now.  Given a variety of factors from the test results, mastectomy of the left breast is a definite.  We are going to do a mammogram of the right breast to ensure it is not necessary to remove that one as well but, for the moment, that doesn't appear to be the case.  The results of the BRAC test will also help us with that decision.  At the time of surgery, they will test the Sentinel Lymph Node.  If they find any cancerous cells, chemotherapy after surgery will be necessary. 

So to recap - what gets me chemo?  If the HER2 comes back positive from the extended testing or if the Sentinel Lymph Node has any cancerous cells when it is tested during  surgery.  We are pleasantly surprised that it isn't already a given and are accepting all positive energy, healing thoughts and prayers on this one!! 

Probably the best piece of news for me was when Dr. N reassured us that the breast lift was truly a miraculous intervention and not an unfortunate complication.  She said that it was highly unlikely that even this year's mammogram alone would have indicated that this lump was cancer and that it would have likely grown for a least another year before it was caught.  It was the fact that Dr. Saltz (my sweet plastic surgeon) happened to remove those two small pieces (each millimeters in size) that may have saved my life in the long run or at least spared us a more challenging fight.

Many thanks to all our wonderful family and friends who've been by our side on this crazy roller coaster of a journey.  We've appreciated the hugs and hand holding...and most especially the patience (a virtue we appreciate that others possess) as we've been a bit 'hyperfocused' on gearing up for the battle to come.  We love you all.