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Here are some thoughts and observations while we await a call from the Oncologist’s office letting us know that a treatment plan has been formulated.

Was our decision to proceed with the bi-lateral mastectomy the correct option to take? Well, let’s list the options:

  1. Stop at the lumpectomy (the second one in less than a year), take Tamoxifen for five years, have a breast MRI in six months, then six months later have a mammogram. The cycle of MRI and mammogram procedures would last five years, or until a cancerous tumor appeared.
    • Diane tried the Tamoxifen and did not tolerate it very well. Then add the apprehension and cost of undergoing a breast MRI or mammogram every six months and it seemed intolerable to us. Plus there was the real possibility that more lumpectomies would need to be performed.
  2. Have the bi-lateral mastectomy and the reconstructive surgery, which should reduce the risk of breast cancer forming in the future.
    • The pathology report from the second lumpectomy showed that there was a real risk of cancer appearing in the near future. We had more than eight years where we did not have the apprehension and worry leading up to the results of the imaging procedures every six months.

Here are some advantages to our situation as it is today:

  • Diane has already gone through the pain and discomfort as a result of the bi-lateral mastectomy and the following breast reconstruction.
  • A lumpectomy will be sufficient to remove the cancerous mass.
  • The existing work done for the breast reconstruction should not be affected.
  • The formation of cancer may have been delayed because we elected to have the bi-lateral mastectomy done pro-actively.
  • The pathology report from the second lumpectomy showed that there was a high risk of two different aggressive cancers forming in either breast and the initial findings so far show the cancer to be a less aggressive type of cancer.
  • In the past nine years there have been advancements in the treatment of cancer i.e. adjustments have been made in the order of the procedures that will need to be done, the drugs used for the chemotherapy and nausea are improved, and there is hope that hair loss can be lessened through the use of cold cap therapy.

The only disadvantage I see is that Diane is eight years older now, which was one of the factors in our decision to proceed with the bi-lateral mastectomy.

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Diane’s breast surgeon’s office just called and she is scheduled for a breast MRI early Friday morning. Apparently the Oncologist and the surgeon decided that they want more information before deciding on a treatment plan. This may have something to do with the lymph nodes above the breast that showed some abnormalities on the images from the ultrasound and CT/PET Scan. This is not a surprise to me since the Oncologist told us that there were contradictions in the test results and he wanted to consult with others before laying out an initial treatment plan.

Diane is very special to so many people for countless reasons. I am not going to attempt to list them here. Those of you that know her personally have had the pleasure of experiencing some of her many special qualities.

The fact that she has been diagnosed with cancer after undergoing a bi-lateral mastectomy in an effort to try to avoid breast cancer from forming, is a rarity. We are now aware of additional reasons that make her special after our visit with the Oncologist. He informed us that the treatments he prescribes are unique to the individual, but they usually follow certain norms. Diane’s case seems to be a first for him and he is an experienced doctor that appears to be in his upper sixties.

I had done some research about treatment options before our appointment and the oncologist seems to be in the know about current treatment protocols, including the new options for the scheduling of surgery, chemotherapy, radiation, and estrogen blockers. It is a common practice now that chemotherapy is administered before surgery and in some cases chemotherapy is not prescribed at all, just radiation, then estrogen blockers afterwards.

The oncologist discussed the results of the ultrasound, the biopsies, and the CT/Pet Scan with us. As a whole the findings are a bit unusual in that the results create some very important questions. I won’t go into specific details except that there are two important issues under consideration.

The first is whether chemotherapy should be administered at all, and if so, when. There is some question whether chemotherapy will be effective in shrinking the mass. The combined findings of the pathology report and the estrogen testing somehow include contradictions about whether chemotherapy will be effective. Why expose the body to the rigors of chemotherapy if it will not be effective in shrinking the mass? There is a genetic test that can be done that may show whether chemotherapy will be effective, but as with any testing, it is not 100% accurate. This test would be performed on the biopsied tissue and would delay the beginning of treatment by two weeks.

The second revolves around the results of the ultrasound and CT/Pet Scan that show abnormalities in the shape of the two lymph nodes that are above the breast but do not definitively show that the nodes are cancerous. Is this enough of a reason to tip the scales in favor of recommending that chemotherapy be administered?

The Oncologist will be consulting with other doctors within his circle of peers and then he will be discussing the situation with Diane’s breast doctor/surgeon. Once he has formulated a treatment plan he will call to discuss his recommendations with us and then we will decide on how to proceed. We want to make sure that we consider the benefits and risks involved and make sure we have done all that we can so that Diane may live a long and hopefully healthy life afterwards.

We were told on Monday, the 11th of June, 2018 that Diane has breast cancer.

Diane was at the city pool putting lotion on and she noticed a lump at the top of her breast. The lump was about the size of a quarter. We decided that it should be checked out by her gynecologist. The doctor examined her and scheduled an ultrasound at the imaging center. Upon completion of the procedure, the radiologist reviewed the images and recommended a biopsy be performed. Several days later needle biopsies on the mass and a lymph node under her arm were performed. The pathology report showed that there were cancerous cells in the mass but not in the lymph node.

There are more lymph nodes above the area where the mass is, but they are not available to do a needle biopsy on because of the anatomy that surrounds them. It would be too dangerous to attempt a biopsy on them, there is some concern about these lymph nodes due to the irregular shapes that appeared on the ultrasound images.

As you may know, we elected to have Diane undergo a bi-lateral mastectomy in order to avoid such a diagnosis from occurring. The odds were in our favor, but not 100%. After a mastectomy there can be trace amounts of breast cells/tissue that does not get removed. That was enough for a cancerous mass to form therefore creating this serious health issue we were hoping to avoid, the type of cancer is a lobular carcinoma. This is the second most common form of cancer behind ductile carcinoma. The cancer is at a stage 2, so it was found early enough to make a difference.

On Wednesday Diane enters the long-awaited final phase of her re-construction and recovery.  She will have surgery to remove the rigid, firm, and heavy; saline filled expanders.  They have literally been a real pain in her chest.

Sleeping has been the biggest challenge, our bed has been taken over with an assortment of props and pillows.  There have been many nights when all of that has not been good enough and she sleeps a good part of the early morning hours in the recliner.  Muscle pain and spasms in the back, sides and chest area have become extremely annoying and uncomfortable.  The weather even pitches in to provide pain and discomfort when there is a front moving in and rain is in the forecast.  Plus each time saline was added to the expanders the pain and discomfort increased until her body adjusted to the additional size and weight.

The surgery is scheduled for 1:00pm and the surgeon told Diane it would last approximately three hours because he has some internal adjustments to make.  As long as everything goes well Diane will be home  late afternoon or early evening.  I will be blogging with updates from the hospital and later on when we arrive home.

As most of you know, Diane is away visiting her mom.  Usually this would mean a nice little break apart from each other; Diane gets precious, quality time with her mom and I get to batch-it with our boys.  I usually tease her that I do not miss her, even though I do.  I was looking forward to it, I figured if she was not here reminding me what was to come, I could relax, take it a little easy, have a break.  Concentrate on work, get a lot accomplished there.  No such luck.  😦

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I have been busy sorting through all the various links for sites that I have collected and I have added some to the links area in the left column.  I have them separated in several categories.  Articles of Interest are articles from media sites.  Blogs of Interest are sites that deal with breast cancer in general.  Previvors and Survivors are blogs by women or their partners.  Support Organizations are breast cancer organizations that offer education and support.

The link for the article at AOL Health with the title Rene Syler Takes On Breast Cancer is the story that resembles Diane’s situation.  Rene Syler did not have cancer or the BRCA gene mutations, she had Atypical Ductal Hyperplasia (ADH).

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Diane was able to get her plastic surgeon to agree with changing the scheduling of her surgery from April to March.  The day we met him in his office to decide  what was going to be the plan for the recon, he mentioned that he was keeping his schedule light in the middle of March due to the impending birth of his child.  The surgery is scheduled for March 16 and the baby is due on the 18th!

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As the Tamoxifen builds up in Diane’s system she is experiencing new and frustrating side effects.  First she was getting sleepy/tired earlier at night than she did before, falling asleep sitting on the couch while reading or watching TV.  Normally she reads or does Sudoku puzzles while watching TV until bedtime, now she seems to be putting the book down earlier and watching TV only.  The next wonderful side effect was night sweats, but they seem to have subsided a little for now.

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When the subject is extremely personal and extracts emotions that have been dealt with over a period of time.  Writing this blog is going to be harder than I thought, but since we have people near and far that are concerned and interested in the outcome, I will persevere.  OK then… back to the details on the included pages.

Breast Cancer Awareness

Breast Cancer Awareness

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