Provisional surgery - 19/8

On Tuesday I met with my surgeon, Mr Sutton and my Macmillan Breast Cancer Care nurse, Cherry. As expected (and appreciated), Mr Sutton recapped everything and asked if I had any questions following my last appointment when I saw his colleague, Mr el Wakeel. I said that the way Mr el Wakeel delivered my results was a bit of a shock and that I didn't fully understand him. (That I found the information confusing as he'd said everything had gone well and no cancer cells were found in my lymph nodes they removed, but that I would have to have a mastectomy and chemotherapy)

Mr Sutton explained...

 

Originally I was diagnosed with Paget's disease of the breast and DCIS (Ductal Carcinoma in Situ) Stage 0, grade 3. All DCIS cancer is stage 0. It's non-invasive precancerous cells that haven't yet developed into a true, invasive cancer. Grade 3 means the cancer cells look very different to normal cells - and these aggressive cells are fast growing.

I was due to have a lumpectomy to remove the mass they found, but on the day of surgery, the radiologist who inserted the guide wire, inserted it to a different area of cells to that which were originally found, meaning they'd missed the new mass in the images that were taken. 

Mr Sutton got his tape measure out and worked out that, even though the areas were quite far apart, he could still conserve some tissue and move it around to even things up. I had the partial mastectomy and then waited for the results. 

This is where I had my knee-jerk reaction and adamantly cried that I couldn't possibly have chemo and lose my hair - or my fertility. 

The new stage of this cancer is unknown at the moment and we will only know more after the next bit of surgery. Stage just means how far it's travelled in my body or whether it's just restricted to that area. I quickly reminded myself that they found nothing in the obvious lymph nodes that they took out from under my arm. They have removed 3 grade 3 (aggressive, fast moving) true cancer tumours - 6mm, 5mm and 4mm within the DCIS (non invasive cancer) area of 80mm. 

 

Back at my appointment on Tuesday, Mr Sutton then went on to discuss different types of reconstruction. He is confident that he can preserve my skin and asked me decide what type of reconstruction to go for. Wanting the most natural look, I am opting for a flap reconstruction, meaning that tissue and muscle will be taken from my back (shoulder blade area) and "swung" around under my arm and into my breast where he may or may not put a new implant in. He let me know the risks of this (including the risk of infection and having to remove the implant after surgery). He said this would leave me with an S shaped scar on my back. S for Superwoman?! Ha ha!

The operation, he said, would take him 7-8 hours and would mean a 5-6 night stay in hospital. He would also put drains into the wounds (queasy already!) He said there would be a considerable amount of pain and that I would need to regulate the pain relief. Can I take morphine home from the hospital please?! 

I thought I might be off the chemo hook, but it doesn't look likely. Mr Sutton advised that I will most likely need chemotherapy and tamoxifen (as the cancer is oestrogen receptive). Chemotherapy is quite something and I'll leave that to another day to talk about. The worry for me is that it affects my fertility so before anything happens, I will have some preservation done. Thank you science! The chemo would take around 4 months. 

The tamoxifen is not so quick and hasn't got great side effects. I've been reading that people take it for 2-5 years...

I won't lie, I have worried and wallowed in self-pity over the last two days, but I'm ready to pull up my positive pants again and get on with it. 

I won't know anything for certain until my results come back from the mastectomy. It's provisionally booked in for Friday 19th of August. Until the results come back, I won't know anything for sure. What I am sure about right now is just how loved I am. I truly appreciate all my friends and family who have and are being truly wonderful to me. Thanks friends. 

Sarah xxx