Radiation Oncologist # 2

Went to see another radiation oncologist. He said he’d use 50 Gray (1.8 Gray a day) dose with two glancing fields. He said I didn’t need 3D conformal or IMRT radiation, although I’d read that they’re more accurate and safer in sparing healthy tissue and organs. I told him my worries about getting a secondary cancer from radiation. He said that happens to only 1 out of 1,000 patients. Not too encouraging, given that my chances of getting breast cancer at all was about 1 out of a gazillion (according to my estimate).

Also went to see surgeon, who drained fluid from the right side only this time - 32 ml.

Chemo # 8

Had my first chemo since surgery. I have just one cycle to do this time, then Herceptin only for the rest of the year.

Radiation Oncologist

Went to see a radiation oncologist. He said since this is just adjuvant therapy, he’d use a low dose of 50 Gray to the chest wall and lymph nodes over a 5-week period.

This guy wasn’t terribly personable or articulate in helping me understand everything I wanted to know about radiation. He then put me off by saying I needed to decide quickly because he’s very busy so I needed to book ahead. I’ve decided to find another radiation oncologist.

Also went to see surgeon, who drained 60 ml. of fluid from the right side and 25 ml. from the left.

No “Gross” Disease

Chemo doc says after surgery, there is no “gross” disease left, but I will need one more cycle of chemotherapy to be extra sure there is no cancer left.

The lab report showed that two of the 17 lymph nodes removed during surgery were cancerous and there was also cancer left in the right breast tissue. Rats. I’d been doing so well. I feel like I’ve let everyone down.

Surgeon changed the dressing and said wounds are healing nicely. Bandages can be removed in one week. Drained fluid - 90 ml. from the right and 30 ml. from the left.

Two days earlier, he drained 80 ml. from the right and 40 ml. from left.

Two days before that, he drained 70 ml. from right and 25 ml. from left.

Drains Removed!

Remaining two drains removed, plus 25 ml. of fluid from right side. I had three drains total after surgery - one on left and two on right (the extra one for where the lymph nodes were removed under my arm). The lymph node one was removed when I left the hospital.

Mastectomy

Surgery went from 12:30 to 5:30. I had a “right mastectomy with axillary dissection and a left prophylactic mastectomy”. In plain English -- had both boobs removed, plus the fatty tissue under my right arm, where the cancerous lymph nodes were. I also had the cancerous skin lesion on the upper right chest removed.

Surgeon said the skin lesion showed a clear margin, so no trace of cancer left. Breast and lymph node tissue will be sent to lab for analysis.

Pre-mastectomy Info Session

Met with surgeon today to get some info about mastectomy. My cancer is invasive (infiltrating) mammary cancer. It’s ductal, not lobular. If lobular, there’s a higher risk of cancer in the second breast.

I said I want to have a prophylactic mastectomy of the left breast anyway. I don’t want to take any chances and play the odds. Even if there’s just 0.07 percent chance of getting cancer in the other breast (which the previous surgeon said), I still don’t want that chance. Plus, if I decide later to have reconstruction, it’ll be easier to achieve symmetry if both breasts are being done.

“Complete Remission”

PET-CT scan results out. Chemo doc says my cancer is in “complete remission”. No sign of cancer anywhere in body. Ready for surgery.

If there’s no cancer left, why do I need surgery? Because the scan doesn’t pick up microscopic disease. And it only picks up active cancer cells. I think that means it only picks up the cancer cells that happen to be dividing and multiplying (and other complex math) at the very moment that the scan is done. I think.

Herceptin Only

Chemo session -- Herceptin only. Hold the Taxol and Carboplatin! Took about two hours on the drip.

White blood cell count a bit low -- 1.9 (should be above 3) so got a Granocyte injection.

Reconstruction Surgeon # 1

Went to see the first reconstruction surgeon again. He said if I’m going to have radiation, I should not have reconstruction right away; wait 3-6 months after radiation to have reconstruction. His first choice would be to use tissue from my back, either with or without implants. If I want a bilateral reconstruction with tummy tissue, he said I need to find a doctor and/or hospital that has experience doing this particular type of surgery because it is very specialized.

Leaning away from having reconstruction at all. Maybe can do without boobs.