Surgery is scheduled for Wednesday July 3. After going back and forth, and meeting with two surgeons, I've decided on a double mastectomy. Bummer. Real big bummer.
Long story short, my surgeon at Group Health recommended that I get a mastectomy based upon my young age and the nasty nature of my cancer. I met with three doctors at Seattle Cancer Alliance, one of whom was the director of breast cancer surgery department. He suggested that I get a lumpectomy now, and pending the pathology from my surgery and a BROCA gene panel test, I may get a mastectomy later, or not. After thinking this was the better option, I discussed with my surgeon whether insurance coverage would be available to do this in a two-step process. She didn't think so--that a subsequent mastectomy would not be 'medically necessary' unless something funky showed up on my pathology or gene panel. If my pathology and gene panel are clean, I would be stuck with a lumpectomy. I don't want to close any doors. I'm not sure how paranoid I would be about the cancer coming back--but frankly, the tumor hid from me the first time around, and I don't feel confident I could find another lump if it came back--whether it were a recurrence of the same cancer, or a new cancer. So back to mastectomy it is. I go in sometime on Wednesday, and will come home on the 4th.
I wont be able to lift or carry West (or anything for that matter) for a couple of weeks after surgery. I'll have two or three drains that to deal with for about two weeks also. Breck is off work for the summer, so he'll be around to help me and the kids.
My pathology results will be in about three working days following surgery. My pathology results will dictate my personal prognosis. I definitely appreciate all of the good vibes, prayers, juju etc. coming my way that the cancer is gone or almost gone.
I will recover for a month, then start radiation. In a year, I can get reconstructive surgery. Not sure when that will happen. I will probably make a decision based upon how I recover from surgery, my pathology report, and my gene panel results. If something does come up on the BROCA panel, I may need to get my ovaries removed too.
The Seattle Cancer Alliance also reviewed my pathology and determined that my cancer tested weakly positive for progesterone--in other words, there may be some benefit for me to take endocrine therapy--hormone therapy-- after treatment. (I was diagnosed with triple negative cancer, meaning that there were no hormone-positive receptors that would respond to endocrine therapy. I was told that a cancer with weak progesterone receptors otherwise acts almost identically to a pure triple negative cancer) It was suggested that I take Tamoxifen for five years. The side effects of that are on par with menopause--awesome--so I may need to weigh the benefits on that.
An average woman's risk of developing breast cancer over her lifetime is approximately one in 8 (12.5%). If nothing turns up on the BROCA panel, my risk of developing a new breast cancer is slightly higher-about 16%. That isn't that high, but hell, I've defied the odds so far. My stupid insurance denied coverage for this test back in March. Since then, the Supreme Court held that a patent for testing on a specific gene isn't enforceable. It will now be more affordable to conduct the testing--and my insurance provider may be more likely to change its mind. I will appeal that after surgery.
Sooooo....grumble grumble grumble. On another note, Breck and I went camping with our friends last weekend on the annual rafting trip down the Yakima River. It was super fun, as always--despite the fact that we received an emergency text about a flash flood warning when we finished the float--oops--but no actual flood. I have about a million bug bites on my feet too. good stuff.
That's all for now.
Carrie
