Tuesday, March 4, 2008

MRI follow up ~ more cow bell in my future

Dr. Specht called yesterday (Monday) morning to tell me that the MRI results showed nothing brewing in my right breast, hurrah, and nothing much more in my left, with the exception of a chunk on the superior side (up towards my chest; the cancer is on the right side of my nipple of my left breast, just to orient you) that still needs to be removed. Good news: no cancer in my right breast. Bad news: nothing to help make the decision easier as to mastectomy vs. lumpectomy. Dr. Specht offered some odds: that there is a 60% chance that I would still have to have the mastectomy after the lumpectomy. I consider this, along with radiation and the prospect of heading down to Cooley Dickinson five days a week for 4-6 weeks for radiation after a trip through chemo country, and remind myself that the radiation possibility exists even with mastectomy if for some reason the margins still come back not quite "clear." That would suck.

At this point, I am leaning towards a mastectomy, with reconstruction--no tummy tuck, no borrowing lat muscle, just a simple silicone implant, done with expanders. I'll tell you more about that later. But isn't it funny, how so many people like to slide in the idea of the silver lining--that if I went with mastectomy with reconstruction, I could make my breasts larger than they are now. Have larger breasts. Larger. As if they've done away with stickers, and are giving away larger breasts as prizes now. And just what would I do with larger breasts? I like my girls just fine the way they are, don't I? Is there some reason why I shouldn't?

More good news: she can possibly do the surgery--whichever I ultimately chose--as soon as March 17th or 24th. I await a call to confirm. Also, I must meet with the onco plastic surgeon and have pre-surgery tests and consultations with the anesthesiologist, etc on the 14th, the Friday before Dad and Mimi's wedding ceremony in Salem. I would meet with the general oncologist to map out a treatment program soon after the surgery, and once the pathology is known (either surgery will include a sentinel, or guardian--the first node in the system of ducts and lobules--lymph node removal and biopsy, which is analyzed at the time of the surgery so that in the event it tests positive for cancer, the remaining nodes can be removed then and there), this program can be relayed to the oncologist closer to home, for easier treatment that will be overseen by the Boston onc. There's a chance that this person might be a Dr. Younger, who was my grandmother's oncologist for her second go around with breast cancer. How crazy is that!

So, the road ahead is further mapped out. Dr. Specht says that after the more frequent follow-ups following the surgery, I would have to meet with her for yearly follow-ups, have a breast MRI once a year (oh, joys, I do hope they get the protocol right), and mammograms twice a year. Given all that, it makes perfect sense that I go with her--I figure that the distance becomes obsolete when the continuity of excellent care is at stake.

More later. I am all blogged out. But I am grateful for the chance to air out some of this angst and confusion, to bounce some things off you, to find my voice in this process, and regain some sense of purpose and direction. Thanks, as ever, for listening.

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