Day 50: Post-op, pathology, staging, decisions and drains oh my!

WOW!  Where to start.  Today is a very mixed bag of good news and not so great news.  I am going to let the words flow through my fingers and try not to over think it.

Starting with some of the good news from the post-op appointment.  The drains are out and the surgical sites look FABULOUS.  The tissue is healthy and clear and it truly looks great.  Having the drains removed did smart a little bit, ok, right drain #2 smarted a lot… and I dropped the “F-bomb” again… but the doctor was very understanding.  Having the staples removed did not hurt at all.  I am still a day away from a shower though.

Pathology report was not what I was hoping for, yet was not a surprise either.  We only removed the sentinel lymph nodes, of which there were two.  Unfortunately both of them came back metastatic carcinoma.  Lymph Node #1 had a metastatic deposit of 1 cm and #2 had a deposit of 0.4 cm.

The tumor size was 6 cm, however it was a dumbbell type shape due to the type of cancer being mostly lobular.  So this was more like two tumors that were connected by a string of cancer cells, normally this would be a T3, but pathology called it a T2.  Something a little scary was that the ILC showed positive dermal involvement, as did the nipple.  Just amazing that it had reached the skin and nipple.  DCIS was also present, but was a minor component of the tumor (5-10%).

So, there is some good news in all this… the margins were negative, which is great news!  I high-fived my surgeon.  The metastasis was NOT blood.  It was only in the lymphatic system.  Still a bummer, but not as bad as it could have been.  Also, prior to surgery they had me listed as a Stage 3, today they backed it down to a Stage 2.  We will see if it changes again tomorrow when I meet with the oncologist.  😉  Oh and the right breast, which we removed preemptively, had a few fibrocystic changes with no significant pathological changes to the skin or nipple and no evidence of malignancy.  YAY!

So, as far as decisions… I talked with the surgeon about lymph nodes.  The typical recommendation is that they open me back-up and remove the rest of them.  However, I don’t want that.  I looked at the surgeon and said, “Cancer really is an SOB isn’t it?  I mean, you are damned if you do and damned if you don’t… pick your poison kind of thing.  If we do surgery and remove the rest of the lymph nodes we know the terrible and permanent side effects afterwards, however the only way to “clear” me of this cancer surgically would be to remove them all… but we are just guessing that there “might” be “more” in the lymph nodes.”  I swear he looked a little sad as I said it.  He did not disagree.  This is but one of the many frustrations with cancer.  No more lymph node removal though, final answer.

So tomorrow at 8:45 am I meet with the oncologist again.  We know the recommendation will be for targeted radiation to the lymph nodes on the left with a recommended chemo regiment.  We know I don’t to do that.

On the one hand, reading pathology today and knowing my own research, I can’t help but feel I was given a death sentence today… or at least put on an accelerated schedule… but on the other hand, I have never rolled with the averages in my life… why start now?  So I intend to remain an “outlier.”  🙂

So… no more fooling on the diet, time to go pH for realz.  Also time to better understand the use of essential oils for breast cancer, as well as meditation, yoga and massage.  Also time to get serious about a visit to an alternative treatment center and of course ask my oncologist about these things in the morning.

Good thing I love research.  🙂

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