[Note: A portion of this has already been posted on the other website.]
The surgical oncologist called late this afternoon with pathology results from my surgery. The news is not all good, but there is definitely reason to celebrate as they did get clean/clear margins and the cancer in the larger tumor (3.2cm - which IS better than being over 5cm) had not spread to the chest muscle or chest wall. This was a concern and had originally meant that radiation would be unavoidable. This is good news for sure!
But the bad news is that they removed four sentinel lymph nodes (I'm linking a description for the biopsy but you can google for more information) and one of them did have cancer present. This indicates that the cancer has moved outside of the breast, but it doesn’t necessarily mean that it has gotten very far.
It leaves the next step in limbo until we meet with the surgical oncologist and medical oncologist (chemo dr) next Wed, 5/16. In the meantime, both of them, along with the radiation oncologist will review my pathology results and discuss what course of treatment they would recommend. In most cases, when cancer is found in the sentinel lymph nodes, they would do more surgery (an axillary node dissection – again, feel free to google it) and remove a sampling of MORE lymph nodes from under my arm to see if there is any cancer. This is all just to get a better understanding of exactly where this cancer may be moving. The detection of cancer in other lymph nodes can help doctors find microscopic areas where the cancer may be trying to grow. Or at least, that is how I understand it.
What does this mean for me? Again, potentially more surgery under my right arm. Yuck. But really it just means that things remain uncertain until we meet with the doctors at Vanderbilt next Wednesday. And it allows more time for God to hear my prayers. And in the meantime, it means that I have to ask for even MORE PRAYERS. I am hopeful that they might wait and just start chemo first. And then I can only pray for lots of miracles and healing so that the doctors will find that no other cancer cells exist and radiation and additional surgery would not be necessary. THAT’S what this means for me.
More details for those who seek out the technical information:
The cancer has now been diagnosed as Stage IIb (2B). This doesn't mean much except that there are more standard courses of treatment (see NCCN Guidelines p 64, p69 - cancer spread to 1-3 lymph nodes so far, p76 - hormone receptor and HER2 positive and tumor is greater than 2cm but less than 5cm).
The doctor did mention something about possibly doing chemo prior to any additional surgery. And she also said that based on the tumor pathology, she would not recommend radiation therapy. BUT she wanted the radiation oncologist to weigh-in on the pathology reports and also get input from the medical oncologist. Apparently there might be some sort of radiation that could be done instead of more surgery to remove/test more lymph nodes? I am not clear on the details of that since she planned to discuss with them first and then meet with us next week. And she might have said something completely different than a radiation treatment as I am still taking pain meds due to the surgery last week, so I cannot be held responsible for any erroneous information. :)
That's about all I can manage to put into words this evening. I'm exhausted. Disappointed. And distressed. Initially, I really believed this was going to be the "easy" cancer. It was very treatable and somehow I felt that I could come through this quickly and with very little struggle. Obviously, that is not the case and it seems that each time we take a few steps forward, we end up getting throttled backwards by additional news that shocks me. Why? I have no idea. Why would this be easy? Why would I be spared any sort of suffering? Am I somehow more special than any of the other cancer patients? Nope. I am just another cancer patient dealing with this ridiculous cancer crap and wondering "How did I get here?" And clearly, I should jump right out of this delusional river of denial and into the cold and choppy ocean-like waters of reality. It's going to be a bumpy ride. I feel like I am going deep sea fishing on a raft.