I am besides myself right now, so much so that I can’t even say this out loud – I am only writing it here. There is a report in my medical portal from the biopsy of my abdomen yesterday. Although there is no pathology, these words are crystal clear:
PRE-PROCEDURE DIAGNOSIS: Breast cancer
POST PROCEDURE DIAGNOSIS: Same.
Now, I think this is actually the coding they use in order to justify the need for the biopsy. There is no pathology, like I said, and lower down on the page, it says:
SPECIMEN: 3 14-gauge core biopsy samples were submitted.
IMPLANTS AND MECHANICAL DEVICES: None.
See how that “Findings” section is empty? I think that is where they will put the pathology. But in prior biopsies I’ve had, there is a statement at the top or somewhere — anywhere — that says something about pathology to be added in an addendum. I mean, it would be strange for there to be a diagnosis this quickly – pathology requires staining of the samples that have to sit over a period of time. It hasn’t even been 24 hours. But there is no mention of an addendum to be added. And, “DIAGNOSIS: BREAST CANCER” is not what I like to wake up to first thing in the morning. I emailed Dr. McAuliffe. My guess is she will tell me exactly what I’ve just written. Still, I am officially terrified.
Second, after my meeting with Dr. Gimbel yesterday, I am torn about what kind of surgery to have. Here is his after-visit summary, which does a surprisingly good job or relaying our conversation:
Considering 2 options:
– One is wide local excision alone through an elliptical incision laterally on the right breast. I drew out a radially oriented ellipse overlying the mass and took a photo to provide for Dr. McAuliffe for recommendations on how to oriented designed this excision, taking the flap into account.
– The other option would be wide local excision in combination with removal of her bilateral breast flaps. She feels strongly that she does not want any more surgeries and is concerned that radiating the right reconstructed breast will significantly alter its appearance, creating asymmetry and potentiating the need for additional revisions of her breast reconstructions. She is hoping to be done with surgery on her breasts as she has gone through a lot already.
So, yeah – Option 1 (remove the lump) or Option 2 (remove the breasts). To add a little more detail to Option 1, Dr. McAuliffe’s excision will already remove a significant portion of that breast (probably a bit more than 1/4 of it). Then radiation could shrink it even more. I am not a very materialistic person – anyone who knows me will tell you that I probably should give a lot more shits about the way I look (put on some makeup? comb my hair?) – but I am pretty OCD about a lot of things, and I know that having two very different breasts will drive me absolutely crazy; I can see wanting to have a second surgery to even things out. But this surgery coming up will be my FIFTH related to this situation, and I am absolutely not having any more surgery after this unless it is to save my life. So I have to make a decision now that I’m going to be able to live with.
Of the two breasts that Dr. Gimbel made for me in 2013, the nicer one is the one that’s going to get wrecked here. The one that will remain in-tact has always had this weird pinched skin around the aureola that has always bothered me a bit. I think I’d rather not have any breasts at all than have one breast I never liked and one that’s going to be half the size of that one. Of course, the key word in there is “think.” Because I don’t really know; even though the idea of living with a flat chest is kind of tempting, I’m not sure what the actual skin will look like, and it could be a scary mess (he’s also said it could be concave – not necessarily flat – although he’d do his best). But once he takes them off, there’s no going back. I do know Dr. Gimbel’s work, and I am pretty confident he’s going to make sure it looks good. Still, this is a really hard decision, and despite talking it over with my husband last night, I feel like there is no one who can help me make it.
This afternoon, I meet with the radiation oncologist to discuss if there is a radiation therapy benefit to one option or the other. Then I will need to make a decision so we can get this surgery scheduled already.