Day 10b: Diagnosis Part II – Today was a long day filled with more information and more testing. Where to start? Met with the surgeon, we talked about many things.
Grade: I have an “estimated” Histologic Grade of 1 and an “estimated” Nottingham Grade of 5-9. Right now we are considering this to be a low to moderately aggressive cancer. This is estimated because we do not know yet whether or not the lymph nodes are involved and they are the keepers to much data it would seem.
Hormone Recepters: One of the tumors is 100% ER and PR the other was 100% ER and 98% PR, don’t get much more strong hormone receptors than these… this means that a hormone receptor blocker will be in my future and it also means no estrogen or progesterone for me… like ever. Was also told to expect the oncologist (yet to meet) to prescribe something like Tamoxifen for a minimum of 5 years.
Ok, Stage. This is the tough one – we just don’t know and won’t know until we get more information on the lymph nodes.
So next steps:
- Blood work-ups which include liver, CA15-3, Vitamin D, and other such stuffs. Did that today
- Chest x-ray, did that today
- MRI, the doctor is getting approval from insurance, so that should be next week.
- Meet with the plastic surgeon (next Tuesday) and discuss simultaneous or delayed reconstruction – I prefer simultaneous, apparently this guy prefers delayed, so I am looking for a referral for someone so I can get a second opinion there.
- Meet with surgeon again next week
If anything in the blood, chest x-ray or MRI look abnormal I may be sent for a PET Scan to get a head to toe.
Surgery: Lymph Nodes
They will do a sentinel node biopsy during surgery
I lose the left nipple regardless of which option I choose. Options are: mastectomy or a lumpectomy (partial mastectomy). Because the nature of ILC is such that it is difficult to detect, slow moving and branches out not necessarily creating palpable tumors or lumps, I am opting for bilateral mastectomy. It is also possible that oncology treatments will be easier with a bilateral mastectomy, again, depending on lymph nodes.
For the left nipple replacement I am looking for some great artwork of the Yai-tzu dragon, the protector and guardian against any physical harm. So feel free to post any cool Yai-tzu art you find to my wall or send me a message.
Timeline: Waiting on insurance for MRI.
Treatment is simple…
1) Hormone blockers
3) Potential radiation Therapy
Seems like a simple 4 part plan to me.