Tomorrow I have a post-op appointment at my surgeon's office. Recovery has been going well. The hard part is really forcing myself to not do too much at this point. I've been feeling pretty good but can tell if I have been reaching too much or lifting things that I shouldn't (like the world's cutest 3-year-old) and things like that. It's not bad, like maybe a 1 or 2 on the "pain scale" but just the fact that it's there at all sucks and sometimes at night it's kind of achy. Our new memory foam mattress topper feels really good when I lay down and it kind of cradles around my arm/side and body, I'll tell you that! I'm also getting good use out of the many boo-boo ice packs we have for the kids. They are the perfect size and feel good on my weird numb skin. Also, I'm kind of tired of wearing a bra (even a really comfy one) 24-7. But not tired enough to not do it... it definitely feels better to have one on! I wore just a tank top the other night but decided I will wait a while more before doing that again.
My surgeon was pretty amazing. According to the pathology details the "mass" she cut out of me and sent to the lab (including margins) was 5.5 x 4.7 x 2.2 cm. I realize that's pretty small, but as far as I can tell there is no dent or anything like that and the line of the incision is tiny. I'm sure the location helps too. The tumor was on the side near my armpit - "10 o'clock" on my boob "clock" - where there is lots of tissue and also not too far from the chest wall. The lymph nodes were a lot smaller but same thing. I'm not going to lie, once I was home I kept thinking about how I was thankful that I was able to have a lumpectomy. Every time I was in front of a mirror I would think how different I would be feeling if I no longer had breasts. If my situation had been different and it would have improved my prognosis I would have done it without hesitation, but I can only imagine how difficult it would be emotionally and also physically. I have a huge respect for any woman who has gone through it.
On Friday I met with my oncologist, Dr. Bridges. I liked him. He was personable and easy to talk with, had a sense of humor, and also seemed to know what he was doing (always a favorable trait in a doctor). He is my medical oncologist who deals with chemo and eventually hormone therapy.
He said, "So, do you know why you're here? What I'm going to talk to you about?" I said, yes that I thought he would go over my final pathology report and that I hoped he was going to tell me I wouldn't need chemo (because no cancer in my lymph nodes so *fingers crossed* no chemo, right?).
Unfortunately, he did not tell me that. Damn!!! He didn't say I would definitely need chemo either, so that's good I suppose.
Instead we talked about the Oncotype DX test (which I was somewhat familiar with and had on my list of questions). It's a genomic test that looks at 21 genes in my cancer and how they behave in order assess my risk of the cancer returning and if I could benefit from chemotherapy. The test assigns you a score that indicates if your recurrence risk is low, intermediate, or high.
My cancer was changed to Grade 2 in the final pathology. It was Grade 1 in the original biopsy. Grade refers to how abnormal the cells are and is related to how aggressive the cancer is (1 being the closest to normal and 3 being highly abnormal). So unfortunately when they had more cells to look at they were a little worse than originally thought. The size hadn't really changed, it was still 1 cm. It's definitely hormone receptor positive (strongly positive he said with 95% of cells being positive). It's HER2 negative (although it's possible this could change as they will retest HER2 status when they do the oncotype test).
Dr. Bridges said my cancer is officially Stage 1. (I think it was Stage 1A plus some other letters that I didn't write down and now can't remember. Oops.)
Regardless of being Stage 1, which I am very happy about, according to my doctor and the NCCN (National Comprehensive Cancer Network) guidelines I may benefit from chemo depending on my oncotype score. In fact, my oncologist said if this test didn't exist, he would recommend chemo for sure.
I have this sinking feeling my score will come back in the intermediate range which means I may or may not benefit from chemo, but my doctor said he would recommend it unless my score is in the low risk end.
And so that means I am back to waiting for test results. The Oncotype DX test takes about two weeks to get results back. Even though waiting is really, really difficult, I am thankful that this test exists as I think it's relatively new (10 years?).
I will meet my radiation oncologist on January 26 and then I have another appointment with the medical oncologist on February 3. Hopefully at that point we can get my treatment plan nailed down and start moving forward, again...
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