Today I had my second meeting with my Breast Surgeon, henceforth known as Dr. Boob. (No reflection on her competency, but I wanted to afford her a little more anonymity.) She had news for us. First, my tumor is HER2 negative. This is good news, because HER2 is a marker for aggressiveness. So the oncotype of my tumor is the best I could hope for: ER positive and HER2 negative. It's the most common, best known. Second, the MRI shows my right boob is clean. So they won't have to do a sentinel node biopsy on the right. The MRI found another tumor in the left boob, but it is right behind the first one, which is very close to the surface, so I have plenty of room behind it to assure a clear margin. (The tissue left behind.) I'm already opting for a mastectomy, so this really has no bearing. The MRI also showed some activity in the nodes, but she said it did not look like cancer, just some inflammation either from my two bouts of ear infection/bronchitis in the past 5 months or my ongoing hay fever.
We spent a lot of time grilling her about surgery and talking about the two plastic surgeons I had seen. She told us her experience with both of them and gave us some additional information about the differences in their methods. After considering all the information, I (with Dan's blessing) decided to go with Two-Drain. Let me explain....
When I first met with him, he rubbed me the wrong way. However it is quite possible I just was not ready to hear what he had to say. I had been hoping to avoid an implant, and he said I wasn't a candidate for FLAP. (Where they use my own tissue.) The second opinion was the same. He also assumed I was going to want a reconstruction when I hadn't yet wrapped my head around it. The second opinion was the same, but by that time I had made up my mind. Thirdly, he came off to me as terse. Dan took it as fact/science based. The second reconstruction surgeon was much more it's-whatever-you-want-you-are-in-charge, which at first blush sounds great, but she's the one who has been doing this for 20 plus years and I've never done it and we could really use some recommendations from her as to what works and what doesn't. Two-Drain explained what he wants to do and indicated he does it like that based on his past experience. After Dan and I discussed it again today. I agreed that his method sounded safer for me. (And Dr. Boob agreed.)
So we are still on for the 16th, but with Dr. Boob and Two-Drain.
Sweetie, we don't know the "oncotype" yet. That won't be known until a more comprehensive pathology is done after surgery... but the underlying point you are making is correct.
ReplyDeleteThere's no question that surgeons would benefit from learning/using "clinical counselling" techniques. They just don't seem to understand the psychological dimension of what they are doing. It isn't JUST surgery.
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