Home from the consultation with my surgical oncologist. I really like her. She is caring and thoughtful and explained everything thoroughly. She even wrote notes for me as she went along so I would have it all written down and be able to refer to it later!
At my appointment, the doc explained that I have Stage 1, Grade 3 Invasive Ductal Carcinoma (abbreviated as IDC or IDCA). It is the most common type of breast cancer and has been studied extensively, so it’s generally quite curable, especially as Stage 1 cancer. I also have the hormone receptor positivity, which creates more opportunities for treatment. However, Grade 3 is the most aggressive grade you can have. My proliferation index (Ki-67, for those who speak cancer) is 98%. I read on the internet that anything over 30% is considered high, but the doc said it’s anything over 20%. The doc was like, “It’s not 100%, but it doesn’t get much higher than that.” And that’s apparently fairly unexpected with this type of cancer and is cause for some concern. (I mean, of course my cancer is an overachiever. Even my cancer is on brand, lol.)
We discussed treatment options. The first step will be surgery. I’ll be having a lumpectomy, where the doc will remove the tumor, as well as a buffer of hopefully healthy cells on all sides. The doc will also remove 1-4 sentinel lymph nodes from my armpit for biopsy. Luckily, these days they use dye to identify the arm lymph nodes vs. the breast lymph nodes, so I shouldn’t end up with lymphedema. As a massage therapist, I treated a fair few older folks for lymphedema and most of it was caused by removal of lymph nodes due to breast cancer. So, I was worried about that. I’m grateful they’ve made strides there.
I was also given the option of a mastectomy, but it wasn’t recommended and that makes sense to me. They want to do as little surgery as possible upfront so that I can heal up and get to the heavier-hitting treatments sooner.
My surgery is called “Right Lumpectomy with Intraoperative Ultrasound Guided Wire Localization, Local Advancement Closure and Sentinel Node Biopsy.” It’s a mouthful. Once they have the tumor, they will run additional tests on it that will help guide additional treatment recommendations. Currently, the doc believes that after surgery, I will need chemotherapy and then radiation. The chemo is because of the aggressiveness of my cancer. It’s not a sure thing yet but she feels it’s very likely. The medical oncologist will make an official chemo recommendation. I will hopefully see them about 3 weeks after surgery.
The doc also mentioned that sometimes more than one surgery is necessary. Basically, if they look at the buffer cells around the tumor and find any cancer cells, they then need to remove more cells because the goal is to get all the cancer out of my bod.
My surgery is scheduled for the morning of October 8. The doc wanted to schedule me for this coming Tuesday, but I have to see my PCP to do pre-op stuff beforehand and there’s no way that could happen in two business days. I also need to take at least a week off work, so a little extra notice for that will be good. (Although my client has been so thoughtful and accommodating of me. Always but especially since the cancer diagnosis.)
There’s probably more info I’ve forgotten to convey but it was A LOT of information all at once. But these are the major takeaways.
Originally posted on Facebook.