My surgery is confirmed for April 23rd. When we discussed all of the options with my surgeon, my choice is to have a total mastectomy, without reconstruction, with a sentinel node biopsy. You can read more about that here It seems to be the safest route to go from both a cancer fighting and complication standpoint. I was able to get in more quickly for the surgery, the recovery time is shorter, there's fewer complications, and there will be shorter delay in starting chemo if that is what they decide I need. I learned that my tumor is strongly estrogen and progesterone receptor positive, and HER2 negative, which my doctor says is actually great news because it means the cells are at least trying to behave like normal cells instead of cancer cells, and it means some endocrine therapies will likely be an option for me. I was glad for that piece of good news!
There are a lot of decisions still to be made, and I have several appointments over the next week. I see a genetic counselor today to discuss testing for the BRCA1 and BRCA2 genes. A positive test would help us make decisions on having a double mastectomy instead of just the left. I have an MRI to check for lesions in the right breast on Tuesday. Please pray that this is negative- if something is found, it will delay the surgery process as we will have to go through biopsies of that site to determine if it is actual cancer or a benign lesion before we can make a surgery decision. I have pre-op teaching with my surgeons nurse to learn about the drain I will have in after surgery and how to care for my incision sites. I am also going to meet with a plastic surgeon to discuss options for reconstruction down the road. I just want to get this cancer part over with first. The last thing I have is an appointment with solid tumor oncology to talk about chemo. There is a small chance that I might not need it if my "oncotype" is favorable (another test they will perform on the tumor now that we know the receptors are positive) and if I have no cancer cells found in my lymph nodes during surgery. My surgeon thinks I will likely have to do chemo because my age is "less than 35 at diagnosis" which is unfortunately associated with higher re-occurrence rates. At any rate, there are still many things up in the air, but we have a plan for a first step in treatment which is having the mastectomy. (I still can't believe I am typing this.)
I've spent some time trying to get organized, and have delved into a little project to spruce up my bedroom decor in anticipation of spending some time in there. Mostly I am trying to pick up my babies as much as possible since I won't be able to lift for a few weeks after surgery. Having a Meghan makes this more complicated as her main mode of transport is still rolling around:) We will figure it out.
Despite the absolute awfulness of this diagnosis, I am already beginning to see God working through this situation. The blessing of having THE BEST friends in the universe (seriously, my girls know how to rally). Fresh appreciation for my family and my sweet daughters. Meaningful conversations. Genuine and overwhelming love from my friends and family. The gift of the living word of God breathing life and hope into my heart. This is the stuff that I will choose to focus on- the blessings- in the days and weeks to come.
"though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that the proven genuineness of your faith—of greater worth than gold, which perishes even though refined by fire—may result in praise, glory and honor when Jesus Christ is revealed"
1 Peter 1:6-7