1st dr. appt. & telling the girls

What a big day! And I'm feeling very optimistic and almost upbeat.

Today Arthur and I went to this 1st appointment with the surgeon who did my biopsy. He seems to be a kind man who was able to explain things in an understandable yet non-condesending manner. He went over the pathology report first - last night I was able to read up through the section on "understanding your pathology report" in my new book so I felt somewhat familiar with some of the terms and explanations.

*My tumor is in my right breast and is approximately 3cm x 3.2cm x 2.4 cm.

*Five tissue samples (from the core biopsy done on 6/21) of approximately 1.3 cm in length were examined by microscope.

*It was determined that I have Invasive Ductal Carcinoma. This means that cancer cells are present in the ducts (the tubes in which the milk travels - milk is actually produced in lobules) of my right breast and that the cancer cells have moved out of the ducts and into other breast tissue.

*Additionally, the cancer cells have been given a "grade" (Bloom-Richardson Grade: I, II, III) to tell how aggressive the cancer. The cancer cells I have received a grade of III. This was determined by how much the examined cells looked like normal breast tissue cells. The closer to normal they look the lower the grade. If the cells don't look anything like normal breast tissue cells they are given a grade of III, which is the most aggressive.

*My cancer cells have estrogen receptors and progesterone receptors. Both of those are good - but I don't understand 100% why yet.

*Finally, my cancer cells have minimal HER2 (a specific type of protein that stimulates cancer growth) which is a good thing.

OK, this may be waaaaay too much breast information for some of you, but as any good teacher knows, it helps a student (me) learn by teaching others (most of you).

So what all this means I have a pretty big cancerous tumor that needs to come out relatively soon. The dr. proceeded to explain that we needed to go about finding an oncologist. This is the dr. we would be spending lots of time with over the next God only knows how long, therefore it is important to find someone with whom we feel comfortable and confident. He gave us 3 referrals. Some of you have shared your recommendations. Please feel free to share with us if you have someone who you think is good.

Finally he explained the surgical options:

1. there is a lumpectomy - a surgeon would go in and remove the tumor plus some of the healthy tissue around the tumor (the margins). While in there, the "sentinel lymph node" would be examined to see if it has cancerous cells present. If it does, the surgeon will remove the effected lymph nodes. With this surgery, 2 incisions are made. After surgery, radiation is often needed as well as chemotherapy. Additionally, up to 25% of the cases, when the margins are examined it is determined that the surgeon must go back into because "the margins are not clean enough" meaning the breast tissue is not as clear as they would like it to be. Finally, because my lump is pretty big, I may end up with a mis-shaped boob!!

2. there is a mastectomy - a surgeon would go in and remove all of the breast tissue in the right breast. The same examination of the lymph nodes would be done and removed if necessary. Re-construction (if wanted) can be done or at least started (depending on type of re-construction) at the same time, in the same surgery, but by a plastic surgeon. There are many other details around this surgery that I will save for a later date. I don't want to tell you all the fun stuff at one time!!

He said the decision about what surgeon to pick, what type of surgery, the oncologist, etc were all up to us and that while time was a concern, it needn't be rushed. Which brings me to my plan of action. After my hair appointment tomorrow - you may wonder, like Arthur, why am I having my hair done when I may be bald soon? My thought was if it was shorter and blonder maybe no one would notice if it all falls out! :) - I will call a few doctors and try to step up a couple of appointments for the end of next week. The holiday may make it a little difficult, but I will try. I'd like to be ready to make a decision about surgery and have an oncologist by July 16th. Too hopeful?? Maybe, but at least it's a goal.

Now on to the most anticipated part of my day - telling the girls. They were at a girlfriend's house during the appt. As we picked up the girls afterward, Arthur and I were greeted with a wonderful dinner! (thank you!!) After we got home, we brought the girls up to our room, all plopping on the bed and proceeded to share the news of the cancer in mommy's breast. We told them all the facts we knew, what will probably happen to my breasts, that I maybe sick afterward if/when I have chemotherapy. We showed them the short book I got and the pamphlet we got from the doctor. We were honest and upbeat. We told them after tonight most everyone we knew would know the news. We told them they could come to us with any questions and/or anything they might hear that scares them. We ended by asking them if they wanted to see the incision from the biopsy or feel the lump which got a rousing "eeww, no!!!!" :) As you know about us, we try to be open and honest with them, so please don't hesitate or feel the need to hide information, emotions, etc from them. We will be using the word "cancer" in our house not "the c-word" in hushed tones. I will begin looking into a support group of some sort for them, so if anyone knows of one, please let me know.

As for me, I'm feeling really good tonight. I think I got more information from the appointment than I thought I would. And it was encouraging to have Arthur ask the doctor some questions and know what page I was on in my questioning. (I know he will be a support beyond words, for me, and especially for the girls. ) Another reason I feel encouraged was the how the doctor presented everything - assuring me that my treatment options were fantastic, and that, sadly, due to the proportion of women being diagnosed (1 in 8 women will be effected by breast cancer!! CRAZY, huh??) treatment has progressed amazingly.

Thank you all for taking an interest in me and my family, and for reading this breast cancer dissertation!! I will continue to update. Much love and peace to you all!