Step 1: Meet with the Surgeon

There is something reassuring in knowing details. Once we know what is going to happen, we can accept it and go forth. It is the not knowing that keeps you up at night. As someone who often flies by the seat of her pants, this is a fairly new realization for me. This is why people find out the sex of their baby or hire a financial planner... to plan ahead.

The appointment with the surgeon went well today. Dr. Preier might only be as tall as Ella and have ice cold hands, but she definitely knows her stuff. Tim and I really like her. We discussed several scenarios; she drew pictures, wrote down definitions and read my nonverbal cues when I didn't understand specifics. We feel we are in good hands. 

The low down: We are starting with chemo first to reduce the size of the tumor. We will meet with the oncologist next Monday and probably start the following week or so. The 3.1cm tumor is very close to the pectoralis muscle and is pulling it upward. Chemo should help reduce this pull of the muscle, which is what is causing the pain in my chest. She hopes it is just the pull that is causing the 'shadow' on the muscle images and that the cancer cells are not spreading. We have another MRI & biopsy in the next day or two so we can rule out another area that also looks suspicious in between the tumor and the nipple. We can not meet with the oncologist until we have these biopsy results because it will help determine the treatment.

We are also waiting for the HER 2 test results, which will determine the type of chemo that is used. We know the estrogen & progesterone receptors were negative, so if the HER is negative as well, then I will be classified as a triple negative, which would mean approximately 5 months of chemo, if it is positive we will have about 4 months. 

It is difficult to classify me as a specific stage. It depends upon: 
A) If the cancer has not spread to the muscle: Stage 2a
or
B) If the cancer has spread to the muscle: Stage 3a 
We will not actually know about the muscle until after the chemo and we see how it responds. Hopefully, the tumor will shrink and the muscle will go back to normal. For either stage 2 or 3 the treatment would be similar at this time, so we are not getting hung up on the stage thing. This is a number people use regardless of the differentials and it serves no purpose than to instill fear. I'm not biting because it serves no purpose in my recovery. 

Good news: As far as we can tell, the cancer has not spread to my lymph nodes. They will not know for sure until they do the surgery, take out a few lymph nodes and dissect them.  By then, the chemo should kill any cancer cells (including any that might have spread) so the process is more of a precautionary ruling out.

Radiation & Surgery: Please do not ask if I am getting a lumpectomy, mastectomy, double mastectomy or radiation because we have no idea. It all depends upon how I respond to the chemo over the next 4-5 months. The surgeon went through all the surgery options and we will consider all the facts and make the appropriate decision at the appropriate time. I get to keep 'the girls' for a little longer, which is fine by me.

Am I similar to Angelina? Maybe, but not in a way I would prefer. We will undergo some genetic testing to find out if I have the BRCA1 or BRCA2 gene mutations. With my sister's history of ovarian cancer when she was young and my mom's DCIS pre-cancer a few years ago, there is the chance I may carry the gene. This knowledge may effect our surgical decisions. 

Okay, that's it for now. We have a plan. I will let you know when chemo starts. 
For now, I am heading to class and then to Annee's BBall game. Go Capital Eagles! If they win tonight, they will go to the district JV championship!  Go baby Wooz!