On Monday Scotty and I went to see the surgeon to receive the pathology from the ALND (axillary lymph node dissection) surgery. Originally the PET scan showed that there appeared to be more than one node involved, however, the pathology came back showing only one. We obviously had questions.

First, and most important, did they get all the tumors out or was there more in there that they some how missed?! After further discussion with the surgeon, and him actually calling and talking with the doctor that had done the dissection, we think the reason the imaging showed more than one node with cancer was because of two reasons. The lymph node biopsied had a metal medical marker clip put inside it. This procedure left an indentation on the node and also removed a chunk to be sent off to confirm that it was cancer. All of that was done prior to the PET scan so it made that node appear to be split in half or more like tightly bundled grapes. The second reason could have been simply a false negative on the PET scan. Bottom line is that all the nodes in the region that had the cancer node were removed.

Second, we wanted to know how many nodes were removed. There was a total of 16 nodes taken out. Each ALND is different because all of us have a different number of lymph nodes. I was told that if you are heavier you tend have more nodes and if you are thinner you have less. This means there is no magic or correct number of nodes that should be removed because it varies based on each individual. And again only one of these nodes came back as having cancer in it.

Overall the pathology report was great news. Not having any additional physical tumors growing is what we wanted and not having any microscopic cells inside any others is pretty amazing.

During that visit I was also able to have my drain removed because it was well under the 30ml threshold. Let me tell you that this surgery was not as painful as the bilateral mastectomy but the drain is 500 times more painful. I’m not sure if it was because of where it was located, the amount of “digging” done on the inside of my body causing bruising, or if I am suddenly becoming a wuss, but holy heaven above did I want that thing out. One other difference from the drains after mastectomy versus ALND was that the incision where the drain is placed takes much longer to close up and heal. With the mastectomy drains I had to wait about 24 hours before I could shower and remove bandages. Today is Thursday and the incision is still not fully scabbed over allowing me to shower.

My mom took this picture about a week after my surgery so I could see where the incision was and how long it was. The puckered looking line is where they opened me up to get out all the nodes and below you can see the bandage, that is where the drain was. The stitches are on the inside and then it is glued together (the puckered skin). Plastic surgeons like to use glue to close instead of stitches to decrease the visible scars after. I guess I got lucky and my surgeon does this. I didn’t know that prior to surgery. In the grand scheme of things this body of mine is no prize. It wasn’t ever a grand showcase but God gave me it and I have tried to treat it like the temple it should be. I have accepted that whenever the end comes for me this body will probably be riddled with more scars than perfection and beauty which I am fine with. Each scar is a visible representation of me fighting to live, and living is all I care about.

Above is a picture I took this morning after I cleaned the drain incision and before I re-bandaged it. Since I did chemo my skin hates all bandages and medical tape. The red surrounding the area is just the irritation from that. You can see bruising and I don’t know why that is there, my guess is from all the digging and pulling during the surgery.

This week I also started doing the physical therapy exercises to prevent lymphadema and to help me regain my mobility back. It is depressing. I am in a full body sweat attempting to do these. Today I also went for a walk. Also depressing because I am slow. No offense to anyone out there but I feel like an 80 year old woman. Mentally I am very frustrated with part. I had just gained back almost full mobility after the mastectomies and was able exercise with 15 pound weights. It has taken a year to get back to that point. Now here I am back where I started. UGH.

Tomorrow I am meeting with my regular oncologist to finalize the treatment plan. Once I am done with that appointment I will post an update.

Originally posted at bcvsbc.blogspot.com on 05/02/18

I just got off the phone with my surgeon where she informed me that the pathology results were ALL CLEAR!  To be specific the lymph node biopsy was negative and all clear of cancer.  NO LYMPH NODE INVOLVEMENT.  I also had clear margins on all sides of the mastectomy and no cancer in my right breast.  

There was great concern that I would not have clear margins around the largest tumor because it was very close to the skin.  Due to this we were prepared for the margins to come back with cancer, and ultimately, radiation would be needed.  This is what I had prepared myself for after the surgeon had explained her concerns to me.  But, some how, we  received the outcome we were praying for.   

Although this news is fantastic there is a stark reality tucked inside it.  The largest tumor was 2.7cm which is over one inch.  The second tumor was 0.6cm which is approximately about the size of an eraser on the end of a pencil. I was never told the size of the third tumor. Inside my left breast was multi-focal DCIS (the first stages of cancer) throughout the entirety of my breast with lobular involvement throughout.  It also was focal vascular invasive.  My cancer nurse explained that if we had not been able to do the surgery as quickly as we had my results would be much worse than what I was given today.  Bottom line is the cancer was spreading, and spreading fast.  I am very lucky that surgery was able to happen as quickly as it had and not waited the average 2-3 weeks. 

My staging will stay at stage II, this is based on the size of the largest tumor.  The next step at this point is for me to meet with my oncologist.  I scheduled that appointment for a phone interview tomorrow.  We will get a preliminary plan started then while I start to mentally prepare for my next battle to conquer.  I will still need chemotherapy and herceptin for a minimum of a year because I have HER2+ cancer and again that is the most aggressive form.  To answer the question, yes I will be losing my hair.  Everyone asks that question first for some reason.  It's just hair and I am not worried about it so please don't any of you worry about it either!

As I sit here and type this post I can't stop crying.  In my heart I had prepared for the worst.  I knew all the outcomes and I wanted to be ready for it.  Each outcome was going to be so much harder on me but in the end my little family, my parents, and siblings.  I have been praying harder, and more frequently, than any other time in my life to give me the strength to endure whatever it was.  And now I am in shock that the news was the best that I could have received.  I know it is not from my prayers alone, but from those of so many others that cared and took a minute to include me and my family in their own prayers.  I want you to all know how grateful I am to you.  It was going to take a miracle and I got it.  

It wasn't just prayers that helped get these results, it was the fact that I did self breast exams.  Until I take my last breath I will beg all women to do self breast exams.  Fear unravels inside my body when I think about the very different future I would be looking at if I had not found that lump and checked it as frequently as I had.  I know that the Lord prompted me to make Scott feel it, to schedule an appointment, and with every step I took to find the tumor(s) as fast as I did.  Please if you are reading this and are a woman, start doing self exams.  If you are a man reading this and have a significant other, start doing an exam on your partner.  If you are a mom with a daughter and she has started her period, sit down and show her how to do a self exam.  I know that this saved my life and I believe, with my entire heart, that it could save another woman too.