I’ve finished 4 out of the 6 chemos in my initial series. (Hopefully my only series!) It was a good time to check in with my surgeon about all that has changed since my initial diagnosis: cancer in my lymph nodes, chemo before surgery, etc. My surgeon is really amazing at considering both data and a patient’s emotional needs in surgery decisions. (Math and mental health, both important!) Some patients’ quality of life requires that they accept a small risk of recurrence to keep more of their breast tissue. Others weigh the risk of recurrence more heavily and wish to take a more aggressive approach. I fall into the latter category, reinforced by the fact that I have an aggressive cancer in one breast and imaging shows an undiagnosed spot in the other breast as well. For these and many other nuanced reasons, I will have a double mastectomy at the beginning of August.
Other things will not be decided until the surgery itself. Generally if a person is node-positive, the surgeon will remove all axillary (armpit) lymph nodes on that side. This, however, greatly increases the risk of lymphedema which is no fun at all. So the surgeon will discuss with his team whether the aggressive characteristics of my cancer make me high risk for recurrence. If the consensus is that I am not, then he will only remove all the nodes if necessary. He’ll biopsy the sentinel, or gatekeeper, nodes to determine this. If cancer is still present in those, then a full removal will be necessary. So that will not be determined until I’m lying on the table.
The pathology report from my surgery, both nodes and breast tissue, will guide my treatment plan afterward. Remaining cancer = more chemo. Either way, I also have a course of radiation ahead of me as well as several months of a targeted therapy via my port.
Making progress on this marathon.
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