I got a call from the surgeon’s office a few days after the MRI. She wanted me to come in to discuss the findings of the MRI. THAT couldn’t be good news. In fact, when Kevin and I went to her office on the 17th, I was pretty sure the surgery was going to be changed from a lumpectomy to a mastectomy. The results of the MRI showed a large mass (correlating with the ultrasound’s 4cm diameter). To be fair, Dr. Wooten gave me 3 options… 1. further biopsy of the mass to see if it was all cancer (or something like that – I wasn’t listening very well. In fact listening to a doctor while you wait for her to say mastectomy is difficult to do). 2. Larger lumpectomy, with the possibility of having to do more surgery if the pathology report showed that not all the cancer was cut out – and with itty bitty titties it would probably be about half the breast that would be removed. 3. Right breast mastectomy – preceded by a sentinel node biopsy.
I had already talked to Kevin about the likelihood of a mastectomy being the best option, so I was ready to say yes to number three. It made the most sense… get that cancer out of there for good! It turned out that I could still have my surgery on the same day (10/19), but that it would be more extensive and require an overnight in the hospital. Pre-op labs and pre-op ekg happened the same afternoon as the appointment with Dr. Wooten. I was all set.
Again such a whirlwind! From finding out that I had breast cancer on 10/10, to having a R mastectomy on 10/19… it was fast. I only cried once that whole time, and that was when I initially told Kevin the diagnosis on the 10th. I think my lack of tears was partly out of the unreality of it all, and partly out of my medical curiosity distracting me from the full impact.
And now a not so brief explanation of a sentinel node biopsy – what it is and why do it: The sentinel nodes are the lymph nodes that lymph fluid from your breast first go through. there are usually 2 or 3 sentinel nodes for each breast. Doing a biopsy of the sentinel nodes usually gives a good idea if the cancer has spread, because the first place it tends to metastasize to is the lymph nodes. The sentinel nodes are identified by injecting radioactive isotopes into the breast tissue and then finding the hot spots (sentinel nodes) with a Geiger counter (more on this test in another post). IF we didn’t do a sentinel node biopsy before the mastectomy then there would be no way to identify sentinel nodes after the mastectomy because there wouldn’t be any breast to inject the isotopes into. So after the mastectomy if there was concern for metastases they wouldn’t know which nodes were the sentinel and they’d have to remove and biopsy all of them. In short: a sentinel node biopsy was a good idea.