Post-op Appointment
My surgeon is already out on vacation, but his surgical nurse saw me and checked the two incision points. Incisions are clean and healing as expected. My levels of pain as well as the numbness from the severed nerves are consistent with expectations. The nurse removed the last layer of suture tape. I am instructed to continue to keep area clean, treat pain with Tylenol and ice, and expect additional nerve pain as they regrow.
Oncology Appointment
Oncologist reports that while the initial testings is good, it isn't clear enough to make an informed treatment plan. The HER2 data isn't clearly positive or negative, and the presence of invasive cells outside of the tumor elevate the risk of spread. She reviewed the pathology results with us and ordered new testing.
Pathology Results
The Short Version
- Successful removal of both invasive and non-invasive (DCIS) carcinoma
- Margins around the tumor are clear, so they got all of it
- Cancer cells were present in the vascular system heading toward the lymph nodes, but no cells were present in the lymph nodes
- HER2 identification remains ambiguous
The Technical Version
Left breast, lumpectomy:
- Invasive carcinoma, grade 2, 21 mm identified
- Ductal carcinoma in situ (DCIS) nuclear grade 2, with comedonecrosis identified
- Margins negative for carcinoma
- Lymphovascular invasion present
Left axillary sentinel lymph nodes, excision:
- Four lymph nodes are negative for carcinoma (0/4)
HER2 Testing was returned with the same ambiguous results as with the first biopsy: some of the cancer cells are positive for HER2, and some are negative.
Next Steps
- Advanced HER2 testing ordered; results expected in 1-2 weeks.
- Oncotype testing ordered, which is a risk analysis of the tumor for recurrence; results in 2-3 weeks.
- Next appointment with the oncologist is June 15, and the goal is to make a treatment plan by then based on the cumulative testing, old and new.
- Healing from the surgery. Nothing happens until I am healed from the surgery.
The ways forward are many. I am stitched, bruised, iced, fed, rested, weary, grateful, unknowing, loved.
Onward.
~ Sherri
McCoy Creek: CattleLong after sunset the afterlightglows warm along the rimrock.A wind down off the mountainblows soft, a little chill.I've come to love the quiet soundcattle make cropping short grass.Day and night are much the sameto them in the pastures of summer,cows and calves, they crop and pullwith that steady, comfortable soundas the light in the rimrock and the skydims away slowly. Now no wind.I don't know if cattle see the stars,but all night long they grazeand walk and stand in the calmlight that has no shadows.
~ Ursula K. LeGuin, So Far So Good - Final Poems
ambiguity in the absence of evidence of spread, to me, is a win. i have ambiguity in my stuff as well. how i approach it, i am healed until proven diseased. and even then..... i'm pretty stubborn, y'know.
ReplyDeleteat 24, i was told i'd never lift my elbow above my shoulder without shoulder socket replacement. oh, really? hold my beer. watch this. no surgery. took two years to heal, but it did.
then, i was told nothing would help my shoulder after the cancer treatment destroyed the muscle and scar tissue that had served me over 40 years. i appealed that verdict, and won on appeal.
the second surgeon was more convincing, until i found a real expert, a carpenter, who suggested something called bowen therapy, which is silly, and can't work. and at this point, i'd say my shoulder is 80% recovered. no surgical shoulder socket replacement anywhere on the horizon. it's a bit twingy, but is remarkable since all i've had done was have a lady poke at it a bit. this crap can't work, right?
you might also want to follow that expert carpenter over to the bowen lady. couldn't hurt. she's moved on from the shoulder to the foot neuropathy, which no doctor i've gone to has a clue how to address. it's not gone yet, but it's better. we shall give her a few more tries at it.
people of our ilk, upon being told we are gravely ill, consider where we have come from, and after they are done scaring us, we tend to giggle.
while i suspect you aren't quite to giggles yet, you are coming along nicely.
Love to you. I am thinking of you so often.
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