18 August 2011

Today I met with my breast surgeon for the first time. Dan came with me. You know when you go to a doctor for the first time and you have to fill out forms full of really inane questions?

What problem are we seeing you for?
I have breast cancer.
Where is this problem?
Um, in my breast.

Who writes these things?

(Dammit Jim! I'm a doctor, not a form writer!)

So I filled out 5 or 6 pages and then the very good nurse came to get us and did some preliminary stuff, (temp, weight, bp, etc.) and gave me a pink folder full of pink brochures full of information I'm sure I can find from gender neutral colored sources online. The room was pink. I think they are taking it a little too far - like when Miriam, at 20 months, refused to wear anything that wasn't purple. But I digress.

In waddles Dr. Boob, who is VERY pregnant. How can she lean into the table with that basketball in the way? I mean, my boobs are big but they can't compete with a 6 or 7 pound baby. Still, I was willing to listen to what she had to say.

So she shows me my last two mammograms, on which the lump is still barely visible, even with the titanium marker in it. She goes over the pathology report and starts making notes and drawing pictures on a piece of paper. The path report findings show the mass is both estrogen and progesterone receptor positive. That means we will have good results with hormone therapy. We should know in the next few days about the Her-2 status, another way to manage through hormone treatment.

My mass (it's not a tooomah,) is 1.5 cm by 1 cm. It's smaller than I thought, but then again, when I was feeling it, I was also feeling the inflamed tissue surrounding it. She did an exam and reassured us that as far as she could tell, my lymph nodes looked clear and along with the pathology report she felt that we were in an early stage. It was better news than we had expected.

We talked a little bit about risk factors and we told her we definitely wanted the genetic testing done. The BRCA gene is a marker for high risk. With my mom having died of breast cancer, and having several other cases in the previous generations on both sides, along with being of Eastern European (Ashkenazic) Jewish descent, and now with a positive biopsy under the age of 50, I have a likelyhood of having BRCA1 or BRCA2. Having this gene puts me at a 85%(?) risk of developing cancer and greatly increases the risk of recurrence. They did a saliva sample in the office today and it will take 7 - 14 days for results.

The geographical location of the mass simplifies our choices. Dr. Boob recommended a unilateral simple mastectomy with reconstruction. We also discussed a bilateral. I'll be having an MRI for right and left and into the armpits to see the nodes. That will be scheduled next week.

I haven't done any research into reconstruction, and that really wasn't her thang, so any questions I have about that I will direct at gals who have had it done, as well as the plastic surgeon she's setting me up with. I'm really on the fence about it. After years of D cup backaches and never finding a button up blouse that fits, the idea of nothing is pretty intriguing. And a solid B sounds good too.