Email Update #1

As part of my goal for this blog is to create a sort of "scrapbook" for my experience, I think I will occasionally include big broadcast emails that I send to my friends and family. There will probably be repeat info in these emails and the blog. C'est la vie.

Thanks to all of you for your support and concern. Sorry for the broadcast, but I'll try to get back to get back to each of you individually this weekend. And sorry for those of you who were just checking in and really don't need this much info. This is cheaper than therapy.

I met with my surgeon today and then with an oncology counselor and a genetic counselor. I basically spent four hours at the hospital today getting advice. Good advice. I feel like I'm in excellent hands.

Speaking of which, before I forget, I should say that Jason deserves a huge gold star. I initally told him that I wanted to do this alone-- in my typical, stubborn, "I am a rock; I am an island" way. But the surgeon called him in without even asking me and then Jason travelled around to every meeting with me, asking questions and being his pragmatic, thoughtful self. I hope all of you have such a best friend in your lives. That being said, it looks like whatever surgery I have to have will be during Jason's big yearly workshop, so I'm probably going to have to take the Big Step without him. Ma will come, of course. But still...

Anyway, no decision has been made yet. But I've narrowed it down to two, very drastically different, options.Pardon the frankness of this-- but it turns out I have very complicated breasts. (In any other circumstances, I might have taken that as a compliment.) They are (ahem) large. They are dense. And they are incredibly fibrous. That makes detection of abnormalities very challenging. This tumor did not show up in ultrasounds and mammograms as late as January. But that doesn't necessarily mean it wasn't there.

I am a good candidate for a lumpectomy. This tumor is presenting as, as my doctor said, very "run of the mill." But. That doesn't mean that it is. And that doesn't mean that there aren't more. It just means that this one tumor that they can see (it's pretty close to the surface-- I can feel it) is your standard issue breast cancer.

But. The doctor said that doing even an MRI on both breasts was a waste of time. It would just turn up a whole bunch of clutter, none of which they could be certain about without doing more biopsies. Basically the girls are full of "stuff." In most people's breasts, that stuff can be ruled out as being dangerous through mammograms and ultrasounds and MRIs... but not mine.

Everyone I talked to said that they would support me choosing to do the lumpectomy as long as I understood that it meant constant vigilance for the rest of my life and periodic biopsies when things looked iffy. And honestly, the biopsy, which sounded horrid, turned out to be a piece of cake, really. And believe me... I'd be vigilant.

That being said, everyone I spoke to suggested that I seriously consider a bilateral mastectomy. I do not have a strong history of breast cancer in my family, although my grandmother had it just before she died. But in 75% of people my age who get breast cancer, the cause is genetic. If you are genetically predisposed to breast cancer, then you have as much as a 90% chance of getting breast cancer in your lifetime and have a 65% chance of recurrance if you've had a lumpectomy. I agreed to have the genetic test, but the results won't be back for as much as three weeks.

I have an appointment with a plastic surgeon on Wednesday. My oncologist wants me to understand the ins and outs of cosmetic reconstruction should I opt for the double mastectomy. And my plan is to make a decision between the lumpectomy and the double mastectomy then. But, truth be told, I feel fairly resigned to the fact that the right option is the more drastic option. Even without the genetic testing (which would all but demand the whole shebang... or shebangs), I don't feel very good about my chances for living a breast cancer free life after a mastectomy. There's just too much static in the picture.

I almost just said "F it," and scheduled the surgery today.

Anyway, the more maudlin side of all of this is that I won't know if the cancer has spread until I am under the knife. During whichever surgery I choose, they harvest a lymph node and biopsy it while I am still under. If it's clean-- awesome. If it's not, they take all of the lymph nodes on that (the left) side and harvest them to test later. If they're cancerous, then the journey has just begun and the hunt begins to find out where the buggers have migrated to. Regardless, chemo may follow.

But we will cross that very ugly and rickety bridge if we come to it.

So that's the scoop, my friends. It all sounds very drastic and weird, but if you know anyone who has had breast cancer then they've probably gone through the exact same thing. There's nothing really special or interesting about my case except my age and my dense and lumpy breasts. :)

Mastectomy Fun Fact: Did you know that when a woman has a mastectomy, they are unable to preserve the woman's nipples? Many women who choose to have their breasts reconstructed opt to have their nipples TATTOOED back on!! My thought is, I wouldn't be ME if I chose to have just your run of the mill nipples tattooed back on the girls. So, should I opt for the whole big kit-n-kaboodle procedure, what do YOU think I should have tattooed where nipples should be? Fleurs de lis? Smiley faces? Peace signs?

Anyway... thank you again for your kind words, your support, and your offers of everything including the kitchen sink. I promise I will do my damnedest to NOT be my usual "suck it up and suffer in silence" self. Lots of love to you all. I'm ok. I will be ok. And believe me, if I have one thing going for me in this situation it is that I'm a frigging terrier when I'm angry. And of course this makes me angry. I'm prepared for a fight.